Changing your perspective on injury

I started dancing when I was 6 years old. My mom used to dance and she put me in ballet to help me open up and be less shy. I immediately fell in love with it. 20 years later I still love the fact that I can express myself without my voice or without words. Most often I find it so hard to explain what I mean but dancing provides that outlet.

By the time I was 11, I was dancing at the School of American Ballet, the school associated with New York City Ballet. I had just stopped doing rhythmic gymnastics and decided to focus all my attention on ballet. And at 13 I had my first major injury.

I remember what class and exactly what step I was doing when it happened. I went to take off for a turn and subluxed (a temporary, partial dislocation) my knee cap. I couldn't walk and was carried out and taken to the emergency room.

I remember waiting in the emergency room with my mom and telling her how upset I was about missing my next ballet class of that day. They did X-rays and... no broken bones.

It swelled to the size of my thigh. There was no distinction of the knee from my hip to my calf. It felt stiff and full. I went to a doctor who had to drain two large syringes of fluid from my knee. But it made it feel a lot better and I had better motion after that.

I got an MRI to see what sort of damage had occurred during the subluxation. We found that during the shifting of the knee cap I had broken off cartilage behind my knee cap in two places. One of which was floating around in the knee. I would need immediate surgery.

In some ways it was nice to have such a definitive outline of the problem and the solution. Majority of injuries that are the most frustrating are those where doctors cannot find the problem and don't know how to fix it.

So I had the surgery and it went as well as could be, considering it was a difficult procedure. I was fitted into a hip-to-ankle brace and crutches. And sent home same day with an anesthesia administration in the entire right leg

I didn't get back to dancing for about a year.

That experience changed me forever. I had never really had a major injury before that so I learned a lot about my body, physical therapy, and the ins and outs of the recovery process. I think it matured me as a dancer. I went back to dancing but I was smarter and more aware.

Shortly after that injury I was applying for high school. All the applications had to an include an essay and I wrote about my experience with this injury. I titled it "A Blessing in Disguise".

Even though I will carry the scars of that injury for the rest of my life, it's all in how you look at it. All of the injuries I have sustained since then, I am always reminded that it's more about how you stood up then how you fell.

We all struggle and some more than others but it's fascinating how much we can recover from. Your body for example is constantly finding ways to heal itself on its own. It never gives up. It's always reinventing itself. And there is definitely something to be said about the mind body connection of healing. There is an article in The Guardian, that interviews Jo Merchant the author of Cure: A Journey into the Science of the Mind over Body. In the interview she says

But there is a scientific explanation: factors such as social support and positive expectation inherent in these treatments can trigger physiological changes that ease symptoms.

I found the interview to be very interesting in learning about unconventional medicine and the true healing power of your mind. Check out the full interview here.

I think the idea of feeling less than (feeling inadequate and useless)... is something that is common when people get injured. It comes from being physically limited in some capacity and the emotional toll injury can take on dancers specifically, as I explained my one of my previous post, Depression is anger turned inwards. But I'm a strong believer in everything happening for a reason and there's a bigger picture behind the events that happen in life.

If I hadn't injured my knee, I wouldn't have gained that perspective and experience. I wouldn't have been left back a level in my ballet school, which ultimately wouldn't have landed me in my dream ballet company. We often don't see the fruits of our labor until much later on.

Photo by Paul Kolnik

My advice would be:

• Trust your body is doing all it can to help you
• Ride the wave of your recovery with all its ups and downs; meaning the injury will take the time it needs to recover no matter what you do or don't do so you have to just take every day as it comes and accept the process
• Try to stay positive, do things that make you happy even if it's in a limited capacity 
• Explore new interests, it will help expand your perspective
• Be open to new cross training and moving in new ways
• Remember that you are valuable, just as you are, right in this moment no matter what injuries you have sustained

As I was writing this post a friend of mine posted this quote on her instagram story and I thought it was very appropriate!

Just as the title of this post states, changing your perspective on injury is very important to successfully get through it and move on. Sometimes injuries can be a good thing because they teach you lessons and you grow from them. It isn't all bad. I hope sharing my experience has helped you feel better about whatever it is you are going through and made you feel more optimistic. 

3 nutrients for a speedy recovery

Injuries suck! The recovery time can be long and painful. They also can keep you away from doing things you love.

However, there are some nutrients that can help speed up recovery time by aiding in the healing process.  Let's look at 3 nutrients that can can help with certain injuries and how to get them into your diet.

1. Collagen

Collagen is a major component in the structural protein of the body. It is known as the glue that holds us together. Your body naturally produces collagen but after the age of 25 our collagen production begins to decline. Which means it takes longer for us to heal. 

It is an important nutrient for wound healing and healthy skin. It is often seen in beauty products. However, type one collagen makes up our bones, tendons, ligaments, connective tissues and muscles. That's why it is very important for maintaining bone and joint health, as well as speeding up recovery of strains, sprains, and other soft tissue injuries. 

Collagen also contains anti-flammitory properties and immune system boosters. Immune system cells are the first to respond to an injury. Which is why a healthy diet is essential to quick healing. 

You can find collagen in: 

tomatoes, rosehips, dark leafy greens, broccoli, pineapple, horsetail, berries, citrus, eggs, egg whites, wild fatty fish, and bananas.

Supplement I use:

Collagen peptides

Vital Protieins is my favorite brand. They sell it at Whole Foods or on Amazon or their website.

        2.  Glucosamine and Chondroitin

Both are usually sold together because they do they same thing. Glucosamine and Chondroitin are compounds found in healthy joint cartilage and connective tissues.  They also play an important role in tissue growth and repair.  These compounds are most commonly discussed around arthritis and osteoarthritis treatment. Studies have shown that they can also help with sports injuries  that involve torn cartilage and improve mobility in joint injuries.

You can find Glucosamine and Chondroitin in:

Bone broth, soft shell crab, small bony fish (sardines, anchovies), egg shell membrane, supplements from animal cartilage 

Supplement I use:

Nature's Bounty

You can find it at any drug store or on Amazon

      3. Hyaluronic Acid

This nutrient may seem familiar because it is in many new beauty products to help reduce the appearance of wrinkles. But, it is also great for relieving pain and to treat bone injuries and osteoarthritis. 

Hyaluronic acid is a molecule found in skin tissue, bones, tendons, and the synovial fluid around joints. One of it's primary roles is to lubricate and cushion the ends of bones to prevent wear and tear. 

You can find Hyaluronic Acid in:

Bone broth, animal skin, root vegetables, leafy greens

I have only begun getting hyaluronic acid injections from a doctor for my knee. 

***

It's important to eat healthy and have a well balanced diet when recovering from injury. Please only take the recommended amount for each if you are going to take supplements. Hopefully this list will help you explore more nutrients that can aid the body in all sorts of ways. Eat well and happy healing!!!

Injury playlist

My roommate and I are both currently injured. And we decided to go to the gym together, to motivate each other. When our workout was over we both discussed how certain songs really helped us feel better and more motivated to get through our modified workouts at the gym because of our injuries.

Here's a list of songs we came up with that you might want to listen to the next time you hit the gym!

1. Fighter— Christina Aguilera 
2. My Shot — Hamilton soundtrack
3. No tears left to cry —Ariana Grande
4. Breathin — Ariana Grande
5. Stronger — Kanye
6. Eye of the Tiger — Survivor
7. Stronger — Kelly Clarkson
8. Hit Me With Your Best Shot — Pat Benatar
9. I Will Survive — Cheap Trick
10. The Broken - Lit
11. Listen to a song of a role you really want to dance or music from a ballet you love to dance
12. It's My Life — Bon Jovi
13. Fight Song — Rachel Platten
14. Survivor — Destiny's Child
15. Roar — Katey Perry 
16. Girl on Fire — Alicia Keys
17. Just Fine — Mary J Blige
18. Fireworks — Katey Perry
19. You Gotta Be — Des'ree
20. You Haven't Seen the Last of Me — Cher

I put the playlist together on YouTube, click here to begin listening.

I hope you enjoy working out to these songs as much as we liked putting them together. Stay motivated and keep pushing!

Stepping back on stage for the first time in 6 months

I had been out for 6 months due to a tear in my posterior tibal tendon. I had gotten a PRP injection and was is a boot for 6 weeks. It was my first injury since entering my dream company of the New York City Ballet. I was scared because I didn't know what to expect.

The injury was caused by overuse and not working the right muscles. I worked really hard to change the way I worked my muscles so I wouldn't have this injury again. It was slow and took longer than the doctors had said it would take (which is always the case, I know that now). At one point in the recovery process it was hurting to do a certain movement. No one could figure out what was causing me pain. I ended up getting a cortisone injection and that seemed to solve the problem.

Finally after 5 1/2 months, I stepped into the studio, so excited to be back and dancing again. The first ballet I would perform was a ballet called Serenade. Serenade is the first ballet Balanchine ever choreographed. The music is exceptional and anyone who has seen it will tell you it is a transcendent experience. The women are in long light blue shirts that billow when you move. The skirts are made of thin tulle and when you move the air catches it and it dances on its own. There is no story line but there is definitely strong emotion portrayed in the choreography.

I had rehearsed the ballet over the course of 2 weeks. I was happy that I wasn't experiencing any pain and I felt strong.

Me in the starting position of Serenade

Opening night of our fall season. I put my make up on for the first time in a while and looked back at myself through the mirror feeling excited to see my "performance face". I went down to stage level and warmed up with the other women in the ballet. It felt so nice to be back with company, being a part of something instead of feeling so isolated. We all gathered around the rosin box, chatting and putting on our pointe shoes. I went to the dressing room to put on one of those iconic Serenade costumes. I looked at myself in the mirror. One last look on the way out and I thought "Yup, I'm ready."

The stage lights were turned on and the backstage lights were turned off. I heard the orchestra warming up. My anticipation was rising. The moment I had been thinking about for the past 6 months is finally here.

I stood in the starting position. The music began and the curtain rose. I began to dance and I felt like I could breathe again, like I've been suffocating and I didn't know it. With each section of the ballet progressing, I disappeared into the music.

During my last phrase of dancing, I felt emotion building in my chest. Finishing the last step, I ran off stage in a blur. Backstage, I cried and smiled at the same time. All the struggle of getting to this moment and I finally did it! It was the most amazing feeling.

The best core work out

One of the first things physical therapy will allow you to do when you are injured are core exercises. Strong core muscles help reduce load on your lower back and transfer force from your lower body to your upper body and vicea versa. Overall having strong and stable core muscles helps prevent injury and allows you to perform your best. Here are some simple but effective exercises to engage and strengthen your core.

First, lay on your back with your knees bent and feet flat on the ground.

Arch your back and then tuck your pelvis repeat this motion a couple of times before you settle into a neutral pelvis position (somewhere between the full arch back and tucked in pelvis).

Feet together and let one knee fall towards the ground. Keep the pelvis from moving and think belly button to your spine.  Alternate legs. 10 times, right and left equal 1 set.

Then march your legs up, up, down, down. Don't let your pelvis move and again think belly button to spine. 10 times right and left equal 1 set.

 

Next, raise both legs to a table top position and tap one foot to the ground one at a time. Don't let your pelvis leave that neutral position and keep your belly button sinking down to the floor. 15 times, right and left, equal 1 set.

Last, raise your legs to table top position and then drop one leg to the ground and extend it out and then return to table top position. Alternate legs. 10 times, right and left equal 1 set.

The exercises progressively get harder. The first two are to help you find your deep abdominals and turn them on. The second two are harder to help strengthen the muscles you have just found. The reps are suggestions. You should do as many as you can while still stabilizing the pelvis and engaging the lower abdominals. If at any point in these exercises your belly puffs out or your pelvis moves, stop and readjust to the correct position. This may mean that you can only do a few at first but the more often you do the exercises the stronger you will become. Happy exercising!!

An interview with Megan LeCrone

Megan LeCrone is a soloist dancer with the New York City Ballet. She has danced with company for 18 years and through the first 10 years of her career she experienced many injuries that prevented her from dancing for long periods of time. Eventually, she was able to stay strong and after a short time she was promoted to soloist. I thought she was the perfect person to interview because she has a lot of experience with injuries and she gave great feedback on what important things to focus on and how she got through it all to become so successful.

Me: Tell me a little bit about what injuries you suffered during the beginning of your career.

Megan: So I sprained my ankle in The Nutcracker the snow scene. I came back from that pretty easily and was back to dancing again. Then I started to feel pinching in the back of my ankle. It felt like I had glass back there. I got tons of imaging and no one could find anything wrong. By this point I was out for a year, and had tried all conservative treatments. Finally, my doctor and I decided to do exploratory surgery to see what was wrong. I had a tear in one of my tendons which would have healed without surgery but I had an extra bone rubbing exactly where I had the tear. So they fixed it and it was an incredibly successful surgery. I listened to my own pace when coming back, I think I took longer than my doctors or therapists were telling me, but I had already been out for so long I didn't want to push it.

Unfortunately, I came back from that and danced for a year and I began to feel the same pain on my other ankle. Instead of waiting, I knew what it was and I wanted to get surgery right away. They did the surgery and they said I did have a tear in my tendon but no extra bone. As I was getting back to dancing my foot still didn't feel quite right. Later we found out that I did have the extra bone but it was just hidden and they didn't see it. Since my foot didn't feel right but I was still continuing to dance, I had been compensating and using my leg weird and I developed a tear in my knee. So when they did the second surgery they fixed the extra bone and my knee at the same time. I had a couple more injuries after that but they weren't directly related to dance. They were traumatic accidents and they did keep me from dancing for a couple more years after both my foot surgeries.

Me: What was it like to be injured so much at the start of your career? What kept you going?

Megan: It was frustrating to be like I can only do the things I can do. I felt like I couldn't challenge myself. I couldn't go take another class, I couldn't do that step one more time. For so long I was just doing what I had to do to get on stage. There were some dark times. I remember at one point, everybody around me, they loved me but they were trying to be honest. Besides my boss Peter Martins, they all said "Maybe it's time [to stop dancing]". But Peter was like I will wait for you forever, because you have a spirit. I said to him I just know it's not over, when I know deep down it's over then I'll stop. I just have this feeling. And he said "I trust you and I'll wait for you, just get there."

And I'm so glad I did. It was really hard and it was embarrassing and it was lonely. Yes I had doubts, but there was just this little voice no matter how hard it got, that was like if I stop now I'll always wonder what would have happened I did one more day. I said to myself if I wake up and that voice goes away then I know it's done. Some days all I could do was get in a pool and move one leg, but at least I did something that day. I'm glad I continued and it helped me build up an internal strength that has helped me now whenever I get frustrated with myself when I'm trying to improve. I just remind myself that even the smallest achievement counts towards the bigger picture.

Me: Is there anything that you do now to prevent injury? Do you have any rituals?

Megan: I try to stay away from anything routine orientated because I don't want to feel like if one part of the routine is off then the whole day is off. But definitely getting enough sleep. I'm more willing to go in later and give myself my own warm up. I used to feel really guilty about missing the usual company warm up class but now I understand that sometimes I need to warm up differently and focus on myself in a different setting.

Stretching, water and also working in water. I love to swim and do anything in a pool. Also I've really found a sanctuary in taking ballet class at other places when I'm not in season at NYCB. It helps me grow as a dancer and widens my versatility as a dancer. I've taken class with the Paris Opera and Netherlands Dance Theater.

Yoga is good. I feel my spine lengthen and it moves my body in a gentle way that feels good. I also think spending some time alone can go a long way in helping rest and refuel your body and mind.

Me: What advice would you give to another dancer struggling with injury?

Megan: No matter what you are going through, try to move everyday. I think that there is a tendency to want to just sit in a dark room and wallow but trying to move even just a little bit everyday can help keep your spirits up and in turn put you in the right mindset for healing. Not just pedestrian movement  but creative movement.

I went to watch performances and rehearsals a lot. Though there were times when I couldn't because it wasn't helpful, but I tried not to stay away too long because I didn't want have the feeling of being at the theater and think 'I can't walk in because it's too traumatizing.' When it got intense I would take a break but I would force myself to go back. I needed to get over this trauma and I needed to feel confident being there because I am still a dancer and I belong with this company. 

Try everything! I did yoga, pilates, gyrotonics, acupuncture and working at the gym. Everything to see what works for you. I tried to work with instructors that were good but remember you are your own instructor too. So take the things that they give and make it work for you body. Make it so it's fun and makes sense and it works because if its fun and it makes sense you're going to make progress. 

***

It was a pleasure getting to know Megan and her  journey with ballet injuries. Hearing her talk about her recovery process was inspirational, especially knowing what a fantastic dancer she has become in spite of all that. I thought how she emphasized how much recovery is a full body experience not just the one specific part that is hurt was very insightful.  I encourage everyone to go catch Megan perform with New York City Ballet this week in Saratoga Springs, NY at SPAC.

Follow up on Wikipedia

A couple weeks ago I found the wikipedia page Dance and Health. I made some additions to the page, that I thought could add more clarity and make it more thorough. In my post 'The risks of dance', I write about what changes were made more specifically.

I decided to go back to the wikipedia page and check if my changes were removed or accepted. Much to my surprise, all of my changes have remained. Ultimately, I think they really add to the page. Even though they were minor changes, to me reading it as a dancer, they make all the difference. If you are interested in seeing the full wikipedia page, click here.

How to reduce inflammation

Tumeric! It's the popular spice of late. Mostly because of its natural anti-inflammatory properties. If you have been keeping up with my posts, then you know by now that inflammation is not a good thing for any injury and sometimes it can be very stubborn. Including anti-inflammatory foods in to your diet can help get rid of some lingering inflammation. One thing I started having everyday is GOLDEN MILK!

Here's a simple recipe to get you on your way!
This recipe is for one serving but can easily be multiplied.

You'll need:

1 1/2 cups of any kind of milk you prefer (including all nut milks)
1 teaspoon of honey
1/2 teaspoon of ground turmeric
3/4 teaspoon of ground cinnamon
1/4 teaspoon of ground ginger
1/4 teaspoon of ground black pepper

What to do next:

1. In a small saucepan, combine the milk, honey, turmeric, cinnamon, ginger, and black pepper. Heat on medium until warm, whisking occasionally.
2. Pour into a mug, serve with a sprinkle of cinnamon on top.

You can also make it iced:

1. Fill one glass with ice and 3/4 cups of milk.
2. Using a blender, blend the remainder of the milk with the honey, turmeric, cinnamon, ginger, and black pepper.
3. Pour the blended mixture over the ice, stir and serve.

Instead of honey you can use maple syrup if you like and you can even add some vanilla extract if you want as well. The black pepper is to help your body absorb the turmeric, so it is a very important ingredient.

Enjoy!

The Healthy Dancer

When I do research into looking for other blogs like mine, more often I find websites that are selling exercises and advice on injuries.  Honestly there aren't many blogs specifically about injury, many have one or two posts about them but not an entire blog dedicated to them. I came across a blog called The Healthy Dancer and I thought it was a very informative blog for dancers, not specifically on injury but many of her posts inform on how to keep a dancer healthy.

The woman who writes the blog studied dance education and exercise science and has taught dance at many institutions. I think her posts are very detailed about what things to be aware of in order to be a healthy dancer. She focuses mostly on nutrition which is very important in keeping dancers healthy but she explains in detail how everything can affect dancers specifically. Such as her The Female Athlete Triad and What It Means for Dancers post where she talks about caloric energy deficiency, irregular menstrual cycles, and osteoporosis. All of which can increase the risk of injury.

Overall I think it's a great blog that is highly informative in the world of health for dancers. I recommend checking it out!

Recovery update

In my post 'Knowledge is power' I discussed some of the injuries I'm dealing with currently. I wanted to update you on how my recovery has been going. My high ankle sprain was doing spectacularly. I had no pain. I was able to walk long distances with no kind of ankle support. I even began taking ballet class again, 3 times a week. No pointe shoes and no jumps yet but all was heading in the right direction. I also started working out in the gym with a new trainer trying to get my whole body stronger, so it would be easier to dance more.

I have the stage 3 sprain

Then about 2 weeks ago, I started having pain in the same spot I tore my ligaments. It was after a day of dancing in the morning and training in the afternoon. I didn't feel pain as I was dancing or training, only after. It hurt to walk more than a block and it throbbed. I followed the RICE protocol. And I spent about 5 days not doing too much until I felt the pain subside somewhat.

I went to see my physical therapist who did some physical tests to determine what is causing pain. He concluded that the ligaments that had previously been stable seem to be loose now. The instability is what he thinks is causing me pain. He recommended I go back to see my doctor. This setback has made me feel very frustrated. I literally had my foot in the studio finally after 7 months of no dance and now I have gone backwards in my recovery. I had a set a reasonable goal of being back to work by late August (when our fall season begins) and now I'm not sure that will be possible. I have already been out of dancing for the past 8 months. I'm anxious about what the doctor might say. He could say I need surgery (which would likely have me out for an additional 6-8 months).  I'm trying not to think of the worst case scenario until I actually go see the doctor. There's no point in getting worked up without knowing, but it's still a struggle sometimes.

***

The other injury I discussed was the osteoarthritis in my right knee. I left off with just having gotten the Monovisc injection. The injection was supposed to help alleviate pain and reduce the amount of crunching, clicking and locking my knee was doing. Doctors say it takes about a month to start feeling any effects. It has been a month now and I can't say it feels that different but I also haven't been able to dance as much as I normally do. I do feel that the crunching and clicking may be slightly reduced now. I can say that it doesn't feel any worse. I may have a better read on it when I'm further along with my high ankle sprain.

However, there is this weird phenomenon where if one area of the body starts hurting more than the other area, that was previously hurting, you suddenly stop feeling pain in the old area. Many dancers will say this happens often to them, but if it's not one it's the other. There's always something.

The risks of dance

While browsing for information on dance injuries, I came across Wikipedia's page on Dance and Health. I was really impressed with how thorough the information was. There was only a small detail I felt I needed to add. Under the subtitle "Injuries", there is information about the most common injury and about shoulder injuries. I felt this needed some modification.

This is the original quote:

Many dance movements, and particularly ballet techniques, such as the turnout of the hips and rising on the toes (en pointe), test the limits of the range of movement of the human body. Dance movements can place stress on the body when not performed correctly; even if perfect form is used, over-repetition can cause repetitive strain injury. The most common injury for ballet dancers is snapping hip syndrome.^[25] Shoulder injuries can be common in dancers due to lifting, partnering and floor work that is commonly seen in modern dance. The periscapular muscles assist in keeping the shoulder still and steady, these muscles are at greater risk for injuries among dancers.^[26]

 And I changed it to be:

Many dance movements, and particularly ballet techniques, such as the turnout of the hips and rising on the toes (en pointe), test the limits of the range of movement of the human body. Dance movements can place stress on the body when not performed correctly; even if perfect form is used, over-repetition can cause repetitive strain injury. The most common injuries for ballet dancers is snapping hip syndrome and foot and ankle injuries. ^[2] Foot and ankle injuries are vulnerable to a wide range of injuries including, stress fractures, tendon injuries, sprains and strains. Much of this is due to not only the emphasis on footwork in dance but also the foot wear. Dancers either wear pointe shoes, bare feet, a soft shoe of some kind or heels, all of which offer no support. Shoulder injuries can be common in male dancers due to lifting, partnering and floor work that is commonly seen in modern dance. The periscapular muscles assist in keeping the shoulder still and steady, these muscles are at greater risk for injuries among dancers.^[3]

As you can see I added some more information on ankle and foot injuries that I felt were lacking in the original statement. I also specified that shoulder injuries are more common among male dancers, which I felt was vague before. I highly recommend checking out this page, because it has a lot of  great information on dance injuries as well as the benefits of dancing for your health.