Rehab, Prehab, and Injury Prevention
Rehab, Prehab, and Injury Prevention by Ellie May Marshall
As circus artists "injury prevention" are two words we should be thinking about. Whether we do circus arts as a form of fitness, recreationally, or as a professional - injuries are unfortunately a very real risk of our amazing physicality - but they don’t HAVE to be so prominent. I have been training in Circus Arts for a little over four years now and have had my share of small tweaks and sprains through to a pretty decent lower back injury. My early training focused around aerials and soon progressed into contortion & handbalance - all of which are subject to their own specific areas of common injuries. From the get-go, I never wanted to experience something that would stop me training for an extended period of time. As a budding -and to be honest, rapidly addicted to- circus artist I couldn’t fathom not being able to train. I went about my training as best I could, armed with a basic knowledge of the importance of, and methods for, preparing my body for extreme physical activity. We all know the routine of a basic training session: ⁃ Warm Up ⁃ Conditioning for the skill set you are training ⁃ Train said skill set/push your body ⁃ Cool Down But are we actually training for longevity out of our bodies? There are so many aspects to consider – this can be quite overwhelming. Are we executing an effective warm up that targets the main areas we are asking to work for us? Are we strengthening the correct areas? I’ve seen more shoulder injuries, back injuries, knee injuries and hip injuries than I care to admit in our community and it got me pondering on our practices as a whole and the burning question: How can we prevent injury?
PREHAB! We’re all familiar with the term Rehabilitation… but PREhab? "Prehab" is a concept built around doing your conditioning diligently & taking preventative measures to strengthen your body for what you are asking it do to BEFORE an injury could occur. Preventative Rehab. ie. Rotator cuff injuries are prevalent among aerialists. Prehab exercises would target these areas, making sure they stay strong and stable enough to keep up with the demands aerialists place on their shoulders. Ask your coaches/teachers for guidance if you are unaware of a good conditioning programme for the skill sets you are training. Take note of what they teach you in class warm ups – repetition is vital for progress, and key for starting to recognise where you have neglected areas that need strengthening. Also ask for your technique to be reviewed and corrected if necessary This is what your coaches are there for. It will save you a lot of strife later down the line! A great example of this is React Studio (Wairau Valley, AKL). They have a shoulder conditioning programme termed “ Tough Cuff”, that Benny Searle (Studio Director & Owner) has tried, tested & developed during his career as a professional circus practitioner. Benny focuses on exercises that improve & maintain shoulder health as a whole by targeting all areas of the shoulders functionality. Tough Cuff is a mandatory aspect of React Studio’s student warm up before every class, which has yielded great feedback from their students. Some of who suffered from past shoulder injuries, tweaks, and pains no longer having discomfort during their training. Hooray!
https://www.reactstudio.co.nz/classes MAINTENANCE After reaching out to our community, I got some interesting feedback as to what we all do individually to maintain and look after their circus body’s functionality. (This data is from a select number of individuals who responded to my call for data. This is not reflective on the industry as a whole.) As you can see below, there are a number of specialists we can turn to when our bodies struggle with functionality, or to simply relieve us from that niggly circus knot in our mid/upper backs! What have our community found works for them? After asking our community about their maintenance programmes and what they have found works best for them, I came to the conclusion: Your maintenance programme is individual as per what your injury is or what your specific skill set is. Some find Physiotherapists better than a Chiropractor, and vice versa. It is also down to the practitioner and their background and expertise! Alot of our community see professionals in Chiropractic, Physiotherapy & Osteopathy who have had experience in treating dancers or gymnastic professionals - means their understanding of what we are doing with our bodies is sharper and their treatment approach is more specific to our needs.
The NZ Circus community indicated that not only are the above mentioned professions a common go to for injury care, but also a few of us use the popular Kinesiology approach (physiological, biomechanical and psychological dynamic principles and mechanisms of movement) and Pilates as part of their maintenance programmes!
Another interesting piece of data gathered was that a number of us use a Chinese medicinal approach in their injury prevention and more specifically as a maintenance tool when there is a minor (yet annoying!) tweak or niggle. Some in our community (including myself) have stated that acupuncture is a highly effective form of treatment, along with an Acupressure massage or sports massage to really work out those tight, fatigued muscles - BEFORE an injury occurs.
Personally, regular sports massage and acupuncture have seen me inside my Physiotherapists office less and of course in conjunction with (the dreaded) REST DAYS - I have managed to successfully maintain a serious injury free body!
Feedback by some of our community members on their experiences with seeking professional treatments as part of their maintenance and prevention programmes:
QUOTES FROM PERFORMERS
"Overall there are suitable and ill-suited practitioners in any treatment form. Given circus is quite niche, I find practitioners that are used to treating gymnasts and cheerleaders are just as effective. Those used to treating crossfit, rugby, cricket, or office injuries? Not so much. Physiotherapists are best for soft-tissue injuries e.g. Impinged muscles, as well as rehab exercises for strengthening. Chiropractors work best for skeletal alignment injuries e.g. A twisted hip. They're also good for nerve injuries, as they're commonly interlinked with skeletal misalignment. Osteopaths are more expensive chiropractor with additional training, but often not covered by ACC. I've preferred chiropractors over osteopaths as I haven't yet experienced the benefits of their additional training over a chiropractor. Acupuncture works great for nerve injuries e.g. Spasms, cramps. Kinda superficial for soft-tissue damage or skeletal misalignment. Helps the pain and symptoms more than it treats the cause." "Physio is good for basic rehab, but unless you get a really good one, no use for getting back to full function or high performance.
Acupuncture is very good at knocking down adverse patterns - particularly suppressing the defensive and compensation reflexes in the short-to-mid aftermath. Osteopathy didn't do much for me.
Physiotherapy is my long-term fix: rebuilding the weak areas that lead to damage in the first place. Not so much short-term. Massage helps to reset the muscles, good for muscle overload and cumulative damage. Chiropractic resets the joint alignment: without that the muscles keep getting twisted up, and things don't recover long-term. A wrist issue that had plagued me for more than a decade, was resolved with a couple of months' chiro. Each has a function, and some complement others well. None of them are a complete solution in isolation."
"I have a physiotherapy program that I do 3-5 times a week and try to always have a good warm up and cool down that is specific to the type of training or performance I'm about to do. I have only used physiotherapists as I have a wonderful physio who looks at the body as a whole and really understands my work. She has helped me so so much!! I think injury prevention is really important and also taking adequate rest days as well as eating and sleeping well!"
(Ed's disclaimer. Ellie is a smart cookie, but she is not a doctor. If you are dealing with an injury please consult a doctor or healthcare professional.)
Photo by Garth Badger from Thievery Studio