When the Curtain Rises – Returning to Dance in the COVID World

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Photo by @tonywang7

When the studios reopen and classes resume, dancers envision parading across the floor in the company of peers and wowing audiences hungry to applaud their artistic talents.

So realistically, how can the dance community prepare mentally and physically for when curtains start to rise?

During these days of being quarantined, seek out rays of positivity within current challenges. This time away from dance could grant gifts of needed rest, healing of overload and overuse injuries, and opportunities to appreciate new hobbies and build central dancer core strength.

Next, continue to strive for appropriate sleep (goal of 7-8 hours a night) and keep up those sleep goals once dance commitments start up again.

I’ve been impressed with reports of dancers and other athletes using time away to explore identities outside of dance and sports. Some of these have included running (yes, some dancers actually enjoy running), hiking, baking, and art projects. I do recommended keeping social distancing in mind when doing outside activities to protect those at greatest risk for COVID complications. The number of smiling faces reporting their new interests are proof positive that these activities have contributed to positive mood elevation. I certainly recommend that dancers make time to maintain these new activities even when dance returns. 

Click here for ActiveKidMD You Tube Video: As a dancer, how can I strengthen my core?

From a dance medicine viewpoint, there are two “core” perspectives that we routinely see contributing to dancer injuries.

  • The Northern Core – upper body including shoulder blade stabilizers, muscles in the back of the neck, and front of the chest
  • The Southern Core – lower back stabilizers, hip external rotators and hip flexors

While the “Northern Core” provides the primary foundation for arm and head movement, the ‘Southern Core” is the backbone for hip, leg, and foot control. Don’t forget that these two regions also support each other. A strong and stable upper body supports the lower area and better lower control makes the upper region move more effectively.

Poor Northern Core control is often a main contributor to dancer headache, neck, shoulder, and arm pain. Without addressing those “core strength’ issues, it will be almost impossible to make the dancer feel and perform better.

It’s the same kind of story with dancer foot, ankle, knee, hip, and lower back pain issues. Sure, one can focus on the foot in cases of big toe or midfoot pain (and that is part of the treatment). However, if any Southern Core issues aren’t fully investigated and treated, then the foot pain will likely continue.

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I highly recommend practical ways to look at basic technique. My favorite is evaluating plie in 2nd position.

Click here for more information about proper leg alignment in plie

Plie in Second Position- solid line shows hip above kneecap, broken line shows kneecap above second toe

I also highly recommend doing an online or video group yoga or Pilates courses that can be an enjoyable way to build central strength and also connections with peers and instructors.

Take an inventory of any past or current bone or joint issues and use this time away from dance to address them now. Previous injuries are the biggest risk factor for future injuries. Not fully rehabilitating or treating a past injury makes a re-injury more likely. If necessary, schedule an appointment with a Sports Medicine physician.

ActiveKidMD is now pleased to offer telemedicine virtual visits in addition to in-office evaluations. 

Emotional concerns such as anxiety and depression already routinely encountered in the dance community are only more magnified with the COVID pandemic. There is associated fear and mourning, such as loved ones being sick or dying from infection, and individual concerns of getting infected. Dancers also must deal with losses of identity, community, connection, income, and roles. Do not hesitate to reach out and get professional assistance with any mental health or emotional challenges.

A focused treatment plan for any type of physical or emotional concern can give a sense of clarity during a time of uncertainty. So now let’s take a look at what the dance community may look like once there is a green light to return to the studios. The reality of dance return likely includes starting on a smaller scale and with a slow rate of advancement.

Don’t expect to start off right where things left off. As much as dancers want to dance and our communities want to see dancers back to dance, there will be limits placed on the rate of return. Be ready for a reduced schedule, and rather than push studios and companies to accelerate the pace of return, realize that public authorities and not instructors or owners are making the decisions.

From studio owners, company heads, to even physicians, we are all going to lean on the guidance of public health officials and other leaders to determine the group size and pace of post-COVID recovery. 

Here’s what we think the dance studios will look like:

Dancers and instructors should prepare to start with small groups as public health authorities will likely limit initial gathering sizes. Social distancing in some form is not going away for a while. I’m guessing that the authorities’ may limit groups to a maximum of 10 people in a room or studio, and that will include instructors. For this reason, privates and small groups might be the first to make a comeback.

Dancers should also anticipate keeping six feet distances between colleagues which means plenty of room for marking steps and free movement. Partnering, use of shared props and heavy floor work will have to come later. 

Dancers should also not be surprised if mask or other face coverings continue to be recommended, even with dance. Yes, there is no doubt that face coverings can be uncomfortable, keep falling off, and make breathing more difficult. However, it is best to try different types of masks and face coverings with your current level of dance and other exercise to see which ones fit better. 

How about lining up at the barre? This will also likely need ample distance in between each dancer, and gloves may also be required.

Dancers will probably come into the studio, do their class, and then immediately leave. Hanging out and catching up with friends may not be an option for a while. There also might need be more time between each class for cleaning of the studio and floor.

With fewer participants in each class, an individual dancer may not be able to do as many classes per week. At this point, it might be best to start with a favorite genre or two, then add others as classes become more available.

Don’t be surprised if you start off at a level or even a few levels below where performance was before the COVID quarantines began. Honest communication between dancers and instructors can allow for appropriate individualized starting points and rates of progression.

So what does this mean?

This means the entire ensemble won’t be able to dance together. Competition teams will have to be split up. The first competitions and conventions will be further down the road. As dancers eventually return to performing and competing, it is best for instructors and coaches to orient dancers first into smaller group pieces rather than moving right into full company work. 

No dancer, instructor or parent should anticipate or be planning competitions or recitals for at least several weeks if not months after dance resumes. Dancers won’t be ready, and very likely that public authorities are again going to be cautious with mass group activities. So, while it is natural to want to “get back to where we were” as soon as possible, there should be no time sensitivity or sense of rush. 

Unfortunately, this does not look like the summer for summer intensives – both from dancer readiness and concern with large group points of view. It is also probably best to hold off on scheduling auditions to allow dancers to regain strength and relearn movements first. Waiting will allow a dancer to better demonstrate aptitude and talent.

A measured and gradual return approach is not only important to reduce infection and illness spikes, but also is actually quite sensible for overall dancer health.

Let’s all agree that after so much time away, everyone is likely going to be out of shape. Timing is going to be off, while leaps and turns won’t be as high or as crisp. Some might be in a better spot than others, but no one is going come back dancing at the same level as before the COVID quarantine interruption. 

Trying to overcome the prolonged break from dance in just a few days, or maybe a few weeks is definitely not recommended. My fear is that dancers who push themselves too much, too fast or too soon to get to past levels of performance are at a greater risk for overuse injuries.

So yes, those first priorities should not be trying to return to previous levels of dance as soon as possible. A more sensible return should focus on the basics of technique, classes, and addressing basic dance movements and positions while also dedicating time to rebuild core conditioning. There is no better time for dancers to reintroduce themselves to the barre and mirrors (actually maybe only the mirrors to start as barres may be “hands off” in initial stages of return).

This is why those smaller classes and individuals/privates are actually exactly what this dance medicine doctor would order. Fewer dancers in a class will allow instructors to pay more individual attention to technical details with the value of smaller student to instructor ratios. Small nuances of movement and positions can be critiqued and improved without time-sensitive pressures of upcoming events.  Instructors can be more aware of particular needs of individual dancers. Forming groups based on equal/near-equal ability and experience can foster collective advancement that is often more difficult with larger groups of dancers with varying levels of talent.

When planning weekly progression, please pay particular attention to the next sentence if you want to limit injuries. Back off during the third week back. I’ll repeat it again for emphasis- Back off during the third week. This is experience gained from military recruits in basic training and other groups of athletes starting new programs. 

Instructors should anticipate a first week that is a blast filled with adrenaline. Dancers will be so excited to return that the resulting adrenaline rush will probably override any soreness and stiffness. By week three, muscles and bones are reaching the point of maximum overload. When demands continue to grow during week three, so do the risks of muscle strains and bone stress injuries. Backing off during the third week has been shown to reduce injuries and rates of drop out.

Many of you might be asking, “How long will it take to get back to prime dance performance?” 

There isn’t an exact evidence-based study to quote, but in the performance medicine world, we’ve often figured that for every week someone is away from dance, there needs to be at least one week of rebuilding, relearning, and reconditioning needed for full recovery. That means if a break from dance was 10 weeks, then assume 10 weeks to get back to higher level skills. 

Eventually the calls to dance will come bringing both senses of familiarity and discomfort as adjustments are made in the post-COVID environment. Having patience, heeding the recommendations of authorities, and focusing on the core foundations of dance movement will help the dance community work together in recovery and return.

Dr. Chris Koutures

Dr. Chris Koutures is a dual board-certified pediatric and sports medicine specialist who practices at ActiveKidMD in Anaheim Hills, CA. He is a team physician for USA Volleyball (including participating in the 2008 Beijing Olympics), the U.S. Figure Skating Sports Medicine Network, Cal State Fullerton Intercollegiate Athletics, Chapman University Dance Department, and Orange Lutheran High School. He offers a comprehensive blend of general pediatric and sport medicine care with an individualized approach to each patient and family. Please visit https://activekidmd.com/ or follow him on twitter (@dockoutures).

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