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Delivering Value: A Day In The Life Of A Ballet Physio

Forgive me right from the off. This post may appear a little self-indulgent but here are my reflections from working within a pre-professional ballet school. Don’t say I haven’t warned you!!

I have recently finished my post at a pre-professional ballet school. I have worked there full time for 15 months and had a wonderfully challenging and rewarding time. I have learnt a great deal and found myself being truly inspired by the dancers who give their all each day to pursue their dreams. I have left on great terms, and my reason for leaving is merely to begin my own new chapter with Mindfully Active Physio. I will miss the School dearly and more so the good friends I have made there.

My typical day would consist of an hour long train journey with my colleague. We would talk about difficult cases, the current state of our profession and generally put the World to rights. We shared many a deep and meaningful moment, many of which I will cherish. Upon arriving we would walk past the multiple studios, with the 3rd Years (aged 18-19 years) already in full flow of their morning ballet class and the 1st and 2nd years studiously working in the classrooms. The talent that pirouettes around every room is palpable, from the dancers to the pianists and everyone that engages within the school.

After setting myself up in the Healthcare Suite, the students would head in after their education. We would gain the daily update from many of the students that found solace within the Healthcare set-up. Most of whom were injured but some were there just to vent and offload from the previous day’s activities. This included frustrations around injuries, not being able to perform, not being cast for performances, stresses of assessment periods, the challenges of boarding, the conflicts between friendship groups, the drama on ITV’s Love Island and so on. As a physio, we gain our fair insight into the lives of the students, both the good and the bad. What we then do with that information is down to our instinctive judgement there and then. Are they after advice? Do they just want to be heard? Is there any immediate action required? Is there any immediate risk (either physically or mentally)? Do we need to refer elsewhere within the Healthcare Multidisciplinary team? These can be difficult questions to answer at times, but we are experienced enough to make sound decisions.

After the initial debrief I would assess and treat students all day, every day. Injury rates are high in this industry and expectedly so. The dancers are in a very challenging environment, where the number of training hours is incredibly high (6 hours per day on Mon-Fri with additional weekend classes), with little recovery time between classes, and educational expectancies outside of this time. Ballet is not deemed as a sport, but as an art form. As such the students must maintain the ‘artistic look’ - typically this means low percentages of body fat and long, slender lines. This presents a challenge for the dancers: how do they fuel properly thus providing sufficient energy to tolerate the daily rigours of training, whilst at the same time maintaining the right look and remaining healthy? Very difficult to do and I see this as fundamentally the most challenging aspect of the environment, not just for females, but for male dancers also. Fortunately the knowledge and support that the dancers receive is forever evolving.

It is important to address the elephant in the room. Eating disorders and disordered eating habits exist within ballet, as they are in many sporting domains. Thankfully, gone are the days where this isn’t discussed. It is, and there are measures in place to reduce the risk of this happening as well as to best manage such habits when they present themselves. However, there is no magic answer and the rehab process is a complex one which is continually evolving (I will discuss this more in the next post, covering Relative Energy Deficiency in Sport).

Anyway, I digress. The dancers I have worked with over the last year are athletes. The level of training they perform is significant. They work through traditional ballet and contemporary classes, Pilates, strength and conditioning sessions and are being increasingly educated around recovery and how to better manage their bodies. They have some of the most incredible body awareness and, in my experience, can understand how to manipulate their bodies in ways that very few sportspeople do. These dancers are a joy to work with and throughout my days of assessing, treating and rehabilitating, I would constantly be impressed with their abilities to grasp a challenge and run with it.

My day would typically end around 6.30pm and each day as the school shut down and locked the doors, I would have to hurry some students to leave the gym. “7 hours of training is quite enough for one day”, I would have to remind students on some occasions. Overtraining is also a common trait within my experience of the ballet world. Quantifying this is somewhat trickier to both measure and manage in an environment where everyone is so dedicated to achieving their dream, and where hard work is constantly encouraged. Working smarter became somewhat of a trend within the prior 12months!

Anyhoo, back to the purpose of this post. Approximately 3 months prior to the end of the term I was having a somewhat philosophical discussion with a friend and S&C colleague. “I wonder if any of the students would remember us when they are our age?” I asked. He felt that they would and that we have had a significant impact on their lives. I was dubious. Not because I didn’t believe we were doing the best we could to educate them around being healthy dancers, but because for teenagers, life moves too fast for you to take stock and appreciate the facilities and expertise they were utilising daily. Also, when you are surrounded within such an exceptional environment, perhaps no one thing would have such a particularly lasting impression. The most I was hopeful for was that we could give each student the tools to better manage and understand their bodies as they embarked on a physically demanding professional career.

I have now just finished my final term and was humbled and honoured to receive many kind words from the students. Here are some of my favourite extracts;

“I wouldn’t have been able to get back to dancing without you.”

“I am truly grateful for having had the support from the Healthcare team and the opportunity to vent.”

“Thank you for creating an environment in and around the gym that allows us to work hard and have fun.”

“Thanks for being there for us both physically and psychologically.”

‘“Thanks for always saying hello and asking how I am.”

“You are my superhero!”

I guess we may make a lasting impression after all.

Clearly there is value for the students in such a comprehensive healthcare provision. Maybe it was because we were able to help students back from injury and into dance. However, from reading the cards, notes and letters, it seems apparent that our impact stemmed from more than this. As a team we helped to develop a safe and friendly environment within which the students (of multiple nationalities and cultures, from all across the globe) could feel a part of something bigger than the individual. In an arena where it is all about each individual progressing, The Healthcare Team harnesses a culture that encourages a team ethos and togetherness that the students value. They are there to listen and engage with students in a context that is separate from the pressures of their academic and artistic training.

During my time in one of my first sporting jobs, an old tutor advised, “We are not there to be their friends. We are there to make them better.” I understood his point but I never thought that two were mutually exclusive, and actually, developing a relaxed but professional relationship has always reaped positive results for me. Not only did these students trust me (and therefore follow direction with their rehabilitation) but they also valued my nice/friendly persona.

Another old colleague once said, "There should be no laughing in the gym. It's a place to work". Again, I have to disagree. Of course there needs to be a balance and finding that can be tricky. However, I found that in the ballet environment where everyone is self-motivated to improve in anything specific to ballet, making gym sessions fun became an incredibly useful way of reducing stress, enhancing more varied movement patterns and providing a different stimulus to empower the students.

Hopefully I have impacted their lives for the positive. I know they have positively influenced mine.

Until next time,

Feel, Think, Move

Mindfully Active Physio


Mindfully Active Physio at

Koru Gym

Peek Business Park, Woodside 

Bishops Stortford, CM23 5RG

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