Why Dancers Deserve Specialized Rehab Therapy — and Tips for Delivering It

When more than 500 dance professionals travel to Cleveland for the Dance/USA Annual Conference in mid-June, they will have the opportunity to attend a panel discussion on healthcare access for dancers. Among the experts on the panel will be Kim Gladden, MD, a physical medicine and rehabilitation (PM&R) physician, and Dawn Lorring, PT, MEd, MPT, CSCS, clinical rehabilitation manager, both with Cleveland Clinic.

They are well positioned to share insight on healthcare for dancers: Dr. Gladden is co-founder of the Dance Medicine Clinic offered by Cleveland Clinic’s Sports Health Center, and Lorring, her fellow co-founder, has worked by her side since the clinic’s inception in 2014.

The Dance Medicine Clinic treats dancers of all ages and levels for injuries ranging from torn ligaments to tendonitis and muscle pain. “We look at the whole dancer — how the injury is affecting their work, their life and their state of mind,” says Dr. Gladden.

Bringing a dancer’s perspective to bear

One reason for the clinic’s success may be the unique qualifications of its healthcare providers: They all are current or former dancers. Dr. Gladden earned an undergraduate degree in dance and danced with choreographers and small companies in Seattle before joining Cleveland Clinic. Lorring was a member of her college dance team, studied dance for 14 years and competed in figure skating for 18 years. Additional PTs who manage patients for the clinic have dance backgrounds as well.

“We know very well the ramifications of an injury,” Dr. Gladden notes. “We understand the physical training involved in dance and what aspects will be impacted by an injury, as well as the psychological aspects behind the pressure to perform.”

One of the first things Dr. Gladden asks patients is to do a plié, a basic dance movement that reveals a lot about how a dancer takes off and lands from jumps and performs other movements. “There are subtleties to that movement that are hard to explain unless you’ve done it thousands of times and understand how it’s supposed to be done,” she says. “There’s a biomechanical chain of events that should be happening, including where the weight is shifted and how the dancer engages specific muscles.”

The staff at the Dance Medicine Clinic also understand the physical demands particular to dance. “Dance movements are not normal movement patterns,” Lorring says. “You are not trying to put your leg above your head in daily life. So it’s important to understand the movements and extremes of motion required.”

What it takes to launch a clinic for dancers

When the Dance Medicine Clinic opened, it had dedicated appointments for dancers every other Tuesday at the Sports Health Center. But the clinic has grown, and patient demand has required additional appointment scheduling. Now Dr. Gladden sees dancers at three locations across Northeast Ohio and sends them to one of three primary PTs in different Cleveland Clinic facilities.

The team offers the following advice to PM&R and other physicians who may be considering dedicating time to dancers:

• Identify a referral network. “As a physician, you have to identify physical therapists and other healthcare providers who understand dancers,” Dr. Gladden says. “If you don’t have that referral network in place, you are not going to be able to develop a clinic.”
• Pick PT partners carefully. “Anybody in sports medicine can see dancers, but I don’t think just any PT can do physical therapy with them,” Dr. Gladden says. “It takes someone who really understands dance training.” The PTs at the Dance Medicine Clinic offer a breadth of therapy — from aquatic exercises to Pilates — geared specifically to dancers.
• Set clinic times based on dancers’ schedules. “Get to know the studios and dance companies in your area and their schedules,” Lorring advises. “Dancers are busy people, so spread out your hours and be as flexible as possible.”
• Read between the lines. “If dancers are in your office, then they are in a lot of pain, even if they’re not admitting it,” Lorring says. She often starts a patient evaluation talking about one part of the body, then watches the dancer move and realizes the problem stems from another area. “I feel like Sherlock Holmes, trying to figure out what’s going on,” she says.

Demand is growing

The Dance Medicine Clinic has evolved into a sought-after service. The clinic team is currently in negotiations to be the preferred healthcare provider for a local professional dance company.

But as its reputation grows, the clinic remains true to its initial mission: “We want to make sure the dance population knows there are folks at Cleveland Clinic who want to take care of artistic athletes,” says Dr. Gladden.