Caring For Injuries

There are three steps you have to complete to become a professional dancer: learn to dance, learn to perform, and learn how to cope with injuries. – D. Gere

             Pain is normally the first sign of an injury and is our body’s built-in alarm system that tells us something is wrong.  Shortly after the pain comes the swelling.

            Swelling is a natural reaction to an injury and occurs in order to promote healing.  When an injury occurs, cell tissue gets damaged, and the body receives a message to begin repairing this tissue.  Blood flow to the area increases as the body sends leukocytes (white blood cells) to the area.  Leukocytes are macrophages, which are the body’s “clean up crew”.  They migrate to the injured area and carry away the damaged tissue fragments.  Proteins are also released into the area to start repairing the tissue.  A hormone called Insulin-like Growth Factor 1 is also released into the area, which has been shown to increase the rate of cell regeneration.  The initial release of these fluids is necessary for the healing process, but the body overproduces these substances, and a large amount of swelling occurs.

            Applying ice to the injured area causes the blood vessels to contract and decreases the accumulation and circulation of the fluids.  Ice should be applied to the injury 3 times a day for 20-minute periods for the first 48-72 hours.  Ice that is left on an area for longer than 20 minutes at a time can damage the skin.  Ice also serves to numb the nerve endings and temporarily relieve any pain.  It is because of this numbing, that dancers should never use ice before dancing.  Since the area is numb, the dancer has no way of knowing if he/she is doing more damage.

            Other ways to limit swelling at the injured site are to take ibuprofen, compress the injury and elevate the injured limb.  Ibuprofen will decrease the inflammation and help to ease the pain.  Acetaminophen can help with pain management but does not decrease swelling.  Compression will minimize swelling by not allowing room for fluids and can be accomplished through the use of a brace or ace bandage.  Elevating a limb above the heart will limit the flow of blood and fluids to the injured area.

            Obviously, an injured area also needs to be rested in order to heal.  All of these treatments can be remembered by using the acronym RICE (rest, ice, compression, elevation). 
           
            After the first three days, heat can be applied to the injury.  After the swelling subsides, encouraging blood flow to the site will provide the nourishment necessary for healing.  It is best to apply moist heat and avoid analgesics like Tiger balm and Ben-gay.  Analgesics contain methyl salicylate and menthol.  These ingredients increase blood flow to the skin, which makes it feel as if the area is being heated when in reality the warmth goes no deeper than the skin.

            As healing continues, gentle stretching will help encourage flexibility in the newly formed scar tissue which will not be as pliable as the original tissue.  It is more effective to stretch often for short intervals than to stretch for a long period of time.

            All injuries should be evaluated and treated by a doctor, but dancers who have information about how to treat the injury immediately improve their chances for a shorter recovery time than those who do nothing.