My injury journey

Introduction

Injury is the worst nightmare in a dancer’s life, no matter if you are a professional dancer or an amateur dancer. Injury wreaks havoc to the body that affects daily lives and in the worst case scenario, a dancer’s career. In the past 6 years as an adult ballet beginner, I have experienced falling from an out-of-balance pirouette, slipping from a grand jeté, falling with both knees landing on the floor, twisting and falling from a grand battement on pointe etc. Somehow I survived all these until landing from a jump on 11 September, 2021.

Photo credit: Tony Tsui

The incident

It was a 1.5 hour morning class for intermediate level adult ballet dancers on a Saturday. As far as I remember, my stomach was feeling bad after barre exercises and I had to skip some of the centre exercises like adagios and pirouettes. I returned to class for petite allegro and the combination included a saute de basque which is rather alien to me, I landed from the jump with a sickled left foot and fell. At that moment I heard some sound of tearing and felt tremendous pain in my foot that I could hardly stand or walk.

Immediate treatment

Based on the knowledge of how to deal with sprained ankle, I followed the Rest, Ice, Compression, and Elevation (RICE) principle except compression. The area between the metatarsal and ankle started to swell and soon developed into a big bulge. I thought it was just another ankle sprain and went to seek medical advice from my family doctor, who prescribed me with anti-inflammatory medicine and painkillers. Unfortunately the pain and swelling did not subside after 3 days, therefore I visited the Accident & Emergency department in a public hospital, X-ray imaging was done and I was diagnosed with 5th metatarsal base fracture which was minimally displaced. A walking boot and elbow crutches became my new friends for the next few weeks.

Ongoing treatment and management

I took a long rest from work and was asked not to put more than half the weight on the injured foot. Icing was done on a daily basis to reduce inflammation and swelling and bruises started to emerge after a few days. For better healing, I adopted a nutritional diet with high calcium and protein intake while stopped eating refined sugar, junk food and declined any social drinking. Apart from diet, I also stayed physically active by doing Progressive Ballet Technique (PBT) exercises and exercises strengthening the core, inner thigh and back on the mat. I was being referred to the orthopaedic department and attended follow-up at week 2, week 6 and week 10. Calluses were observed in an X-ray done at week 6 and I was being referred to physiotherapy at the same time. Having attended physiotherapy in the public sector for 4 sessions and in the private sector for 15 sessions respectively on a weekly basis, I resumed barre exercises at home in mid-January, 2022 due to skyrocketing local Omicron cases and temporary closure of dance studios.

Insights

1. The importance of warm-up

I cannot stress too much the importance of warm-up before class, especially for amateur dancers as we all have busy schedules, probably with a full-time job and/or family to take care of. Whether you perceive ballet as just an interest or a committed part of your life, warming-up properly before class is essential. Arrive at least 30 minutes before class is highly recommended in order to have enough time to get changed and warm up. Layer with warm-ups (such as sweater, down jacket, sauna pants, warm-up booties etc.) when necessary to keep the body warm. A full meal should be consumed at least 3 hours before class. If you are hungry, light snacks such as nuts are ideal before class to fuel your energy.

2. Seek medical advice, go for X-ray immediately

You will never know what is happening inside your body after an injury, it may be tendon or ligament rupture or tear, or bone fracture, or both. A diagnosis will not only give you a clear idea of what is happening, but also get access to appropriate treatments and resources.

3. Start physiotherapy as soon as possible

In my personal experience, immediate intervention by physiotherapists in the public hospital included icing and educating me about how to walk with elbow crutches. It was week 9 when I got access to out-patient physiotherapy service in the public sector for rehabilitation. Timely assessment and treatment, together with exercises and education about self-management strategies, contribute to better pain control and reduced disability in the short-term and are vital to better rehabilitation prospects in the long-term (Barrett & Terry, 2018; Kilner, 2011).

4. Stay physically active

We put a lot of effort into building strengths, yet injury gets in the way or even causes muscle loss due to lack of mobility. It takes a lot of motivation and persistence to stay physically active with injury. Maybe you have to stop ballet temporarily, but there are still a lot of strengthening and conditioning exercises that are suitable for your condition. Do consult your physiotherapist for recommendations.

5. Self-awareness

We all have those days when we are not feeling the best, perhaps we did not sleep well the night before, too stressed out, having PMS, or period. Instead of pushing yourself through the class, you always have the option to take a rest or leave the class when the body is giving you such signals. Afterall, you are the only one who knows your own body and limits, you have all the rights to honour what your body is telling you even though it may be embarrassing or even shameful to walk out of class. It takes courage to be vulnerable, but it is never a sign of weakness.

6. Financial concerns

Injury may affect our income due to the need for sick leave, unpaid leave, underemployment or even unemployment, especially for those who are working as freelancers. Having insurance covered and an emergency fund may ease the financial pressure.

7. Post-injury mental health

All the discomfort and pain on the physical level affect our emotions, vice versa. The body is so important to a dancer, be it bruised toenails, bunions or ankle sprain, influence our overall condition and performance. Mental health after injury is often overlooked as it is invisible, yet dealing with all different kinds of emotions can be as devastating as dealing with the physical pain and discomfort itself. Fear, guilt, frustration and hopelessness emerged from time to time after I got injured. Whenever I felt vulnerable, I reached out to my supportive network and practiced mindfulness meditation. Instead of pushing away the emotions, I attended to them here and now and gave them all the loving kindness, which nurtured self-love, self-acceptance and gratitude. Resources such as seeing a mental health professional locally or online is always available when you feel like it is too overwhelming.

8. Making meanings from the injury experience

Injury is an accident that cannot be controlled or reversed. Even though the process is painful both physically and psychologically for me due to temporary disability, loss of physical strength, loss of opportunity to devote to ballet and to develop in terms of skills and techniques etc. At the same time I went through profound personal growth and spiritual awakening that fundamentally and tremendously changes how I view myself and people around me. I gained inner peace, confidence, self-awareness about my thoughts and emotions, strengths and limitations, needs and desires which help me to develop more empathy and acceptance for myself and others. It comes as a revelation that suffering in the self from the injury experience transforms into a blessing in others.

9. A holistic approach to post-injury care

The problem with the medical perspective is viewing a person as fragmented parts. Indeed, our body, mind and spirit is whole and interconnected. While physical well-being is important, psychosocial and spiritual well-being is just as important. The latter affects how we perceive and cope with problems and difficulties in life. As Virginia Satir suggested that “problems are not the problem; coping is the problem”, the injury or illness itself is not the problem, how we cope with this injury or illness is the problem, and you have the power over choosing what to believe and to respond rather than to react. Holistic wellness is not just about the absence of illnesses or diseases, it integrates all aspects into consideration.

Final words

No matter if you have experienced injury before, or other kinds of illnesses, or even COVID-19. I hope my personal story will not only give you practical information, but also shed light on the lived experience as a person. Dealing with injury or illness may be one of the most vulnerable experiences in life. Instead of running away from your darkness, own your story, embrace all your emotions gently, as Brené Brown wrote, “only when we are brave enough to explore the darkness will we discover the infinite power of our light”. Afterall, we all have our own struggles in life, internal experiences like emotions are never wrong, instead they are a compass guiding us to see what we really need.

I would like to express my heartfelt thanks to my parents for offering practical help in daily lives with disability unconditionally. I am forever grateful to my dearest friend Jovi, for loving me for who I am and companionship through ups and downs in my life; my childhood friends Osanna and Monica for growing and learning life lessons together, and for calling at 6 a.m. to check on me and to offer a listening ear.

Thank you Damon, my physiotherapist at Phyziowork Physiotherapy Centre, for inspiring me to write this story and contributing with your expertise, and together with your amazing team, including Lesley, Justin, Car, Dir and Marco for your continuous support throughout my rehabilitation journey. Thank you Thomas, my insurance agent and friend, for your assistance in my insurance claim process, your genuine care and spiritual support, for inviting and joining masses with me when I needed the most.

Book recommendations

For coping with injury/ illnesses

1. No Mud, No Lotus: The Art of Transforming Suffering by Thich Nhat Hanh
2. Full Catastrophe Living: How to cope with stress, pain and illness using mindfulness meditation by Jon Kabat-Zinn
3. Man's Search for Meaning by Viktor Frankl

For inspiration

1. Life in Motion: An Unlikely Ballerina by Misty Copeland

For personal growth

1. Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead by Brené Brown
2. The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are by Brené Brown
3. Reconciliation: Healing the Inner Child by Thich Nhat Hanh

References

Barrett, R., & Terry, L. (2018). Patients’ and healthcare professionals’ experiences and perceptions of physiotherapy services in the Emergency Department: A qualitative systematic review. International Journal of Emergency Medicine, 11(1). https://doi.org/10.1186/s12245-018-0201-z 

Kilner, E. (2011). What Evidence is There That a Physiotherapy Service in the Emergency Department Improves Health Outcomes? A Systematic Review. Journal of Health Services Research & Policy, 16(1), 51–58. https://doi.org/10.1258/jhsrp.2010.009129