Stuck on the Sidelines
September 1, 2008

ina Klyvert-Lawson, artistic director and dance program director of New York City’s Harbor Conservatory for the Performing Arts, was touring with Ailey II in the mid-1980s when she first heard it—a loud “snap” coming from her knee after landing a difficult jump. “The dancers around me heard it, the director heard it,” she recalls. “But I didn’t feel any pain.” She continued to rehearse, but by the end of the day, the pain was so severe she had to rush to the emergency room. At the time, the doctor couldn’t find anything seriously wrong, so Klyvert-Lawson iced her knee, wore a brace and finished the tour. After many years of ignoring the pain and continuing to dance and teach, she was faced with the tough decision of whether to undergo a knee replacement.

Surgery is an option for many dancers who have neglected a long-standing injury or delayed proper treatment, but the decision is a weighty one. Factors to consider include high costs and long recovery periods, as well as whether you’ll be able to return to your profession at full capacity. “The question regarding surgery is very dependent on the injury, person and type of dance,” says Megan Richardson, MS, a certified athletic trainer and clinical specialist at The Harkness Center for Dance Injuries in NYC. I would say, ‘Yes, you can teach after surgery’—if you receive good care, follow your rehabilitation regimen and slowly reintegrate into your schedule, allowing time for your body to regain the strength and stamina needed to teach. But again, it’s very individual.”

Here, we take a look at some of the pros and cons of surgery, and talk to two dance teachers about their roads to recovery.

Weighing the Factors

For Nicole Sao Pedro, a dancer since age 3, injury came not in the dance studio but on the ski slopes when she twisted her knee. “Many dancers end up hurting themselves doing another activity entirely, even just tripping while walking,” says Sao Pedro, who currently works as a teacher, choreographer and college dance-team coach. Despite the painful ski accident, she was itching to get back to dance as soon as she returned from vacation; she had recently earned a spot on the Boston Celtics Dance Team. “It’s very hard for dancers to completely stop dancing to treat an injury,” she says. “Not only do I love it, but teaching and choreographing is how I earn a living.”

Sao Pedro, who is holding off on reconstructive knee surgery, admits to knowing a lot of dancers who refuse to go the operation route. “They’ll do physical therapy or the holistic thing first, or try prescription drugs—they’ll try whatever they can before going through something as big of a deal as a surgery,” she says.

In fact, notes Richardson, the average rate of surgery among dancers is roughly two percent, meaning 98 percent of dancers are treated non-operatively.  “However, it’s been found that 80 percent of dancers have a disabling injury in their lifetime as a dancer,” she adds. “Sometimes this results in a few months out of dance, other times, it leads to them changing the type of dance and/or stopping altogether.”

Taking time away from something you love and depend on for financial security can be a daunting prospect, especially if the injury isn’t truly hindering your day-to-day activities and job duties. Indeed, the long recovery period is the number-one downside of surgery for dance teachers. With recuperation times ranging from two weeks to several months, depending on the complexity of the procedure, the temptation to ignore the problem is just too great.

But a minor pain, whether caused by overuse (which, according to The Harkness Center, is the prime reason for dance injuries) or an unexpected fall, can turn into a serious injury if not addressed. Stephen Rice, MD, PhD, the director of Jersey Shore Sports Medicine Center in Neptune, NJ, says people often ignore the first two stages of overuse—pain only after activity, and pain during activity that doesn’t affect performance. Stage three, pain during activity that affects performance, “is when most people seek medical attention for a ‘new’ problem,” he says. “But in order to avoid a stress fracture (stage four), activity should decrease by 50 to 75 percent,” which is a challenge for those working in the dance profession.

Despite having increasing problems with her knee locking and swelling, Klyvert-Lawson continued dancing and teaching, never wanting to stop for more than a few months. Doctors finally operated and found a medial meniscus tear; several years later she had a second similar minor surgery on the knee. “Things were hard,” she says. “The recuperation time took months.”

In 2000, her doctors saw the beginning signs of progressive degenerative arthritis and advised her to consider knee replacement surgery. Klyvert-Lawson opted out, instead choosing to have arthroscopic knee surgery to alleviate the pressure on her knee. “It was a personal decision,” she says. “I could walk up stairs, I could walk 15 miles without getting tired, I didn’t need a cane and the pain wasn’t waking me up at night. My responsibilities in my job don’t require me to perform jumps anymore.” Family, she says, was another consideration. “At that point, it would have been too hard to take time away from my daughter and from my daily responsibilities. It wasn’t right for me.”

Unexpected Advantages

While taking time away from the studio might be a scary thought, don’t assume that an injury, or surgery for that matter, will completely derail your career. Many dance teachers are still able to work during the recuperation process; for some, it’s a matter of coming into work and planning classes and running rehearsals, but sitting out the actual dancing.

Sao Pedro was back to teaching within weeks, even though she had to be chauffeured to class and instruct students verbally while staying seated. She also worked out a payment plan with one of her employers so that she didn’t lose any income.

Both Sao Pedro and Klyvert-Lawson believe their experiences have even made them more proficient at their jobs. “I was a good teacher before surgery,” says Klyvert-Lawson, “but now I’m better. I’m more patient and run the class more slowly. I don’t rush through things, and dancers learn better with lots of repetition. I also watch students more carefully, so I can prevent them from getting injured,” she says. Her students have learned to be more focused as well. Since Klyvert-Lawson can only demonstrate a step once, she first explains it in great detail and then asks them to really pay attention when she does it that one time. For Sao Pedro, being forced to give more elaborate definitions of movement and use a class demonstrator has also been advantageous: “The younger ones all want to be chosen as my demonstrators,” she says.

Klyvert-Lawson’s students have also benefited from the emphasis she now places on stretching to prevent injuries, as well as by watching her treat her own injury, visit doctors and pay close attention to her body. “Just as important as it is for them to hear stories of success in dance, it’s important for young students to hear the war stories,” she says. “They’re getting a taste of reality.”

Klyvert-Lawson admits she wishes someone would have taught her to listen to her body earlier in her career. If someone had, she would have consulted more than one doctor after her fall. “My students are learning how to notice when something doesn’t feel right and how to speak up about it,” she continues. It’s a lesson that Sao Pedro, too, hopes her students can gain from her experience. “Only you know your body. Paying attention to it is part of dance.” DT

Debbie Strong is a New York City–based writer and dancer. She teaches dance and Pilates at All the Buzz in Queens, NY.