When a dancer breaks: how injuries impact a dancer’s mental health

My heart is pounding in my chest as I watch the piece before me perform. I can hear my friend breathing beside me as we wait to go on stage. I take a step back and shake out my hands and feet, reviewing my choreography in my head. I push over the arch of each foot and roll out my wrists. The audience applauds as the lights dim and the dancers exit the stage. I take a deep breath and walk out to my spot on stage sitting down on the floor and placing my left hand on the ground. As the music starts I push up onto my hand feeling a twinge in my wrist. “I just need to get through this show” I think to myself. “My wrist is healed now, I can do it.” I continue through the choreography thankful to have finished the hardest section. As the lights fade to black and the audience applauds I exit the stage, relieved. 

In December 2022 I fell in my dorm room resulting in a fracture in the scaphoid bone of my left wrist. I spent the next eight weeks in a splint and followed my doctor’s orders: no weight bearing and no lifting. Under the direction of a different doctor I was cleared to resume normal activities after the eight weeks in a splint as long as I was careful. I gradually returned to weight bearing in preparation for my spring dance show. Four weeks later I was on stage, ready to perform.

While I didn’t injure my wrist dancing, not everyone is so lucky. Lexis Trechak has been a dancer since she was two years old. Lexis danced competitively in high school and decided to pursue a minor in dance to allow for space to explore her other interests in college. Lexis joined her school’s dance company, Reflections Dance Company,  her freshman year of college and served as the president of the organization her junior and senior years. 

“I absolutely loved my dance company,” Lexis said. “I discovered my love of choreographing through this organization since it was all student run.” 

The summer after graduating college, Lexis did a Summer Stock Theatre program in Georgia. As explained by On The Stage, a summer stock program is “theater that is put on by companies that only operate during the summer months.” While performing in Georgia, Lexis realized how much she loved musical theater. From October through December of 2023 Lexis performed in the national tour of “How the Grinch Stole Christmas! The Musical.” 

“Booking the national tour of The Grinch felt like a sign that I was on the right path doing what I was meant to be doing,” Lexis said.

After returning from tour Lexis began auditioning for more productions in New York City. Five days in to audition season, Lexis injured her knee during an audition.

“I was in an audition and I did a kick and my bottom knee buckled,” Lexis said. “I ended up tearing my ACL and it ended my season right there.” 

Like many dancers, Lexis has struggled with anxiety and body image. Terry Hyde is a member of the British Association for Counseling and Psychotherapy (MBACP). In his work as a therapist, Terry primarily works with dancers. 

“From my own experience growing up a dancer, I realized how important it is for dancers to have psychotherapists who understand the pressures of dance training,” Terry said. 

Terry began dancing at six years old and at age 10 he earned five, one year scholarships to train at the Royal Academy of Dance in London. He then attended the Royal Ballet School. Prior to graduating from the Royal Ballet School, Terry earned a contract with the Royal Ballet Company. He spent time performing in both ballet and musical theater before eventually becoming a psychotherapist. 

“Many dancers come to me with what they say is anxiety,” Terry said. “But anxiety is a symptom of so many underlying things that we then work through.” 

One of the main trends Terry notices in dancers is the tendency to put significant pressure on themselves. Allie McDonough-Padden danced competitively in middle school and high school. Allie has struggled with anxiety for most of her life, constantly pushing herself to be perfect. 

“I have a really hard time when I’m not perfect at something and that’s really hard in dance,” Allie said. “In ballet especially when it’s all about perfection.” 

Because of this strive for perfection, many dancers will put a lot of pressure on themselves.

“Dancers are afraid of not being good enough so they put pressure on themselves to always work harder,” Terry said. “They’re told from a young age that dance is a tough career and you need to be tough so they’re afraid to show any weakness.” 

Wearing tight clothing in a room lined with mirrors, dancers frequently compare themselves to others, constantly finding parts of themselves to critique.

“Because there is the anxiety about not being good enough, dancers push themselves past their limits to the point of exhaustion which then causes injury,” Terry said. 

As explained by physical therapists at Johns Hopkins Medicine, the most common injuries amongst dancers are overuse injuries. Overuse injuries occur when a dancer works a certain part of the body— typically ankles and hips— too frequently. To combat this, performing arts physical therapist Megan Wise works with dancers to prevent injuries. Megan grew up training in classical ballet but had to stop after injuring her ankle at 16 years old. 

“After getting injured myself I had to find a way to move forward,” Megan said. “I now work with dancers and other performing artists to prevent injuries.” 

Dancers spend a lot of time training. Many find being a dancer is a huge part of their personality. After injuring her knee, Lexis struggled to fill her time. 

“I’ve been a dancer my entire life and having that just taken away from me really sucks,” Lexis said. “I try to find the positive but some days it just sucks.” 

Lexis is not the only dancer to have this experience. When Allie was 16, she tore the labrum in her hip. Unlike when she had injured her foot several years earlier, there was no bruising around her hip since the labrum is constructed of cartilage and soft tissue. 

“Because I couldn’t see the injury and it was a deep pain I kept dancing on it,” Allie said. “When I did see a doctor they originally thought it was just diffused pain from my endometriosis. I didn’t have surgery on it for over a year.” 

Many dancers regularly hear the phrase “your body is your instrument.” However, that isn’t always helpful. 

“I remind dancers that your body is more than just a tool for you to use,” Megan said. “This body is the only body you will always have. It’s your home so you want to treat it really well.” 

While every dancer has unique needs, Megan begins by recommending a few things to every dancer she works with. Megan stresses the importance of getting enough rest and adequate nutrition. 

“Rest is so important because it’s when your body heals and recovers,” Megan said. “It’s important to also make sure you are getting adequate nutrition because as dancers we put our body through a lot. When you are training long hours it’s not about keeping yourself as small as possible but about fueling your body enough to withstand the high demands you are placing on it.” 

While Lexis has always had a complicated relationship with her body, this recent injury has given her a new perspective.

“In dance I’m always throwing myself all over the place and doing crazy things and I’m not sure I’ll do all of that when I get back to dancing,” Lexis said. “I want to make sure I treat my body with more respect going forward.” 

This shift in mindset is something Terry works on with dancers. He primarily works on shifting from a “fixed mindset” which is very black and white, to a “growth mindset” or “flexible mindset.” 

“Dancers, especially ballet dancers, get stuck in black and white thinking. It’s right or it’s wrong, things like that,” Terry said. “I work with them to reframe their thinking to ‘I can’t do it today but I might be able to tomorrow’ to relieve some of the pressures they put on themselves.” 

Terry also encourages dancers to work on trusting themselves and their bodies, something Allie works on every day. Allie has Amplified Musculoskeletal Pain Syndrome (AMPS) and is hypermobile. According to Children’s Hospital of Philadelphia, AMPS is a medical condition that causes widespread pain in the body. Coupled with her hypermobility which leaves her ligaments more likely to tear, Allie is very aware of what she needs to do to take care of her body and prevent injury. Megan stresses the importance of warming up properly before dancing to prevent injury.

“Warming up is extremely important because a warm-up prepares your body for what you are going to ask it to do,” Megan said. “If I placed a 200 pound barbell in front of you and told you to walk up to it and lift it over your head you would look at me like I was crazy. Jumping pushes significantly more force through your legs than simply walking so you need to make sure your joints are mobilized and muscles are activated.” 

A good warm-up does not need to be long, but it needs to be comprehensive. It should generate heat, meaning your body temperature will rise, and it should mobilize each joint. Megan recommends starting small by rolling each body part in a circle, bringing awareness to each area of the body. In addition to adequately warming up prior to rehearsal, Megan emphasizes the importance of conditioning and cross-training for dancers. 

“Technique is important in a ballet class but you need to be doing normal human movements as well,” Megan said. “You should be doing squats and lunges and other strength exercises so you don’t have to go into the full range of motion you use in ballet class just to pick up a box.” 

While both are important, there is a difference between conditioning and cross-training for dancers. Conditioning will look and feel like your activity while cross-training is doing something different than your activity to intentionally fill in the gaps of your training. Many dancers practice pilates as a method of both conditioning and cross-training. 

“Depending on the goal of the pilates session and the style, it can be conditioning or cross-training,” Megan said. “If you are doing it specifically to work on your rotation and extensions, then it’s conditioning. But if you’re working on strengthening other muscles then its cross-training.” 

Finding other activities and forms of exercise that you enjoy is crucial for dancers. When injured, many dancers are still required to attend rehearsals.

“I hated going to rehearsal when I was injured,” Allie said. “I was forced to sit there and watch my friends do the one thing I could not do. It made me feel worse than the injury already did.”

When dancers are forced to take time off it often results in a loss of identity. 

“Dancers enter a grieving process when they are injured,” Terry said. 

Both Terry and Megan strongly encourage dancers to engage in activities outside of dance. Terry suggests having friends outside of dance and spending time with them on days off and to actually take a break. 

“When you have time off don’t do anything related to dance. Give yourself mental and physical space from dance. It will help separate your identity as a human from your identity as a dancer,” Terry said. 

Additionally, Megan stresses the importance of addressing an injury immediately to avoid further damage. 

Unfortunately, my wrist did not completely heal after the eight weeks in a brace, something I did not discover until seven months later. Following the spring performance I continued dancing. I had been told the fracture had healed and it would take time to get my range of motion back. The next fall I continued dancing and weight bearing, noticing pain any time I tried to do a plank. After that semester I decided to return to the doctor as it had been a year since my fall. It turns out the fracture did not heal and had now become a break. My scaphoid was in two pieces and would require surgery. To avoid transferring care again we decided to wait until the summer to complete the surgery. I was given the same orders “no lifting and no weight bearing.” I’ve been able to continue dancing through this injury, carefully avoiding placing my hand on the ground, nervous to do anything that would further injure my wrist. Dance has been the one constant in my life and although I’ve always had a complicated relationship with my body, I understand the importance of respecting it. At the end of the day, my body allows me to do what I love and for that I am endlessly grateful.