Broken Bones, Healing Hands

panta rei dans lullaby

Video - Panta Rei Danseteater 'Lullaby'

Norwegian dance company Panta Rei Danseteater, late last year, conducted a little experiment whereby three dance makers created two pieces with the same name based on the same idea, featuring three male dancers and two musicians, to see what the outcome was.

June 2nd, 2016

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by Michelle Lefevre

If a professional dancer makes just one wrong move in class, in rehearsal or on stage it could, literally, be the end of their career. Feeling a crack in an ankle joint, twisting a knee or experiencing a sharp pain in the lower back along with a multitude of other injuries are all things dancers dread more than anything else. Injury brings even greater fear, uncertainty and doubt into a profession where job security is a joke.

Next to pay levels and actually having a job, the treatment and prevention of injuries are the biggest single problem faced by dancers in todays professional dance world.

It's not that the injury's suffered by dancers are impossible to fix. The problems arise because dancers in the UK have little or no access to treatment for those injuries. Local GP's have little knowledge or interest in treating broken dancers and even if they do make a referral to a physiotherapist or a clinical specialist it could, and usually does, take months to get an appointment.

The National Health Service (NHS) is slow to react, most small to mid-scale companies lack the resources to provide comprehensive healthcare and independent dancers and choreographers face the same problem.

A document released by DanceUK and presented to the DCMS Dance Forum entitled "Provision of dance medicine and science support services" outlines the staggering cost involved for a dancer if they have to pay for their own treatment when they suffer a serious injury.

Recovering from a ruptured achilles tendon, taking into account all of the required scans, operations and recovery time runs to a colossal £10,970. Ask yourself how many professional dancers have that kind of money lying around? The obvious answer would be private medical insurance but even that runs to approximately £700 per year and very few dancers can afford even that amount of money. According to DanceUK just 7% of contemporary dancers have medical insurance.

Dancers will, more often than not, muddle through with the small amount of treatment they can afford or whatever is provided for them, if they're lucky, by their dance company. In many cases the dancer is not properly recovered by the time they have to go back to work and there is a definite risk of their injury becoming chronic.

Quick Facts
A study found that 83% of dancers have suffered some form of injury within a twelve month period compared to just 16% for rugby players.

Only 7% of professional contemporary dancers have health insurance.

Recovering from a serious injury could cost as much as £10,000.

£400,000 is the approximate amount needed to provide comprehensive health care to 830 professional dancers.

£388,000 will pay for the "Dancers’ Health Pilot Scheme".

100 dancers will benefit directly from the Health Pilot project.

Pilot project will collate all of their research information onto an online database.

DanceUK is recommending that all ACE funded dance activity carries a health care provision before it is accepted.

Pushing Back

In an attempt to counter this dismal outlook DanceUK and Laban are currently mounting a multi pronged attack to restore the balance and give professional dancers some decent health care options.

By far the most complex plan is to establish, what DanceUK are calling, "The National Centre for Dance Health and Performance". Far from being a single facility with limited access they are hoping to create smaller facilities or "hubs" across the country that, according to their own published materials, will;

"Provide the infrastructure for experienced multidisciplinary teams of dance medicine and science professionals to be accessed by all professional dancers, ensuring timely and affordable access for these dancers to the high standard of care necessary to maintain their health, fitness and performance."

To kick start the project and test its feasibility a pilot programme entitled "Dancers’ Health Pilot Scheme" is under development. The project not only provides comprehensive research on the nature and frequency of dancer's injuries and how best to treat/prevent those injuries but will also, over two years, give 100 dancers access to comprehensive medical insurance.

In the first year of the program 50 dancers will be provided with health insurance. All of their injury issues will be dealt with through private health care providers. As dancers become injured and are subsequently treated for those injuries a medical officer and physiotherapist, along with medical research assistants employed by the project, will collate and analyse the data. Both the Jerwood Centre based at Birmingham Royal Ballet and the Olympic Medical Institute will be taking part to provide facilities and expertise.

Instant Feedback

As well as providing instant feedback to the dancers and their companies about the specifics of their particular injury and how best to prevent them in future (if possible), the data will also be available online for the duration of the pilot project although for privacy reasons access to the data will be restricted to participants. There is also the very real benefit of dancers having comprehensive medical cover, even if it is only for two years to begin with.

Choosing who will participate in the pilot is a tricky process. The health insurance provision is obviously of great benefit to a large number of professional dancers. DanceUK's Helen Laws explains;

"What we will need to do is choose a whole company of dancers because if you just allow a few from each you won't get a realistic picture of what the [injury] trends might be for that company working in that environment.

If you start picking and choosing dancers from different companies then A: It might be only the most injury prone dancers that go on [the program] which would skew the statistics and B: Yes you would get a general overview but you wouldn't get as much usefull information. By doing it with companies you can extrapolate the information to other, similar companies, but also, you can provide valuable real-time information that will be of use to that company."

The entire cost of the pilot project is calculated at £388,000. Interestingly, DanceUK has calculated the cost of providing comprehensive health insurance, under the British Olympic Association's health insurance program, at just £400,000 for 830 dancers. To put it another way, the cost of Dance East's new building in Ipswich would pay for dancers health care for 20 years.

Ms Laws has also negotiated access to the British Olympic Association's (BOA) "Athlete Medical Scheme" for elite athletes that provides health cover for as little as £470 per year.

In addition to the "Dancers’ Health Pilot Scheme" a smaller scale pilot project will see some dance companies take advantage of that access so they will be able to provide full health cover to their dancers.

So far Phoenix Dance Company have signed up to participate in the project with, hopefully, more companies to follow. Since the company will have to pay for the insurance on this particular project, participation will be dependent on the funding available to each individual company.

More Options

Not content with the two pilot schemes DanceUK and Laban are also proposing that professional dancers, without medical insurance, should be able to "self-refer" to appropriate injury specialists following an initial visit to a GP using a list of specialists held by DanceUK and the BOA. Such a scheme would significantly cut the amount of time it would take for a dancer to receive treatment for their injury.

A further plan is to incorporate health care provision into all funding applications associated with dance that are made to Arts Council England. Although such a proposal would not give dancers comprehensive health care it would ensure the dance makers had taken injury treatment and recovery into account when planning their projects.

Roadblocks

One particular obstacle to the development of the project is the existence of the NHS itself. UK citizens are entitled to universal health care coverage via the NHS and this of course includes professional dancers. There may be resistance from government departments, like the Department for Culture Media and Sport (DCMS), when asked to endorse and ultimately fund a project that readily admits the NHS cannot cope with the particular, specialist needs of dancers.

Emma Redding, Project Leader of the MSC Dance Science at Laban told us;

"I think the statistics [speak] for themselves. [The Government] are behind sports and sports science and dancers get injured just as much or more often than athletes and they get money from the government for treatment (via the Lottery) so why not dancers?

The interesting thing is the Arts Council give money to professional dance companies and a lot of the companies are project based so they don't employ their dancers all year round.

They get given money and the choreographer can do what they want with that money. So, the choreographer often says [to the dancers] right I'm going to work for three month, this is your salary for [those] three months. There's no contingency in there [for] health care, physiotherapy and all the rest, this is my understanding.

There's no extra money for treatment but there's also no money after the performances have finished for a one week rest period. So that freelance dancer has to go straight into another job, there's no rest time. Fatigue is the biggest cause of injury in dance. So something the Arts Council have a responsibility to do, if they're shelling out all of this money for wonderful art. Surely what they should stipulate in the criteria to the choreographers is that they should put some money to one side for health care."

The DCMS declined to comment when asked about the issue.

Real Benefit

One of the most striking things about this list of proposals by DanceUK and Laban is the actual real world benefit to professional dancers. So often in dance we are used to fairly benign projects (like the DCMS Dance Forum itself) that offer a lot of talk but little action.

Should the pilot health care project and The National Centre for Dance Health and Performance in full ever take flight then professional dancers would finally be recognised as the highly skilled professionals that they are and receive the highest levels of medical care they deserve to enable them to continue their careers firing on all cylinders.

The recent cuts to the Grants for the Arts program of almost £30million have made realising these ambitions all the more difficult. We'll keep you up to date.

[ DanceUK Proposal Document PDF ]
[ DanceUK Website ]
[ Laban ]

[ image by Konstantinos Kokkinis ]

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