A Look at Serious Injury from the Inside Out

Photo Credit: Amanda Tipton. 2014.

Photo Credit: Amanda Tipton. 2014.

Pilates calls to all of us with a different siren song. For the lucky ones, we hear it many times over during moments of hardship, change, and reinvention in our lives. I first discovered my practice as a young ballerina at the School of American Ballet, the elite training ground for the New York City Ballet. I devoured the movement as a way to cross train and encourage the length and strength that my idols showcased onstage; to this day I attribute several of my seemingly natural gifts to simply falling into Pilates at a pivotal developmental stage in my career. I dove deeper into my practice during my undergraduate work at Indiana University under former dancer and Lotus Pilates Studio owner Corinna Cosentino, and began studying for my PMA certification while performing and earning my degrees. The University also provided a program within their School of Public Health that offered a STOTT Pilates mat qualification upon completion. As that course could simultaneously apply towards my Bachelor of Science in Ballet Performance, I soaked up the experience of learning more about the movement with students who weren’t dancers themselves: an incredibly valuable lesson. It was a thrilling moment in time where I was allowed to pursue a passion in Pilates that also embellished all the physical aspects of my future careers, and I was all in. After three and a half years in Indiana, I began the taxing process of auditioning across the country for a coveted role in a company and hoped for the chance to perform professionally. The moment I auditioned and received my contract to dance with Ballet Nouveau Colorado (now Wonderbound), I scoured the Denver area for Pilates studios that would allow me to teach during my season. The time to put all my preparation into action had finally arrived, and I was eager to define my role in the dance world.

Once in Colorado, I poured myself into my art and relished the success of actually earning a living while doing the two things I loved: dancing and teaching. Knowing that the artistic freedom and nurturing environment my artistic directors’ offered was a gift that few artists enjoy, I performed through injuries and past comfort zones because I didn’t want to miss a moment. And that committed passion thrilled me! Due to Ballet Nouveau Colorado’s intense season, I began teaching both ballet and Pilates to students and adults with the company’s affiliated school (now known as Colorado Conservatory of Dance). In 2010, I began working with Mary Jo Tyman of Elixir Pilates in Denver and have continued with the organization ever since, growing in her client-focused environment.

The First Signs of Something Terribly Wrong

Five years into my career, I found that my body wasn’t rebounding the way it once did. Suddenly my long days of dancing followed by long nights of teaching were brutally painful, and my hyper-mobile hips were shifting in and out of place at an alarming rate. Blaming the intense season schedule and new (to me), contemporary choreography that pushed my limits, I pressed through the sharp pain and dismissed the warning signs. When my hip and back throbbed more than usual, I would check in with the company’s doctor and head to the physical therapist with a fresh label: severe inflammation, SI joint instability, bursitis of the hip, old age. While I was twenty-eight at the time, my body had been through the rigors of classical and contemporary ballet for twenty-one years. It is not uncommon for females to retire in their early thirties due to persistent injuries and fatigue. Despite my best efforts, my pain continued to simmer and I began to dread the boiling point.

As both a professional athlete and professional instructor, the knowledge of the body, of MY body, helped me to recognize that I was being misdiagnosed. But defeat was starting to permeate my practice and my dancing. I was willing my body into movement, riding my adrenaline rush to perform above the pain, but even I knew that I could trick myself for only so long before reality set in.

And then, one ordinary afternoon nearly three years after my hip pain began, my left side gave out while I tried to lift my three-year-old nephew. Amidst the chatter around me of “You have to be careful around Aunt Meredith’s hip” and “You can’t hug her too hard,” I made a choice. I decided to dance for one more season, and then I would listen to my body and force myself to retire. All the PT and Pilates in the world couldn’t fix what was wrong, so I would begin my transition to a teacher, a mother, and a second career outside of the arts. I was starting to fear that my fearlessness as a performer would cost me much more than my dancing: that this permanent damage to my body would change the possibilities for the rest of my life.

Grieving Through My "Last" Year as a Dancer

Once my decision was made, I found that instead of making every moment in the studio count, my spirit was withdrawn and defeated. My heart couldn’t accommodate my head’s logic, and I was bitter that my life’s choices were insurmountably controlled by the bones I was born with and not the strength I had fine-tuned. I was losing control, and knew that without that edge my technique and ultimately my roles for the season would suffer. Ever the perfectionist, I was determined to finish my career at a dizzying height of accomplishment.

At the close of my seventh season, I went to a final doctor’s visit and received my official diagnosis. Through an arthrogram MRI, recommended almost as an afterthought, the technician reported several significant labral tears in my left hip, and through comparative MRI’s and X-rays of the sight suspected bone impingements on the femoral head and acetabular cup. This definitive answer gave me hope because now my injury had a name. And once defined, there could be a solution.

I rushed to make appointments with the top Denver surgeons, eager to establish a quick surgery date over the company’s offseason and be back in full form in time for the 2012-2013 season. The first round of recommended surgeons each dashed my newfound hope. The first took one look at the films and said I would never dance again after a surgery of this magnitude. The other quipped that he didn’t know how I managed to walk into his office with a tear that large and said that in all likelihood, I had probably just performed my last ballet. I remember sitting in the hospital parking lot, unable to process how a supposed caregiver could so callously disregard my life’s work. It was an hour before I could begin to drive myself home, and it felt like the grief process had begun anew.

I was bereft. There is no other way to describe the pain except to say that I was grieving the loss of the person that I had always been. A dancer. I scoured the internet for dancers who had come back from this sort of surgery and grilled former classmates for insight. There are, in fact, an increasing number of dancers who have been diagnosed with labral tears that manage their pain levels with the help of injections, adjustments, or yoga and perform with limited discomfort. But enough time had passed and my quality of life was so significantly altered by my injury that I knew I had exhausted the alternatives. Still, I held on to the chance that my final appointment, a consultation with Dr. Brian White, would offer something more.

From the moment I shared my injury and my obvious passion for my career with Dr. White, I had a supporter in my surgeon. He poured over my case and assured me that he would shave down the bone impingements, smoothing them to prevent future tears, and replace my labrum with a cadaver IT band, fashioned to fit my hip socket to perfection. He promised to give me a new hip if I would give him the chance, and there was no doubt in his mind that I would rehabilitate and perform again. Within hours, I was scheduled for surgery.

Post-Op in a Foreign Body

I lay submerged under a steady diet of pain medicine, sedated and blissfully unaware that I was in a foreign body. Then, I tried to move. The first attempt to sit up in bed sent me reeling as I tried to separate my left hip flexor from my abdominals. But my muscles stubbornly refused to listen and obey, their first sign of post-op rebellion in a steady stream of disobedience that would follow me throughout the next 14 months. This was the dreaded disconnect from my body that I had heard about: the reluctance to activate, the loss of control, and the overall despair of starting at ground zero. And it hit me much harder than I thought it would. As an athlete, I had defined myself as a dancer for over two decades and utilized the precision of a surgeon over each muscle and bone in my body. That tight-reigned control was what allowed me to execute the most difficult two-hour ballets with ease. Suddenly, a small task like tying my shoes became an exhausting ordeal that left me shaky and light headed. I began the process of not only re-learning how to walk but how to control my muscles and make them my own once more.

Becoming the Student Again

I had been lucky enough to establish a relationship with my physical therapist, Lori Snow of Alpha Rehabilitation, long before my final diagnosis. She and I had been working on an overall equality of my body as my doctors bounced from ailment to ailment. I was also lucky enough to find a therapist who, in addition to loving Pilates as a means to rehabilitation, also loved my ballet company and came to every performance in order to know the extremes my choreography demanded of my instrument. Lori was a constant support system. She was there during the years of pushing through pain, problem solving and creatively integrating Pilates into our therapy. She was by my side for all six and a half hours of surgery, watching Dr. White’s every meticulous cut, shape and suture. She was the first person to see me after I was discharged, assuring me that I wouldn’t re-injure myself on that first stationary bike ride. Inevitably, my most poignant memory with Lori was the first day I was allowed back on the reformer. Setting my crutch aside and carefully navigating myself onto the carriage, I felt the tears well up as I felt the smooth leather welcome me home. And I cried throughout my foot series, feeling each press bringing me closer to the person I once was.

My desire to dance never stopped, even in sleep. With my entire left leg strapped to a machine and wrapped in a sleeve of ice, I would dream of flying through the air and performing my favorite roles. The anticipation in the wings, the last minute corrections from directors, the elation at the applause: I had that familiar rush almost every night.

Without a doubt, waking from those dreams strengthened my determination to practice rolling onto my stomach each morning. Yes, I was a movement teacher and professional athlete who now had to practice rolling over.

I acknowledged each small improvement, but in my mind I was willing my scars to heal and going through a technique class in my head. I visualized myself onstage to keep my body from giving up, and to this day I feel like that was one of the strongest exercises I took away from my experience.

The process of becoming a dancer again was painfully slow and viciously long; once my labrum was replaced, I was confident that my high threshold of pain would keep me progressing at lightning speed. My mind swam with visions of an awestruck surgeon watching me perform mere months after surgery, with every naysayer who doubted my comeback swallowing their bitter words. Once again, my dreams didn’t align with my reality. For three and a half months, my major hurdle was to walk without crutches and roll smoothly from heel to toe. A movement that I had once done without thought now demanded every bit of attention and tenacity once reserved for the most complex of choreography. But eventually, I gave myself loose guidelines to track my progress, moving through the practiced sequences of a classical ballet barre, rediscovering the fundamentals that I learned along with my alphabet. Then I adjusted those expectations. I gave myself credit for what I achieved, even if it was a fleeting first position. Every day since my surgery, I’ve been forced to allow myself to be less than ideal. A hard pill to swallow, certainly, but I knew that although my body had changed, my grit had only hardened. With this thought in mind I’m drawn back to the beauty of Pilates, because the ideals we set for ourselves in Joseph Pilates’ Teaser series, for example, are in fact well beyond what he himself could execute. The pursuit of perfection is lovely, but there are times when something far more beautiful will emerge out of the struggle. Something that is uniquely yours and surpasses whatever the textbook definition might have been.

Comebacks Don’t Feel Like They Look in the Movies

August 2013 marked my return as a full time company dancer with my colleagues, and I have since performed in three full-length productions. Our forty-hour work weeks demand our best, our constant dedication in mind and body and soul, and while I couldn’t be more exhausted I couldn’t be happier. Comebacks are never easy, but they are so, so worthwhile. And every time I dance I am moving proof of the power of tenacious human spirit. I willed myself back to ballet.

Yet I am still regaining ownership, and at times I still feel my body grow restless and as if it will never listen to reason. So I breathe in through my nose, and out through my mouth, and I give my body permission to feel less than stellar. I love it into submission, and I allow a sort of democracy to rule rather than the harsh dictatorship of my past. And while aches and pains and frustrations will forever play a role in the landscape of a professional dancer, I remind myself of how far I’ve come and how much more I have to give. Every moment I get to spend moving is a moment I fought so hard to reclaim, and I’m not going to waste a second of it.

My Lessons as a Teacher

I kept a series of journals in my social media accounts, chronicling my journey and commemorating my stepping stones, and I’ve found that as the trauma heals and the pain lessens, I need to look back at my process to remember my lessons. My rehabilitation has taught me patience, understanding, and the subtle art of pacing. After my surgery, I had a whole new appreciation for clients dealing with crutches and walking issues. As teachers, we have all encountered clients who allow pain to draw the boundaries of their world and their movement. The subsequent stages of frustration, anger and begrudging acceptance of their own limitations filter into their practice; these are our chances to step in and redirect their class into an avenue of success rather than failure. Because a serious injury is rough not only on the body but also on our internal worth structure. Despite a career filled with many other interest and pursuits, I felt empty and useless without my definitive “dancer” and “Pilates instructor” status. Obviously each person is different, so listen to their cues and facial expressions to find out how far their pain is spreading into their mind, body and spirit. After experiencing the loss of career opportunities firsthand, I found that I am more open to asking clients how they feel about an injury rather than simply their physical symptoms. If I can help them find a modification to a favorite exercise, I’m giving them a piece of their former self back and hopefully keeping the debilitating despair out of the room. More often than not, I found that I was just looking for a healthy way to move and work determinedly. I found comfort in pulling back from my normal extremes to focus on fundamentals, resulting in less pain and a fine tuned awareness to my internal structure. Even now, I force myself to pause at the threshold of discomfort and intelligently analyze the exercise or combination. Will this stubborn moment of perseverance cost me in the long run? Can I achieve something even more important by choosing the beginner variation? Above all, encourage your injured client to establish a support team of specialists that can work towards one committed goal: healing all of you. I trusted my massage therapist to gently work my overworked body, and I had my guided meditation group to help me visualize my healing and to love me as a person, not as a dancer. I had my surgeon, my workers compensation doctor, my physical therapist, and even my crochet club. Injury can be extremely isolating, so a reminder that he or she has a community to rely upon can be a comfort within the trauma of the unknown. But perhaps more importantly, try to imbue the path to rehabilitation with hope. The positivity and light of a better future with brighter possibilities still resonates with me today because I have found a deeper gratitude for each moment I’m allowed to do what I love. And while the path was never easy, I listened to the advice around me and pushed on. Above all else, I’ve gained faith in the power of me, and I strive to bring that into every class I teach.

Originally published at pilatesmethodalliance.org.

Meredith recounts the difficult and lengthy process of recovering from a potentially career-ending injury.

UncategorizedSamuel Pike