Athletic Trainers Help Performing Athletes Excel by Providing Best Practices of Care

Tuesday, February 16, 2016
DALLAS – They dazzle us with their leaps and bounds and often leave us spellbound with their sophisticated footwork, sensational jumps, twists and turns, musical gifts, grace and energy. Throughout the year, performing athletes from Broadway to ballet and from youth to professional levels add an extra sizzle to the stage.
These athletes have exceptional skill and stage style. But what happens when a performing athlete sustains an injury? Increasingly, their companies, schools or health programs are providing on-site injury prevention care to keep them on stage or to minimize their time away from it.  As a result there is a reduced frequency and severity of injury, reduced cost and time loss, increase in education for the performing athlete and tremendous return on investment for the companies or shows.  
Athletic trainers have been working with performing athletes for more than 25 years. The National Athletic Trainers’ Association sheds new light on this sector and the benefits to employers who have athletic training programs on-site. “The athletic trainers’ expertise in musculoskeletal health makes them a vital part of the health care team whether working as independent contractors or employed through a company, hospital or other facility,” says NATA President Scott Sailor, EdD, ATC.
Harkness Center for Dance Injuries
The Harkness Center for Dance Injuries (HCDI), now in its 27thyear, is a care centerwithin NYU Langone Medical Center in New York City. “Our world-renowned dance medicine institute has three main areas of focus: research, education and clinical services with a mission to enhance the health, well-being and quality of life of dancers and dance companies by providing state-of-the-art, affordable medical care,” says Alison Deleget, MS, ATC, program manager, HCDI.
The multidisciplinary staff includes physicians, athletic trainers and other rehabilitation specialists. HCDI is one of the only hospital-based programs in the U.S. which employs athletic trainers exclusively in the dance medicine field. The five athletic trainers on staff are responsible for the evaluation of the dancers’ functional abilities, analysis of movement dysfunction associated with injury and goal setting that will lead to return to the stage and prevention of future injury.
The athletic trainers at HDCI provide these services to the companies with which HCDI has contracts for on-site medical care. They travel to the company or school studios several times per week to provide injury triage, treatment and injury management education. The on-site athletic trainer is solely responsible for facilitating communication between the dancer, the supervising physician and the company artistic staff to ensure each dancer’s injury is effectively managed. The athletic trainers also provide community outreach and education to the broader dance population and to fellow health care professionals through injury prevention workshops, assessment programs and CEU offerings.
HCDI’s cost savings of on-site care have provided a significant return on investment for companies and Broadway shows. “Itis not unusual for a company to realize a 50 percent or higher reduction in health care costs after the introduction of on-site medical careand to see a drop in the number of disabling injuries anywhere from 20 to 50 percent per season.” says Deleget.
A typical injury rehab program consists of six to eight visits. With on-site medical care, there is no direct cost to the dancer and the company sees cost savings through less rehearsal time lost, fewer workers’ compensation claims and more productive dancers in rehearsal and performance. “We are truly affecting a change in the management of dance injuries. Having happy and healthy dancer patients is wonderfully rewarding.”
“HCDI has made such a difference in our dancers’ lives, not only through exceptional care, but through aconstant expansion of our understanding of how dancing bodies, spirits and minds can thrive in this art form.” Virginia Johnson, prima ballerina and artistic director, Dance Theatre of Harlem.
“Time after time HCDI has saved me and countless others from pain and premature or unnecessary surgeries. They truly listen and remember the details from visit to visit, from year to year; they guide us and heal us. Basking in their calling to save dancers, athletes and all people who through some exciting moment found that they went just a bit too far with their own physicality, they put us back together and allow us to fly again!” Elizabeth Streb, director of STREB Extreme Action Company, and recipient, John D. and Catherine T. MacArthur Fellowship Award.
Cincinnati Ballett

The Mercy Health - Performing Arts Medicine Program has a primary site located at Cincinnati Ballet. The staff provides complete orthopedic and wellness care to the Cincinnati Ballet dancers as well as a referral source for young dancers in the greater Cincinnati area. Athletic trainers are on-site for all rehearsals, performances at home and touring of Cincinnati Ballet and provide injury assessment and prevention programs as well and daily maintenance treatments for the dancers.
“For the area dancers, the ballet company offers studio wellness visits, injury prevention workshops, pre-pointe screenings, healthy dancer screenings and physician referrals,” says head athletic trainer Kelly Jo Trimble, ATC.  “Our program was created by Jacqui Haas, ATC, and our health care team includes one full-time and one part-time athletic trainer, as well as one athletic trainer on call in the event of on-site assistance. With the program providing care and education not only to Cincinnati Ballet dancers but also dancers in the community, we have become a major resource for people in the community to seek orthopedic care.”
The company has seen a reduction in injury and a quicker return to dance rate since having an athletic trainer as part of the team. It has an affiliation with 100 plus dance studios in the Greater Cincinnati area and has created a team of supporting orthopedic surgeons who understand and treat the dancers.
“We have an amazing opportunity to work with high performance athletes who work hard at returning to their sport. The demand for return to dance is not based solely on ability but also on aesthetics of the performance. We see multiple unique injuries not seen in the traditional settings such as ankle and foot fractures, ligament ruptures in the ankle, degenerative changes normally seen in a geriatric population that occur in late 20s, early 30s and hip labral tears seen in teenage females. These high level performers must do high jumps, lift each other, perform floor work and endurance variations, all while looking completely graceful,” says Trimble.
“Our program has given the dancers the ability to cross train for injury prevention and conditioning during lay off periods. As a result of our association with the hospital we are able to provide all of these dancers with access to our health care services for any musculoskeletal or other injury. A great majority of our dancers are international and may be accessing some of these preventative health screens for the first time in their lives.”

“The Mercy Health - Performing Arts Medicine team at downtown Cincinnati Ballet is an excellent program! They are very knowledgeable, caring and passionate about the work they do. They made sure I received the best care when I was going through my injury, surgery and rehabilitation for my stress fracture on my left tibia, so I could get back to what I love to do – dance!” – Liang Fu, former Cincinnati Ballet dancer
“When the urgent care diagnosis was a broken ankle, our daughter's dream of dancing the role of Clara in de la Dance Company’s “The Nutcracker Jazzed Up” at the Aronoff Center seemed to melt with her tears. The next day she began to work with the Mercy Health Dance Medicine team on a customized rehab and Pilates regimen that not only allowed her to heal quickly, but to do so while she strengthened her core. Six weeks later she took the stage with grace and confidence, something that would not have been possible without the care and treatment from Mercy Health Dance Medicine team.” Chris Strobel, father of a young dancer

AMDA (American Musical And Dramatic Academy)

The AMDA Health and Wellness Center opened on the AMDA Los Angeles campus two years ago. The school has been based in Los Angeles since 2003 with an original campus in New York City since 1964. The center is staffed by one full-time and one part-time athletic trainer who advise on general medical conditions and provide evaluation and treatment of musculoskeletal injuries as well as first aid to the 700 plus performing arts students.
“Since opening, we have reduced students’ time-loss from classes as well as related health care costs students may incur. Previously, injured or sick students would be referred to the local urgent care facility. We can now provide those services on-site,” says Shari Sipka, MS, ATC, director of Health and Wellness at AMDA. “This is a benefit to students, provides a quicker return on investment, and also provides parents with peace of mind that medical care is readily and immediately available. Given the intense training that many of the performing artists are required to do each semester, we are very hands on should an injury occur and can schedule doctor visits, guide the individual through prehab and surgery if required and provide his or her post-surgical needs and rehab.”
Students at AMDA are often in classes all day with rehearsals at night. When injuries occur the Center staff aims to get them back to activity within a two week period: they either need to fully participate, take a medical leave of absence or withdraw within that time frame. The goal is to ensure complete recovery before return to activity so the performing athletes don’t experience set-backs or re-injury.  
The Health and Wellness Center takes on the role of first responder in most medical emergency and non-emergency situations and works collaboratively with other departments to ensure emergency action plans are in place if needed.
With the implementation of the Health and Wellness Center located on campus, students, staff and faculty now have the ability to easily access guidance/therapy for minor injury and medical needs. Athletic trainers bring to AMDA a design to address minor medical needs including: first aid, injury evaluation/rehabilitation and basic general medical needs. In addition, students who may require additional medical assistance, beyond minor medical needs, now have trained personnel to recognize that an issue requires a community resource referral.” Cynthia Moj, director of education services, Education Services department, Academic and Registrar’s office, AMDA College and Conservatory of the Performing Arts
"Having Shari as an athletic trainer at AMDA has changed my training for the better. Before Shari, I would deal with my injuries best I could, but I couldn't easily get to someone who could help me. Things were often ignored instead of fixed. Now that Shari is here I've been able to heal and strengthen my injuries. In turn I have been able to concentrate on my technique in class, rather than being in pain."
Senior AMDA student Kate Coleman,BFA Dance Theater
“Performing artists have unique requirements when it comes to rehearsal, competition or performances,” concludes NATA’s Sailor. “It is our job to provide them with the right combination of hands-on care, immediate attention to prevention and treatment, and to ensure a complete return to activity should injury occur. With a safe and effective plan in place, we can get them back on stage so they can do what they do best.”
About NATA: National Athletic Trainers’ Association (NATA) – Health Care for Life & Sport
Athletic trainers are health care professionals who specialize in the prevention, diagnosis, treatment and rehabilitation of injuries and sport-related illnesses. They prevent and treat chronic musculoskeletal injuries from sports, physical and occupational activity, and provide immediate care for acute injuries. Athletic trainers offer a continuum of care that is unparalleled in health care. The National Athletic Trainers' Association represents and supports 43,000 members of the athletic training profession.