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It’s well known that sports-related injuries can devastate athletes’ careers as well as their bodies. When a famous athlete is felled by an injury, the story is likely to receive considerable publicity. But less publicized are the equally grave struggles faced by performers to maintain their health and rehabilitate their bodies following performance-related injuries. Performing artists dance, sing, and make music with a grace and ease that belies the strain that such activities can place on the body. In reality, performers are constantly engaged in a battle against injuries and pain that could separate them from what they love: their art.

Fortunately, artists do not have to engage in this struggle on their own. In the industry of performance-related rehabilitation, specialists work not only to help heal artists but also to prevent injury in the first place. Student performers at Harvard who treat their craft as seriously as athletes treat their sports have had to cope with a wide variety of injuries and learn how to treat their bodies in order to protect against future damage. Meanwhile, doctors at the nearby Harvard-affiliated Spaulding Rehabilitation Hospital are working to revolutionize performance-related injury rehab. While the specifics of different performers’ stories vary widely, the stress on knowing the right way to practice your craft is consistent. For those seeking a life-long career in performance, proper form and technical foundation are imperative to staying healthy. How to realize this imperative is far from obvious.

A DANGEROUS DANCE

Ileana C. Riveron ’17 never planned on applying to college. A member of the Royal Dance Company in London from 2008 to 2011 and of the Boston Ballet from 2011 to 2013, Riveron had an established career as a dancer.  However, 17 years of dancing (12 of them en pointe) had a devastating effect on the young dancer’s feet. The thought of rehearsal began to bring tears to Riveron’s eyes; even walking caused her considerable pain. Riveron’s story is not a unique one in the ballet community. Recalling her days as a member of a professional dance company, Riveron describes an environment where pain was the norm. “Everyone is in quite a bit of pain at all times,” Riveron says. “The [physical therapy] room is always jam-packed full of dancers.”

When her feet did not recover after two months off from dancing for a broken wrist, Riveron was diagnosed with degenerative joint disease. Her doctors told her that she would likely never be able to dance again and that she should told start looking for a new career. “It was heartbreaking,” she says.

Riveron did not take the news lying down. Even before the doctors’ devastating prognosis, she had begun an intensive rehabilitation program that incorporated a spate of treatments. “I started getting ultrasounds done on my feet every day, [and] stem treatments, which is like electroshock therapy for your feet,” Riveron says. “I got injections a couple of months later…for two years I was on hardcore painkillers.”

It was while Riveron was engaged in her rehabilitation regimen that she made the decision to apply to Harvard. Because it led her to pursuing an undergraduate education as opposed to embarking on a professional career straight out of high school, Riveron has come to view her injuries as a blessing in disguise. “I will always love dance, but I’m so happy I’m here,” she says.

Though Riveron will never dance professionally again, rehabilitative treatments have enabled her to recover enough to dance in a non-professional context. After matriculating at Harvard, Riveron joined the Harvard Ballet Company. Since returning to dancing, she has adopted habits that combat the possibility of future injury. “I know now that I could’ve prevented how bad my feet got,” she says. “[Now] I tape them a special way, and they don’t bother me unless I push too hard and do things I shouldn’t.”

INSTRUMENTAL STRESS

Whereas a ballet dancer’s struggle may stem from too many hours en pointe, instrumentalists are a class of performers instructed to keep their feet planted firmly on the ground. But this difference in podiatric orientation does not exempt musicians from doing battle with performance-related injuries. Gabriela D.M. Ruiz-Colon ’16 didn’t start playing cello until high school. Determined to catch up to the level of her peers, she spent two hours every morning practicing her instrument.  “It was a very intense regimen and very physically demanding,” Ruiz-Colon says. “I developed tendonitis on my right and left hand…just from playing too much…. It was one of the sharpest pains [I’ve] ever [experienced].”

Ruiz-Colon’s condition forced her to cut back in her practice time and ultimately take a break from cello. It also led her to work with a teacher to develop recovery strategies, including many elaborate hand stretches. “As a musician, I wasn’t really aware that [stretching] was a thing you had to do because at orchestra concerts you see this virtuoso that plays so gracefully,” she says. “But you don’t really see all the stuff that happens behind the scenes. It’s not just the practicing, but making sure that your hand muscles are well.”

By pacing her practices and maintaining her stretching regimen, Ruiz-Colon regained the ability to play cello. Like Riveron, her experiences with injury taught her to be mindful of her body in her approach to musicianship. “It’s like how you can’t become a runner and just start running a marathon,” she says. “I had to build up stamina.” Although she is currently taking a semester off due to a busy schedule, Ruiz-Colon has continued playing cello at Harvard with the River Charles Ensemble and in pit orchestras.

Had Ruiz-Colon continued to play as often as she did without adapting her playing habits, it is possible her condition would eventually have led to far steeper consequences for her body. As a pianist at Berklee College of Music, Erik Hanson practiced his instrument for four to six hours a day. After months of this intensive schedule, Erik developed an extreme case of tendonitis. Eventually, he was forced not merely to cease playing, but to stop using of his right hand altogether. He got out of his performance requirements at Berklee and spent the last year and a half of college writing with his left hand.

Hanson’s debilitating pain continued to plague him long after he graduated from college.  “I’d play for 30 minutes and then hurt for three days,” he says. “I had to minimize the use of my right hand for 25 years.” After giving physical therapy and acupuncture another shot, Hanson decided to reevaluate the foundation of his technique. Although he had taken lessons for years as a child, Hanson’s problems came from the very basics of his performance process. Realizing this led him to discover the Golandsky Institute, an organization dedicated to educating and rehabilitating musicians that uses the Taubman Approach: a corrective process based on close analysis of piano virtuosos that trains pianists to keep their muscles in natural alignment.