PT and Dance
I have been very excited about this interview for quite some time with Dr. Mary Frances Roebuck PT, DPT. Mary Frances is a PT in New York City and works with dancers! She is also my former colleague from South College DPT school. She was gracious enough to provide pictures from classes she teaches as well as a youtube video to help understand the demand during her interview! I hope this interview gives readers a better glimpse of the PT field within dance, what these clients need, and how YOU could further grow in this niche if that is something you are interested in!
Website: Mary Frances Roebuck PT, DPT
1.) Tell me about your education background: undergrad, PT school, any special courses etc. and where are you currently working?
a.) “I earned my Bachelor of Science in Dance and Arts Management from Oklahoma City University. During that time, I worked with the American Spirit Dance Company both on and off the stage. This training helped me to understand what it takes to be a professional dancer and manager in the entertainment industry. I then earned my Doctorate in Physical Therapy from South College in Knoxville, TN. During my clinical rotations I spent time in Chicago working specifically with professional dancers with the Joffrey Ballet and Hubbard Street Dance. We provided physical therapy services onsite weekly and then backstage during performance seasons. After graduating I took a continuing education course through Sugarfoot Therapy which is a training program that helps to bridge the gap between dance training and physical therapy. The program provides therapists and dance teachers the ability to incorporate multiplanar movement to reduce injury risk and enhance performance by providing cross-training tools. I am currently working in NYC in an outpatient orthopedic clinic. I treat dancers both in the clinic and provide in-person and virtual strength training classes for children and professional dancers.”
2.) Why did you want to work more specifically with dancers as a PT?
a.) “I have been dancing since I was 3 years old and have had my fair share of injuries, many resulting in having to sit out of dance and multiple surgeries. My first injury was in junior high and consistently kept recurring throughout college. I would become frustrated because it seemed many therapists were not familiar with dancers and their specific demands. I then became a dance teacher and realized the importance of beginning strength training programs with children at a younger age. Dance is one of the few sports that train for their sport by doing their sport. This can result in repetitive overuse injuries and muscular imbalances. I wanted to be the physical therapist that performers could come to and know that I had a thorough understanding of the demands of being a professional dancer and could provide a clear plan for recovering and prevention.”
3.) Are there common injuries/ailments you see in dancers, if so what are some ways you address this and/or work on prevention?
a.) “Surprisingly, dancers tend to have significantly weak, inactive glutes and gastroc/soleus muscles! Tying back to dance being one of the few sports that lacks cross-training, I provide basic exercises that specifically focus on key impairments and retraining the neuromuscular system. Squatting, lunging, and deadlifts are great basic functional exercises to incorporate because most dancers are told to never hip-hinge. This stems from ballet training and maintaining the artistic component of dance. Most dance choreographers are focused on artistic imagery instead of functional ability. Once they have mastered the basics with appropriate mechanics and muscle activation, I will slowly transition into more dance specific movements. This helps dancers to also establish a conditioning program that will prevent future repetitive injuries. Approximately 40% of dance injuries occur at the foot and ankle and 20% at the knee and hip. The most common ankle and foot injuries I see are stress fracture, lateral ankle sprain, ankle tendinopathy (Achilles, flexor hallucis longus, and posterior tibialis tendons), posterior ankle impingement, cuboid syndrome, and metatarsalgia). You will commonly see patellofemoral pain syndrome at the knee and snapping hip syndrome, hip impingement, labral tears, hip flexor tendinitis, hip bursitis, and sacroiliac joint dysfunction at the hip.”
4.) What does an evaluation look like for a dancer? Any differences than in a basic evaluation in outpatient?
a.) “Evaluations with dancers are similar to any other outpatient patient. The main difference is I will usually ask them to demonstrate when they specifically notice the pain. Professional dancers are typically performing 8 shows a week resulting in repetitive overuse injuries. They are also typically placing their bodies in different positions than your typical patient. By seeing the actual move that is causing the pain, I can discuss with the dancer ways to physically change the movement without any artistic difference or how to communicate modifications and restrictions to choreographers and company managers. I think dancers also require more specific one-on-one treatment than most patients. Dancers know taking care of their body will provide longevity in their career and have spent many years seeing lots of physical therapists. Once you find specific imbalances and “habits” that have formed, most sessions are spent with neuromuscular re-education training. Do not be surprised to ask dancers to perform a single leg balance and they are unable to do it!”
5.) Are there any certifications/qualities/advice you think would benefit those that are interested in working with dancers?
a.) “If you are interested in working with dancers, especially professional dancers I would recommend understanding the demand of the job. When teaching children, I always show this Youtube video created by ESPN. I always remind younger dancers that even though dance is artistically pretty it is a lot of hard work! https://www.youtube.com/watch?v=7GfhwpGDANA I think it is also important to remember as PTs we can provide the importance of cross-training and adding in a solid injury prevention program that balances out a performer’s current routine. I talk with professional dancers all the time about if we had added in different forms of training earlier on it would have made such a difference today.
Be the provider that focuses not only on the short term goal of current injury relief but long term goals of returning to sport stronger and more aware than prior to onset.
I am a certified Pilates mat instructor so I will usually start with basic postural control awareness and not letting dancers use momentum or flexibility to achieve their goals.
Most important advice I could give though is- do not be afraid to load dancers! It is probably something they either are not doing or they have started on their own and have no education on.”
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