Ballet News | Chiropractic for ballet dancers
“For a lot of dancers, seeing a chiropractor rather than a physiotherapist is a big jump,” says Dr Camilla Ellis DC. “Within companies they can be led to believe that ballet dancers don’t see chiropractors. It’s not true.”
Ballet company staff
Ballet companies sometimes have physiotherapists on the staff and some dancers might try an osteopath or acupuncture, but rarely is chiropractic suggested as an option.
If you have a niggling injury Dr Ellis says, “once ballet dancers actually see the muscle testing in play they get excited about how much stronger they become.”
Chiropractors treat misalignments in the musculoskeletal system, in particular the spine, by manual (usually pain-free) adjustments. Dr Ellis, a chiropractor with lengthy additional training in applied kinesiology (muscle-testing) says “at a basic level what happens is that normal life stresses your body & then you come to a chiropractor and we take away that stress & keep you at that equilibrium. When your spine goes out of alignment the joints become misaligned and that interferes with the nervous system, which controls everything in your body. Misaligned joints stop your body from functioning at optimal level. So essentially chiropractic is known for pain relief, but actually the first adjustment was given to someone because they lost their hearing.”
Applied Kinesiology & some surprises
Some chiropractors, including Dr Ellis, undertake post-graduate courses; in Dr Ellis’s case, in applied kinesiology, a system of diagnosis that uses muscle testing which incorporates the physical, chemical & emotional aspects of health; treating your whole body rather than the isolated symptom/s that you present with. Dr Ellis says, “muscle testing helps me to hone in more specifically with what’s going on in your body, including organ dysfunction.” With applied kinesiology, practitioners work on the basis that each organ dysfunction is accompanied by a weakness in a corresponding muscle, called the viscerosomatic relationship, and this can produce surprising results. Dr Ellis says, “with ballet dancers it’s ankles, ankles, ankles. Knees and lower back too.” But, while many dancers have problems with or pain in their ankles, Dr Ellis finds that ankle pain can also indicate a bladder problem which she can treat with massage, adjusting the ankles if necessary. “Applied kinesiology looks at the balance within your body’s triad of health & when a person experiences pain or dysfunction it is due to a problem in one or more of these areas affecting the others.” Beyond misaligned joints, Dr Ellis says that “irritable bowel is the most common problem, followed by parasites & candida equally. I find that gut & hormonal issues are the most common, causing joints to be loose & out of alignment.”
How do you know if something is out of alignment ? If you have sciatica [Dictionary.com definition : pain and tenderness at some points of the sciatic nerve, usually caused by a prolapsed intervertebral disk; any painful disorder extending from the hip down the back of the thigh and surrounding area], that’s a strong signal that your pelvis may be misaligned. Even if it’s not, pain signals that something is wrong and the surrounding muscles and ligaments could require massage. Sports massage, which can be painful, helps to alleviate tightness in muscles/ligaments and sometimes this can be recommended in order for the pelvis and other areas to remain well aligned. If a joint has been misaligned for some time (even from birth – Dr Ellis is an advocate of chiropractic once you’ve given birth, for Mum and baby), you may not realise it, and once symptoms appear it can be difficult to pin-point where you should go for treatment. Your GP can treat you for parasites, for example, but Dr Ellis finds that the treatments can be quite harsh on the intestines. Muscle testing has an advantage - it negates the need for samples to be taken & gives an immediate diagnosis. Once you’re in regular care it becomes easier to spot when a joint is misaligned.
Bunions & bone spurs -and avoiding arthritis
Bunions are a problem for many ballet dancers, and they nearly always stem from misaligned joints. Bunions can be extremely painful and if they flare up (which they often do under a heavy workload), they could keep you off-stage for a long time without chiropractic adjustments. When I tell Dr Ellis that I’ve seen dancers who have been off work for months with painful, almost disabling bunions, she’s quick to say, “there is no need for anyone to be off work for a long time because of bunions. When a foot is misaligned, bone starts growing in the wrong area. Also, when there is pressure on a bone, more bone will grow there. There is also a protective bursa that flares up when aggravated over the first toe. When rubbed a lot, the bursa flares up as more pressure is placed upon the misaligned foot/ankle/toe. The idea is to keep the foot and ankle well adjusted to stop the flaring up and prevent the arthritis that can occur; as with all things, prevention is better than cure. A lot of adjusting has to take place at the early stages to prevent and to correct it. Once it’s there, we can help with the flare ups; sometimes it takes 1-2 weeks, sometimes 2-3 months depending on the state of it when they come in.”
Bone spurs are also a problem for dancers & Dr Ellis explains why, “the reason why bone spurs occur is that there’s intense pulling on the bone where it’s not used to being pulled, nor with such intensity. When you’re doing a lot of exercising then yes, there’s extra pulling on the muscle, but it shouldn’t over-pull. When the joint is out of alignment you may not feel it & you may not notice it, but what it’s doing is it’s causing a muscle to pull at the wrong angle, causing the body to deposit bone. So spurs occur because of the deposition of bone in a place that’s weakened. If you keep your spine well aligned then it stops those spurs from occurring and building up.”
It’s important to keep in mind that not all chiropractors treat the extremities, but for Dr Ellis “the interesting thing is that you’d think that ballet dancers’ ankles would be strong, but there’s a difference between them being strong in their physical or structural form, because of the impact of what they do with their feet. With muscle testing you are testing 100% of nerve innervation to that muscle, so you want that muscle working at optimal level. Because ballet dancers are strong, their muscles can work at 60-70% & they can still dance; but if you muscle test them, they would only be at 60-70% and my job is to get them at 100% & keep them functioning at that optimal level to avoid repeated injuries.”
You might wonder whether that’s possible, given a dancer’s propensity to keep going through injury, allied with their high pain threshold conditioned through years of intensive training, but Dr Ellis is adamant, “it is absolutely achievable. But the thing is that the later you leave it the worse it is. Get it looked at. You can keep training & having adjustments if you are at that ‘I’m not too bad but there’s something going on’ stage. I just hope people don’t miss their spot in the dance world through injury.”
What you’re doing by having chiropractic treatment is making a lifestyle choice; early diagnosis using applied kinesiology could prevent an operation & accompanying recovery time & it could detect underlying problems before they are noticeable to you. Any time off stage is a stressful & extremely testing time; by having adjustments your body will be stronger, more able to cope with your workload and at the same time you considerably lower your risk of repeat injuries.
Dr Ellis graduated from the Royal Melbourne Institute of Technology (R.M.I.T) in 2000, has been practicing in the UK for ten years & owns her Richmond clinic, treating dancers from a variety of genres as well as the general public. Dr Ellis also incorporates SOT, or Sacral Occipital Technique, which “is how the occiput, which is in your head, moves with the sacrum, which is in your lower back; it’s how the two move and breathe together.”
A cautionary tale
Dr Ellis recalls a ballet dancer who came to her aged 25 with a long-standing problem that caused her to stop dancing when she was around 19. She had been through vocational dance training but the school had told her that the injuries to her ankles meant she’d need an operation. Having the operation, and the subsequent recovery time, would have meant that it would have been too late for her to return to ballet, and so she decided not to have the operation and to stop dancing. At that time (and it’s still commonplace) the dancer didn’t know anything about chiropractic, so when she came to see Dr Ellis some years later, it was initially for lower back problems. Dr Ellis’s tests also revealed her ankle injuries. “I said; well, let’s really do a lot of work on these ankles and see if we can get them back. We were able to strengthen her ankles and she actually went back to her trainer and started again. However, being 25 and having such a gap in training she just couldn’t do it to the same level and she said ‘I’ve missed my spot’”.
Working with dancers
What does Dr Ellis say to dancers ? “Look after yourself now. By the time you get to the injury stage there’s already so much weakness that has happened within your joints that it’s difficult to turn it around. It does take time. And a lot of the time you might have to stop dancing.” Dr Ellis is realistic though, “you’re telling professional dancers that – and it’s not going to happen. So you have to work with what they’re doing while they’re training. It makes getting better more difficult, so if you can get it looked at before you get into that injury stage, then your prognosis is much better and you can keep on training while you’re doing it.”
What’s in it for you ?
So why should a ballet dancer see a chiropractor when they may have access to a company physiotherapist or osteopath ? Why, in fact, might companies benefit from having a chiropractor on the staff ? “That’s where Chiropractic is different. You want to get a body that’s functioning well and make it optimal, rather than a body that’s injured and just make it manageable, so that the dancer can keep on going. That’s why I say it’s more of a lifestyle choice.” If chiropractic adjustments can correct, say, a bunion in a month instead of 6 or more, that’s more efficient for the ballet company.
Nutritional advice goes hand in hand with applied kinesiology and covers dancers who present with eating disorders. Dr Ellis won’t duck the issue, “absolutely. Look, I’ll be really honest. I don’t understand where dancers can get their energy from if they are anorexic, I really don’t. You can keep as thin as you like being a dancer & still get the nutrients you need by eating a lot of vegetables & salads, & you do need the good fats. If your body isn’t nutritionally healthy, structurally you won’t be strong. It’s as simple as that.”
The performance buzz brings with it huge rewards for a dancer but “because a lot of dancers can be stressed, that can cause nutritional deficiencies & the body can get overloaded, which causes a weakness in ligaments. So emotional stress & the performance pressure that dancers are quite often under can cause & manifest a physical problem.”
Dr Ellis believes in giving clients plenty of information throughout their treatment. Initial consultations last up to an hour & follow-up appointments are of a similar duration. After that, each adjustment can take as little as 10 minutes. It’s important to appreciate that one or two adjustments will most likely not be enough; remember that lifestyle choice you made ? I’ve heard of dancers who had one adjustment, felt worse, and never went back. Actually, feeling worse can be a great sign. If you have a long-standing injury, you may find that it takes up to 12 adjustments before you begin to feel the benefit, though some people feel much better almost immediately. Likewise, 10-15% of clients report flu-like symptoms and/or soreness after the early adjustments, but Dr Ellis says “if your body reacts in that way, it’s actually a good thing; it means things are changing. That’s what we want to occur.”
Another huge benefit that saves a lot of time is that muscle testing provides immediate diagnosis, so you can leave with any medication prescribed by Dr Ellis & start taking it immediately. I know that for some dancers, the cost of treatment can be a factor, especially at the moment, and Dr Ellis has treatment plans to help reduce the cost. Perhaps you have medical insurance? Your initial assessment can cost £40-£50 and sessions thereafter £30-40. Time, too, is an issue when your schedule is already packed, and whilst I can’t promise a handy Tardis, I do believe that the benefits of finding time for regular adjustments will pay dividends for you throughout your training & career.
The familiar saying “if you do what you have always done, you will get what you have always got” is very apt. Perhaps it’s time to look at chiropractic and make some changes ?
Please feel free to call Dr Ellis for advice, or to make an appointment on 0208 332 2395 or visit her website. If Richmond (19 minutes from Waterloo) isn’t convenient for you, Dr Ellis can recommend another chiropractor so please don’t let that put you off seeking advice. Sports massage is also available at the clinic.
A version of this article appeared in Dance Today.
With many thanks to Rachel Fisher and her family.