Dance students encounter obstacles accessing physical therapy

Dance students at Swarthmore have access to physical therapy on campus to help treat injuries. However, there has been no direct, convenient way for students training in dance classes at the college to see a physical therapist, particularly one who has experience treating dance injuries.
Gabriella Small ’19, a non-major student in the department, sustained an upper back injury from overuse in a ballet class during the spring semester of her freshman year.
“It got to the point where I couldn’t take a full breath without really sharp pain or lie down on my back,” Small said. “Over spring break of my freshman year, I went home to see my physical therapist who works with dancers, and she showed my mom how you could see the [rib] bone. It was a dislocated rib that was twisted and sticking out of my back, it was kind of gross.”
According to Small, the lack of a convenient option on campus prevented her from treating her injury early on and further exacerbated her dislocated rib.
“I didn’t see anyone before spring break because there wasn’t an easy way to quickly go and talk to somebody about a twinge in my back before it got really out of hand,” Small said. “[My PT] did some manipulations over spring break to try to put my rib back in place, but the problem is that I let it go on for months so the muscles had gotten used to it being rotated out, so pushing it back in at one session didn’t work.”
Small returned to campus with the injury and, after seeing a doctor at Worth Health Center, was given a prescription for physical therapy with the Sports Medicine Office. However, because the injury was mainly found in dancers, the PT at the college was unfamiliar with it and recommended other exercises instead of the same treatment Small’s PT at home provided.
“I needed to see someone who knew about it and did some research on my own and found the closest PT,” Small said. “I had to bike a mile and a half there once a week or so for a couple weeks because they were able to do the manipulations I needed to put my rib back in place.”
According to Olivia Sabee, assistant professor and interim director of dance, while access to physical therapy on campus is both possible and beneficial to dance students, dancers have not been able to make total use of physical therapy.
“I haven’t seen students accessing physical therapy as much as they should,” Professor Sabee wrote in an e-mail to the Phoenix. “[One student] received PT while at home but didn’t continue upon returning to campus. [This] student, who has a chronic injury, would have benefitted from continuing to receive treatment upon returning to campus.”
According to Amelia Estrada ’17, an honors dance major who also worked closely with the Sports Medicine Office to pursue an interest in sports medicine, access to a PT is incredibly important especially for dancers training a rigorous amount.
“I spent about 90 percent of my time dancing, especially in my last two years, and I definitely did sustain injuries while I was in school specifically from dance,” Estrada said. “I think there should be some understanding that dancers who are taking more than one class a week should have access to a PT or at least resources.”
According to Marie Mancini, director of sports medicine, the athletic trainers work under the supervision of an orthopedic surgeon who sets the parameters of their practice within the limits of their licenses.
“Who we are allowed to treat as athletic trainers is governed by our state and national licenses,” Mancini wrote in an e-mail to the Phoenix. “We are hired by the college to care for intercollegiate athletes and club sports participants. We will see non-athletes on a referral from a physician with a working diagnosis and a prescription for therapy on a space available basis.”
While dancers can be treated by the physical trainers on campus, they are not a top priority since the athletic trainers are contracted to treat athletes involved in sports on campus. However, for dancers, being seen by a physical trainer is not always the best option, since dancers utilize their bodies in such a specific way that physical therapy treatment sometimes needs to be distinct from typical sports medicine.
“ I’m not quite sure how familiar PTs on campus are with dance-related injuries, but I feel like that is a common problem dancers have,” Chandra Moss-Thorne, associate in performance, said. “I went to my insurance PT and asked for dance-related physical therapy in particular and they didn’t know what I was talking about.”
Estrada also believes that it is not just the accessibility of physical therapy resources that is important, but rather the access to physical therapists who have experience treating dancers.
“I was having issues with my foot and Worth gave me a recommendation to go see a podiatrist [outside of the college] who ended up making my injury worse because he didn’t understand dancers,” Estrada said. “It didn’t occur to me to look for someone who specifically works with dancers even though dance medicine is a very different beast.”
Small has also experienced frustration when seeking medical help from professionals at Worth who did not have experience working with dancers. She also would like to see a way for dancers to seek help early on before injuries become worse.
“I saw the doctor [at Worth], and she said it was just a pulled muscle, which I knew it wasn’t,” Small said. “Right now, there’s not a way to get seen sooner. If I had gotten to see somebody, it wouldn’t have gotten as bad as it did, and it wouldn’t have taken three months to heal— it would’ve taken a week.”
Barrett Powell ’18 experienced an injury his junior year and was recovering while also enrolled in a dance class. He also feels that he would have benefited from seeing a PT who was familiar with dancers.
“I didn’t necessarily feel hampered by not having a PT easily available since you heal when you heal, but I would’ve appreciated having a PT person who I know is familiar with dance and injuries associated with dance,” Powell said. “From a certain perspective, there are many people who do athletic things on campus, and some of those things are sports and some are performance arts. I understand why physical therapy has historically been easily available to sports, but resources should be available to both.”
While Sabee believes that it is not feasible for the college to hire a physical therapist for dancers specifically, she is a proponent for early, easy-access treatment for injuries so that dancers can get treated before injuries become severe.
“Our program is too small and it would be too cost-prohibitive (not to mention that we don’t have the facilities for it) to hire a staff physical therapist,” Professor Sabee wrote. “One potential solution could be to offer a periodic Dance or Performing Arts Medicine Clinic, but we still need to do more research into what is feasible. A clinic like this might help students get help before their problems become chronic.”
According to Estrada, having a specialist or even a list of resources available to students would allow for dancers to seek the treatment they need.
“I really do think that for some students, it is necessary to have a dance medicine specialist available,” Estrada said. “I understand the confines of the [college] setting, but I don’t think it’s out of the question to find a research page of local people who can be contacted when you are injured who understand dancers or even contracting someone to come to college once a month and work with dancers.”
Outside of referring students to Worth to receive treatment, the dance department is working to develop more programs to help dancers build strength and flexibility so as to prevent injuries in the first place.
“While they cannot replace appropriate medical care and physical therapy, two critical elements of injury-prevention are cross-training and developing a better knowledge of your body and its alignment,” Professor Sabee wrote. “Cross-training is especially important for those students who have come out of pre-professional training programs and who are used to dancing upwards of 20 hours per week. There are ways for these students to continue to maintain their technique and dance smarter while spending comparatively fewer hours in the studio, but these are also the students most at risk of injury if they aren’t able to take the time to maintain their bodies.”
While the department of music and dance has courses like yoga and will be offering pilates in fall 2018 to help dancers prevent injury, the lack of a convenient and immediate way to access to physical therapy that understands dancers has made it difficult for students to maintain their physical health.
“I think that it’s extremely important for dancers to know that they can see a PT on campus and the protocol to go through it because that is better than nothing,” Moss-Thorne said. “I also hope that dancers know to take advantage of the other class offerings that we have here because cross-training is key.”
However, the experiences of dancers working through both acute and chronic injuries have raised an awareness of the need for more direct access to resources ranging from ice to a trained medical professional who has experience working with dancers.
“I know that we are working on getting an ice machine so that we have one in close proximity. Our ultimate intention is to model after other schools by bringing in a dance PT on campus to have preventative talks teaching different exercises and having appointments,” Moss-Thorne said. “This is a priority, and we definitely see a need for it.”