This is so difficult

[Spacy]

My DD has been injured since April. She has been diagnosed with inflammation of the ankle bone (posterior talar process) following an MRI scan. She is wanting to audition this year for vocational school but has been unable to do pointe work or jumping and has had other limitations for nearly six months now and the injury has not been improving despite the restrictions.

Following an appointment with a dance specialist doctor my daughter has been advised that she will need surgery if she wants to pursue a career in ballet. They advice her to  have a steroid injection first and then surgery at a later date. DD has seen London dance physio whose initial reaction was she doesn't like steroid injections although she did say that DD would probably need an operation eventually. DD associate teacher also expressed alarm at injection and surgery.

If DD has injection she may be able to do auditions next year although obviously she is not going to be at her best, she has been  advised that she will not do any further damage but it will probably still hurt, with the injection masking the pain!

Is she was fortunate enough to gain a vocational  place she would probably need surgery in the summer which takes 4-6 months to recover from!

It is so difficult to know what she should do, although she wants to audition and says if she doesn't go at 16 it will be too late. What with 11 GCSE s and mocks early next year I do worry about the stress of all this. Any advice or opinions would be greatly appreciated.

[Harwel]

You have my greatest sympathy. This is a horrible dilema. I can give you my thoughts as a previously professionally trained ballet dancer who had to stop at the end of vocational training due to injury.

 

My thoughts are that pain is present in the body for a reason. A steroid injection that masks pain is therefore a bad idea, I believe untold damage can be done this way. I was given advice by a top Harley street dance Physio many years ago which I followed, and many years later when training as a Pilates teacher, discovered that that very advice was a massive contributing factor to my non recovery!

 

If this had happened to my child I would strongly suggest they get the operation done, sooner rather than later, if this is going to have to be done. Concentrate on GCSEs, rehab the ankle thoroughly and then audition a year later. If she gets the operation done immediately prior to full time training, she will be under pressure to do more than she should and could lose the best part of the first year. That is no way to start a very strenuous training programme.

 

I know she will be massively disappointed and I'm sure she believes 17 is too late. It is not. This is a very serious reason for the delay and I believe would give her the best chance, otherwise she could be lurching from one crisis to another.

 

I wish you both the very best of luck.

[2dancersmum]

your poor DD. You both have my sympathy.

All I can say is 16 is not too late. I am sure she will be better placed to do her vocational auditions and training once she has recovered. If she is not at her best it may affect her chances of getting a place at vocational school in the first place, and of course you do not want her vocational training compromised if she gets a place and then has to miss classes. Long term aim a career in ballet - take the time out to get physically ready rather than struggling through and never being able to give 100%

 

Wish you all the luck in the world for getting your DD better.

[JulieW]

I can empathise too having had a dancing son needing surgery and seeing others go through it too.  I agree with Harwel - get the operation done asap (although realistically this probably means after GCSEs unless she could have the op in a school holiday and get back to the school on crutches without missing lessons) - if it's going to have to be done you want it done and recovered from before taking training any further.

 

Good luck.

[Thecatsmother]

That sounds really tough. I would also urge caution with cortisone injections as one year on I am still suffering from a bad reaction to these. My thoughts are perhaps upon seeking advice to get the injury sorted properly even if this requires surgery. Better to have one period off to recover than start and have to stop mid training. She could audition a year later once the injury more under control but having said that you know the context best. Cortisone is by no means a cure so tackling the route cause seems the best course of action.

[Circe]

Sorry to hear about your dd's situation Spacy.  A girl at my dd's dance school was injured and unable to audition in Year 11 and is now intending to apply in Year 12 so there are always likely to be other 17 year olds applying.

[Spacy]

Thanks for your replies. I was led to believe that with this type of injury they like to do a steroid injection before surgery as it confirms the diagnosis if it gives relief. also that in some situations the injury can improve without the need for an operation.

I refused for my daughter to have this done a local surgeon. we have just seem Dr Wolman who I understand specialises in dance injuries. I don't think they will do an operation without the injection first.

[Anjuli_Bai]

My experience is that cortisone therapy is problematic for the many reasons stated above.

 

The first priority is the thorough healing of the injury and if surgery is indicated - so be it.  Unless healing - true healing is the first priority - all else is null and void, if not immediately, then eventually.  

 

An injured foot/ankle cannot be asked to take on the heavy load of dance - especially since dancet often uses the foot in ways in which it was not meant to be used - such as pointe work, turnout, jumping and rotating.  Thus, it is extremely important that one start from a solid base with a healthy happy foot.

 

The bottom line is that the body will win - it requires healing - and if that bottom line is not served - the consequences are not only pain but the condition becomes chronic.  One cannot argue with the body's requirements.

 

I wish your daughter every success and a swift and complete recovery.

[LinMM]

Wishing your daughter well and a resolving of the problem soon.....but I think some pretty expert advice has already been given above.

 

Is there any idea of why there is inflammation of the bone......has it been caused by dancing? Is it some old injury playing up? It's not in any way connected to arthritis is it?

 

I do sympathise as Ive also had a somewhat recalcitrant ankle injury ........from last February ......and there is no hurrying it in the end......and I do believe one should only mask the pain in extreme situations or some really long term chronic condition.

 

I was about to go to the NHS for a second opinion when it suddenly started to improve after about four months of rest!! It is now improving by the week and I had begone to feel it was a permanent injury!! It will still be another couple of months before it's "back to normal" .......or as normal as it will ever be probably!!

 

However it is much harder for younger people to cope with these longish term recovery periods and in a peak year too. So lots of sympathy from me.

I think Harwel has given really great advice viz a viz exams etc too.

[Stitch]

Spacy, you stated, "My DD has been injured since April."  Can you explain how your daughter was injured?

Additionally, I'm curious as to how surgery can help inflammation.  Did anyone explain that to you?

[drdance]

Dr Wolman is one of the best - I would trust his advice. If he recommends a cortisone injection first then go with it but ensure adequate rest. Sometimes these do help (otherwise orthopaedists would've stopped using them a long time ago). The surgery itself is fairly simple and can be done quickly, the start of a 2 week holiday period would be ideal - but the rehab takes time and needs care. If you use one of the NIDMS dance medicine facilities then you'll ensure your DD gets good dance specific physio and full rehab back to a decent level but it takes a while. Auditions for vocational schools are too soon, and your DD won't be back to full strength for the auditions if you had the surgery tomorrow. If she got into a school/ college it would be hard work to get ready for the start of next academic year if you had the surgery at Easter.

[Spacy]

Although it is an injury/inflammation  to the bone posterior talus process to be exact I think the bone is sharp (not the extra bone os trigonum) but the shape of the structure is causing it. My understanding is that even if this was to heal it would probably happen again. DD also had a huge growth spurt in the past year and is 5 foot 9 now.

[tabitha]

I really sympathise with you Spacy as my DD was recovering from injury during auditions and couldn't jump or do pointe. We explained the situation and the schools were very understanding.

 

I wouldn't worry about delaying a year. I know some students who have been accepted at vocational schools for 6th form and incurred an injury which meant that they missed most of the year and so ended up repeating the year. Better to get things sorted out.

[Stitch]

I was led to believe that with this type of injury they like to do a steroid injection before surgery as it confirms the diagnosis if it gives relief.

If the purpose of the injection is not to mask the pain, but rather to confirm the diagnosis, then that sounds like a sensible first step.  It seems to me that passing over that recommended first step and going straight into surgery would be unwise.  Afer all, there are risks associated with surgery such as general anesthesia and  possible infection. 

[Spacy]

Dr Dance, I did feel that Dr Wolman was probably one of the most experienced people we could see. I think my DD is hoping a steroid injection will get her through auditions and yes maybe surgery at Easter. I agree it all sounds very difficult . She has been told she can do as much as the discomfort allows and will not do any further damage. I just wish someone could say this is what you MUST do ( as long as that was the correct advice of course)

[Ecarte]

Just a thought but have you looked at http://www.danceagain.org ? They may be able to help/advise? Good luck

[HAIRBELLES]

Hi Spacy I can empathise with your situation wholeheartedly ..... This summer little dd broke her leg badly in 2 places , luckily for her she narrowly escaped having it plated and pinned back together. She has been unable to return to her Vocational school ,missed all her summer schools and I have had to cancelled dance forward at half term and ENB . By the time she is able to return fully to dance she will have missed nearly a year of training which brings us up to auditions for 6th form.

I agree with Ecarte , I contacted The dance again foundation and had a lovely reply from Celia Widdoson who said they don't normally deal with under 16s but she would send me some questions to ask post plaster removal . They may give you some valuable pre -op advice.

Besides physio we have gathered support for her rehab back into dance so she doesn't do any further damage to muscles etc.

As for the auditions , we have turned this setback into a positive ,after having such a long time off she will probably leave auditioning until later so she can concentrate on her GCSEs without the added stress. By putting a plan into place has also stopped me worrying about her immediate future .

One of my concerns if auditioning injured would be the if the physio check, others who have been through the Ballet 6th form process will have more knowledge if this would have a negative effect on gaining a place .

As usual some very good advice from everyone , wishing your dd a speedy recovery !!

[2dancersmum]

All the best to your DD too Hairbelles for a good and speedy recovery. I am sure with the right support and physio she will come back as strong as ever. DDs friend was younger than your DD when she broke her leg - shin bone broke badly in 2 places. She had a tendency to favour the uninjured leg for a good 3 months after she was back to dance, a bad habit to break - but she had no physio and only danced a couple of times a week at that point. She is now doing vocational training.

[Harwel]

This is why it's so difficult. There is no one who can say this is what you 'must' do. All you can do is gather as much information as you can, and make the most informed decision possible. You can do no more. You are the one with all the information at your fingertips, you have to follow your heart.

[HAIRBELLES]

Thankyou so much for that 2dancersmum very reassuring to hear others have been through the same thing with no adverse affects to their training !

[Spacy]

Thanks you for your response Hairbelles.

 

It sounds like your DD  has been very unlucky and had such a difficult time, I feel for you both  I wish your daughter a speedy and full recovery and hope she is able to continue with her training in the near future

 

I am sure we will look back on this all one day and it will just be a blip in the rich tapestry of life. When going through it with your child it is difficult to keep it all in perspective.

[Tutucute24]

Wishing your daughter a speedy recovery Hairbelles x

[HAIRBELLES]

Thanks for the good wishes ladies x

[victoriapage]

I know of a dancer who fractured his lower leg in mid-career, had a steel rod placed into the middle of the bone and spent about 10 months recovering and was quite brilliant still afterward. It can be done! (though carefully).

[Lisa O`Brien]

Very best wishes for your DD`s recovery,Hairbelles.

[HAIRBELLES]

Thankyou thequays ....... Victoriapage it's good to hear of dancers still able to have a successful career after such a serious op .

[Jan McNulty]

I've come across this article about a Boston Ballet soloist coming back from a bad injury:

 

http://www.thevermontstandard.com/2014/09/barnard-ballet-dancer-back-from-devastating-injury/

[HAIRBELLES]

Thankyou for posting Janet , what an inspirational article.

Dd is a reticent ballet dancer, and I've questioned on more than one occasion ,wether striving for a career in ballet was for her.

When in hospital waiting for her op ,she announced her 'life was over' if she didn't dance I felt this was a turning point , excuse the pun .

I have been told a few times that the dancer can come back stronger than before .

She has a renewed determination so hopefully she can too.

[Picturesinthefirelight]

Fingers crossed for your dd. a renewed determination is hopefully just what she needs.

[HAIRBELLES]

Thanks Pictures ! .....Sorry Spacy I feel like I've somewhat hijacked your thread ..... Please keep me posted on what advice you get and what route to recovery you decide on for your dd .

[victoriapage]

Hairbelles I know of a Boston Ballet principal who tore her Achilles tendon in the middle of a diagonal of jetes across the stage - of course being in Boston is a coincidence only as we're speaking of things that have happened over a number of years. Boston is lucky to have an incredible Sports Medicine department a local hospital that also specializes in ballet. They were focused on getting the dancer back on stage if that is what they wanted, and didn't spend time trying to convince them not to!

Edited September 22, 2014 by victoriapage

[straighttothepointe]

My daughter had a very similar problem with her ankle. We also saw Dr Wolman who advised the cortisone jabs plus physiotherapy. Unfortunately this was insufficient to help her get over her situation and eventually surgery was necessary. This was done by an associate of Dr Wolman, Mr Nick Cullen. Both Dr's were marvellous and it so helped that they fully understood the demands placed on the joints of someone wishing to be a professional dancer, not always the case with some of the doctors we saw initially. Its been a bit of journey from prognosis in my daughters 1st year of 16+ vocational school to where we are now but she has come through this a much more resilient person emotionally. I wish you the very best with whatever route you go down.

[Anna C]

Welcome to the forum, straighttothepointe. :-)