Stress fractures, labral tears, chronic knee pain... Oh my! Do any of these conditions sound familiar to you? Unfortunately, most dancers - students and professionals, alike - will likely suffer from at least one injury at some point during their careers. Whether it happens on stage or after weeks of repetitive rehearsals, getting hurt can take a toll on your mental and physical well-being.
To talk all about injuries among dancers, including the number one thing she wishes she knew as a young dancer, we sat down with Dr. Amanda Rixey, a former dancer turned Physical Therapist now specializing in Dance Medicine, chronic pain conditions, and Pilates-based rehabilitation.
P.S. - If you’re at all curious about a career in Physical Therapy or Dance Medicine, read Amanda’s story to learn how she got to where she is today!
Hi, Amanda, thanks so much for joining us! To start, can you tell us a little about your background and what made you want to become a Physical Therapist?
I grew up dancing in Kansas City, and in middle school, I decided that I wanted to take ballet more seriously. (At the time, I was doing more competition dance styles.) I was lucky to train with a few Kansas City Ballet company dancers, including Juan Pablo Trujillo and Stefani Schrimpf, who now have their own studio, Kansas School of Classical Ballet.
After high school, I chose to go to the University of Kansas on a dance scholarship, where I was able to get a Bachelor’s degree in Dance and complete my prerequisites for physical therapy school. I always knew I wanted to be a Physical Therapist after having two elbow surgeries as a nine year old. I sustained a lot of dance-related injuries growing up due to underlying generalized joint laxity, which kept reinforcing the idea of becoming a Physical Therapist.
Growing up in Kansas City, we didn’t have a lot of resources for ballet dancers, which always motivated me to want to give back to that community and figure out a way to get dancers the services they need!
How would you describe your job and area of expertise?
Currently, I am working as a Physical Therapist in Seattle, WA. I have my own company, Newfound Physical Therapy PLLC, where I provide on-demand physical therapy and wellness services to patients at their homes, studios, or via telehealth.
I specialize in treating dancers of all ages, and all backgrounds of dance, however, I am very biased towards ballet :). Additionally, I also love treating chronic pain conditions, so the other side of my practice looks like that.
I use an eclectic approach to treating patients where I combine a variety of different backgrounds and techniques depending on each dancer’s needs. Usually, this includes a variety of manual therapy techniques, biomechanical retraining, and ultimately getting each dancer on a regimen for self-management with tune-ups here and there as needed! I also offer injury prevention/body conditioning classes for ongoing care.
Professionally speaking, what was your journey like to get to where you are today?
I am very lucky to be where I am today professionally, having only practiced as a Physical Therapist for approximately four years. Thankfully, I knew from a very young age exactly what I wanted for a career. I was lucky to have an experience in college where I could both dance and complete the academic requirements for physical therapy school, as well as get involved in numerous projects along the way.
After four years of undergraduate college, I spent a year working as a rehabilitation aide and completing my comprehensive Pilates teacher training, both of which taught me skills I would never learn in P.T. school.
Ultimately, I chose to attend Regis University in Denver, CO due to the location, the extensive training in manual therapy, and the diverse curriculum offered by the school. I knew those skills were what would be needed to be a successful dance Physical Therapist. I obtained my doctorate degree after 3 years. During that time, I also instructed group and private Pilates equipment classes at Colorado Athletic Club.
For my last clinical affiliation for P.T. school, I was lucky to find another dance Physical Therapist, Kendra Gage, who at the time, had just moved from Chicago and had been working with Joffrey Ballet. By the time my rotation started in the spring of 2018, she had obtained a contract providing P.T. services for the Kansas City Ballet company.
Upon graduation, I accepted a position with their team, and worked with their company for two years. During that time, I was also able to form partnerships with numerous local dance studios, and we collectively grew the Kansas City dance medicine scene, which was so much fun and the dream I had always wanted back in high school. Sadly, my husband’s medical residency moved us out to Seattle in the spring of 2020.
What are some of the most common things you work on with dancers?
Even though every dancer is unique, there are quite a bit of commonalities in the things I see and treat.
The first things that usually come to mind are any and all foot and ankle conditions. One very frequent diagnosis I see is posterior ankle impingement. (Watch this video for a quick explanation and why it's so common in ballet dancers!) To treat this, we start conservatively with physical therapy then consider more invasive routes if we are not achieving the results we want.
My favorite things to work with are hip conditions, most notably labral tears and femoroacetabular impingement syndromes (FAIS). I have worked with dancers as young as fourteen as well as dancers in their forties who have this type of injury. It is a “newer” diagnosis and procedure over the last twenty years, as we can now diagnose these injuries with proper imaging and modernized surgical approaches.
Truly, you can see just about anything in dancers, but the lower extremities and back are really the most prevalent. You occasionally see upper extremity and neck issues, but not as often in my perspective.
Do you have any advice for dancers who struggle with chronic injuries?
Luckily, in today’s dance medicine world, we have so many resources available that are more readily accessible than ever. If you struggle with chronic injuries, it is important to actually address the issues.
Our dance culture still has so much stigma surrounding being “injured,” and we will do anything as dancers to hide the issue until we literally can’t walk anymore. By that time, you must really consider what your long-term goal is. Do you want to have lifelong repercussions for a short-term dance involvement, or would you rather take care of the issue and heal (hopefully allowing you to achieve those long-term goals)? It’s a tough position and not always an easy decision to make.
What is the best general self-care/physical maintenance tip you can give dancers?
Self-care must be your priority as a dancer. You must be proactive about physical and mental health and not reactive. If you do find yourself with an injury or set-back, however, it is also ok to take a step-back and reassess.
Many dancers overcome injuries and often come back stronger than before. Make sure you come up with a game plan with professional assistance to help you manage the things you are unable to do.
Injuries can be extremely tough mentally as well as physically. Do you have any words of wisdom for coping with injuries?
I think the biggest thing lacking for me, and I think for most dancers I work with, is the reassurance that you are going to be ok. Injuries happen. They are inevitable, no matter how hard we cross-train and do preventative self-care measures. Ballet is inherently unnatural movement, and it takes a huge toll on the body, both mentally and physically. How we cope with our injuries truly is what will guide you to overcoming these obstacles.
The field of sports and dance psychology is growing which is very exciting! I hope we can integrate this into the field as the norm moving forward. I am currently in therapy and working through a lot of the mental health toll from my prior dance injuries/surgeries as I write this, eight years after stopping dance!
So, help will always be there, even if it is a few years down the road. :)
What is one thing that you know now that you wish you knew as a young dancer?
Cross-training, cross-training, cross-training. In the sports physical therapy world, the biggest topic that’s discussed is not letting kids specialize in one sport early on. In dance, this is inevitable. But we can mitigate some of it with cross-training as the norm - even for kids.
Strength training will help you, and you will not “bulk up.” There are so many myths about strength training that sadly influence dancer perception on the activity. Dance class alone will not strengthen the muscles you need to survive a dance career. That needs to be reiterated over and over again!
I advise all dancers to cross-train in ways that they enjoy, making sure to train in parallel as much as possible. Dance class and performances alone will not allow your body to physiologically handle the demands of dance as we know it in this day and age, therefore, we must take the time to properly care for our bodies. A healthy amount of cross-training and having your injuries addressed by a provider specializing in your needs (MD, PT, etc.) will allow you to hopefully meet your long-term goals.
As a dancer in college and an aspiring Physical Therapist, what were some of the challenges you experienced along the way?
There were definitely challenges along the way, don’t get me wrong. At one point during college, I had applied to at least 100 different jobs (and that is not an exaggerated number), had really no money, and honestly not much on my resume outside of dance.
While dancing, I was also unlucky and experienced multiple injuries, with the most extensive resulting in hip surgery upon graduating college. But those injuries honestly helped me fall in love with the profession more and only strengthened by my drive to become a P.T. and extensively learn about the depth and breadth of knowledge surrounding hip anatomy and injuries in dancers. I consider myself a “pathological empathizer,” so I am selfishly obsessed with helping other dancers and patients who are dealing with many of the issues I sustained during and after my time dancing.
I was very lucky to meet my prior boss/professor, Dr. Kelly Johnson, my junior year of college, for whom I served as a physiology and anatomy teaching assistant for five semesters. This opportunity truly opened the doors for me professionally. It allowed me to get into the physical therapy schools I wanted to attend and taught me invaluable skills not only about physiology, but also about teaching, vulnerability, and professionalism very early in my career.
What makes your patient care different from a general Physical Therapist, especially when it comes to working with dancers?
I think the most important thing that makes me different as a Physical Therapist is the understanding of ballet and dance culture along with my obsession for finding “flow” in my work. This is what allows me to fully invest myself into working with a client. That last piece alone allows me to collaborate with dancers, personalize their care, find the root causes of the problems, and really experiment (and not feel guilty about failing) until we get the result we are trying to achieve.
Often, regardless of practitioner, it is easy to be complacent in the product provided or services performed. It’s sadly something seen with many physical therapists. This leads to lack of personalized care, which honestly is very detrimental to clients and dancers. I have always said, once I am ever bored or complacent with my work, I need to leave this field!
Is there an easy way for dancers to find Physical Therapists specializing in dance medicine where they live?
Word of mouth, Google, and asking your dance instructors about providers they know or have worked with in the past are great starting points. I would also check out the International Association for Dance Medicine & Science practitioner directory page, and you should be able to find someone in your area.
There are also a lot of free resources for those without insurance in most major cities! Make sure you research those opportunities, because they do exist for those in need!