Brain-body dance: addressing mental health during injury rehabilitation (2024)

Brain-body dance: addressing mental health during injury rehabilitation (1)

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Brain-body dance: addressing mental health during injury rehabilitation

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  1. William Bracewell
  1. The Royal Ballet, Royal Opera House, London, UK
  1. Correspondence to Mr William Bracewell, Royal Opera House, The Royal Ballet, London WC2E 9DD, UK; william.bracewell{at}roh.org.uk

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    • Rehabilitation
    • Dancing
    • Psychology
    • Athletic Injuries

    My career in ballet is probably one that echoes many others. I started dancing around the age of 8, and was recognised by my teacher at the time as having potential to progress further. At the age of 11, I moved from Swansea to London, after receiving a place to live and train full time at The Royal Ballet School. This was an intense introduction into the ballet world to say the least; a pressure cooker environment that suited some and not others. At the time, there was a focus on hard training of the ballet skill, with less concern over the holistic development of the student. After 8 years of training I joined Birmingham Royal Ballet and danced professionally with the company for 7 years, touring nationally and internationally for most months of the year (sometimes for several months at a time). In 2017, I moved to The Royal Ballet, where I now dance as a Principal of the company. This means I perform the main or title roles in up to 13 productions each season.

    Spinal surgery

    My injury history had been sprinkled with minor ankle issues and growth-related problems, but in April 2019 I underwent microdiscectomy surgery on my L5-S1 level in my spine. After a herniated disc injury 3 years prior, I had been managing ongoing back pain, and after what I initially thought was a minor hamstring tear, it quickly became apparent it was much more serious and now restricting the sciatic nerve in my left leg. I could not move at all without intense searing pain which immobilised me for weeks. I began a very slow and conservative rehabilitation approach, but 6 weeks into the programme, my leg would intermittently give way during the most basic warm-up dance movements, and I would end up collapsed on the floor.

    At this point, I discussed my options with our clinical director: continue a conservative rehabilitation with the potential for surgery a year later, or opt for surgery immediately. The MRI suggested I had quite a severe herniation, which, coupled with the fact that I had been struggling with the rehabilitation mentally—including ending up in tears on the floor during coaching sessions—made the surgical route seem like a clear choice. The healthcare team supported this decision, and while there was, of course, a large amount of trepidation ahead of spinal surgery, I’m happy that 5 years later it seems to have been the right decision.

    Connecting mind and body

    I would describe myself as incredibly ambitious, so to have extended periods of stagnant time after my surgery was very frustrating. I tried to fill my time with other interests that were not physical, but I missed the rigour and passion of dancing. Being back in the gym, sweating and working towards my goal of returning to the stage was a huge relief mentally. My physical rehab went well. I tried to cross-pollinate the expertise of my rehab team (figure 1) as much as possible; my Pilates and strength and conditioning (S&C) coaches would watch ballet coaching sessions to assess posture and consider new exercises that would be beneficial. Incorporating exercises that I could clearly associate with dance helped transfer the strength I gained during S&C and Pilates into the studio, which I otherwise had a tendency to disassociate. In many ways rehab suited my personality really well: I could schedule my days as I wanted; I could rest when I needed; and there were clear goals to be achieved. I cannot overemphasise how aware I became of the link between my mental and physical health. It seems obvious, but it’s easy to detach the two.

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    Figure 1

    Celebrating with my rehab team following a successful return to the stage (from left to right: Gemma Hilton, Brian Maloney, William Bracewell, Jane Paris, Adam Mattiussi).

    Addressing my mental health

    An aspect I had not considered until it was looking me directly in the face was the potential loss of my profession and a huge majority of my life. I love my work, and the thought of that being taken away before I was ready was a difficult thing to process. There were also points early in the rehabilitation where I began to fear the loss of more general physical functions. For example, walking a dog that might pull in erratic ways, or bending to put on a sock comfortably. These fears eventually faded as my movement improved, but the initial worry was vivid. During this time I saw our in-house performance psychologist, who helped me work through the day-to-day mental difficulties, and identified elements of post-traumatic stress. With the advice of our wonderful internal healthcare department—and private funding from a generous individual—I saw a psychotherapist. This became a turning point as we discussed life from a wider lens and assessed why I was putting myself through such an extreme process to continue dancing. I realised there was no other option than to give everything I could to try to return to dance. I would not be able to walk away from the situation without knowing I’d done everything in my power to get back to the stage. We assessed why I love dancing so much and why it was worth the effort. I learned that it’s the effort that I love: I love to work, which in some ways was the reason I had become injured initially… by overexerting myself without adequate recovery.

    Moving mindfully forward

    I wanted to highlight the mental health aspect of rehabilitation as it’s maybe not always factored into a programme but in my opinion was a key pillar in getting me back to full capacity. I have come to realise that strength and mobility work will be a part of my life forever, and I relish that. My fundamentals will be keeping a strong and mobile core and hips and moving as much as possible for as long as possible. I am aware that the neurological connection and sensitivity to that area of my back remains heightened 5 years later. I have had two subsequent MRI scans on my back after being worried something had happened again due to pain. This will probably be something I do every few years while I’m dancing to keep my mind at ease as much as keeping an eye on the condition of the disc. I still worry that I might injure my back again, not so much that it stops me dancing but there are some movements that still scare me and probably always will.

    With high-profile athletes becoming more vocal about their mental health capacity and needs, I feel positive that this will become commonplace in dance rehabilitation.

    I would encourage practitioners to value mental health as highly as strength training, mobility training and other physical therapies:

    • Anticipate psychological challenges and programme therapy into a rehab plan.

    • Promote honest discussion around mental health and function.

    • Explore cross-pollination of coaches’ expertise through joint sessions.

    Ethics statements

    Patient consent for publication

    Not applicable.

    Acknowledgments

    I would like to thank Adam Mattiussi, Jane Paris, Gemma Hilton, Brian Maloney, Greg Retter and Angela Bernstein for their support in helping me back to the stage.

    Footnotes

    • X @will_bracewell

    • Collaborators Joseph Shaw: The Royal Ballet, Royal Opera House, UK

    • Contributors Content of submission: WB. Support with editing and submission: JS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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    Brain-body dance: addressing mental health during injury rehabilitation (2024)

    FAQs

    How does dancing help with mental health? ›

    Ease depression and anxiety.

    Dance is an effective type of exercise that raises your heart rate and works your muscles. Exercise can help with symptoms of depression and anxiety by releasing certain chemicals in your brain. It also provides a way to escape repetitive negative thoughts and worries.

    How does folk dancing promote mental well-being and reduce stress? ›

    Furthermore, the incorporation of music and dance can stimulate endorphin release, promoting overall well-being and reducing stress and anxiety. Folklore is a physical activity that can involve intense and vigorous movement, which can help improve cardiovascular health, flexibility, and muscle strength.

    Why is dancing good for the brain? ›

    Scientists have found that the areas of the brain that control memory and skills such as planning and organizing improve with exercise. Dance has the added dimensions of rhythm, balance, music, and a social setting that enhances the benefits of simple movement – and can be fun!

    What are the benefits of dancing to the mind and body? ›

    Hence dancing lowers stress and anxiety. Dancing exercises the heart, lungs, muscles, joints, and ligaments, and in doing so it tests your balance, muscle strength, and coordination. But more than that – dancing also requires cognitive skills and memory.

    What are the 3 main purposes of dance therapy? ›

    They aim to: Facilitate life-span development. Prevent, diagnose, and treat issues that interfere with healthy functioning. Assess, evaluate, and develop treatment goals.

    What is the power of dance how dance effects mental and emotional health? ›

    Dancing not only reduces stress but also promotes a positive mood. The combination of music and movement triggers the release of dopamine, a neurotransmitter associated with pleasure and reward. As you dance, you can experience a sense of joy, happiness, and even euphoria.

    What is the power of dancing? ›

    Dance may promote wellness by strengthening the immune system through muscular action and physiological processes. Dance conditions an individual to moderate, eliminate, or avoid tension, chronic fatigue, and other disabling conditions that result from the effects of stress.

    What are the spiritual benefits of dancing? ›

    In dance, the rhythmic movements of the feet and body create vibrations that connect the dancer to the Earth and to the spirits of the ancestors. Through dance, the community can communicate with the spiritual realm, ask for blessings and guidance, and express gratitude for the Earth's gifts.

    Which dance is best for brain? ›

    Line dancing may protect brain tissue, and ballroom dancing may improve spatial analysis (the part of the brain focused on navigation and remembering layouts), studies show. Latin dances, from the salsa to the merengue, may boost skills such as visual recognition and decision-making.

    Is dance your way to better brain health? ›

    The study found that undertaking structured dance of any genre is generally equal to and occasionally more effective than other types of physical activity interventions for improving a range of psychological and cognitive outcomes including emotional well-being, depression, motivation, social cognition, and some ...

    How does just dance help mental health? ›

    Next to body image, dance movement has significant positive effects on mood, stress, and anxiety. Within the scientific community specifically, there is evidence that an abundance of mood-improving chemicals are released within the body while dancing. Once released, these chemicals help improve one's state of mind.

    Why are mental skills important in dance? ›

    The general goal is to teach a dancer the mental skills necessary to perform consistently in both training and competition. Dancers need to train their mind to ensure that what they train for in rehearsal actually happens on stage when it counts.

    What are the five social benefits of dancing? ›

    Social Benefits of Dancing
    • Social dancing has several health benefits, including enhanced self-confidence, weight loss, and physical strength. ...
    • Improves physical fitness. ...
    • Enhances balance and posture. ...
    • Keep your mind sharp. ...
    • Reduce stress. ...
    • Increases social interaction. ...
    • Provides a means of artistic self-expression.

    How does dancing make you happy? ›

    Dancing is a great way to overcome these negative feelings because the exercise and emotional responses to the music we're hearing can increase the release of dopamine in different parts of the brain. As dopamine levels go up, we can shake off some of those negative feelings and float into a euphoric state.

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