Put the pressure on: healing techniques.

Wear and tear on muscles and joints are a dancer's occupational hazard. But alternative or complementary Eastern therapies like acupuncture, shiatsu, and acupressure can help fend off injury and even speed healing. Though they sound similar, each works slightly differently.

To demonstrate the different approaches, let's use the example of a shoulder injury. The acupuncturist would place needles along the appropriate meridians in the shoulder area. The shiatsu practitioner would mobilize and gently stretch the area, and work the meridians (or "energy lines") using finger pressure on specific points. The acupressurist would find two points, holding them until he or she felt a change in the quality of the energy in between them. All of these approaches increase blood flow to injuries, which helps healing by removing toxins.

Acupuncture is an ancient Chinese modality that works by regulating a person's qi (pronounced CHEE), or vital energy, and blood. Very thin needles are inserted along meridians related to different organs and systems, moving the qi, and bringing the body back into balance. Acupuncture can be used for any injury, acute or not. Dr. Ronald Golden, an acupuneturist who frequently works with San Francisco Ballet dancers, suggests dancers get an MRI first to determine exactly what type of damage occurred. He believes that pain signifies a blockage in either the qi or the blood and treats the problem area by working on many related acupuncture points. This gets the qi and blood flowing through the injured muscle, which promotes healing and rebalanees the system. It's a particularly good treatment for acute injuries because it goes past the skin, getting in deeper than a massage therapist can, yet without the physical manipulation that can sometimes be too invasive.

Like acupuncture, shiatsu's main principle is that our bodies' health depends on an even flow of energy (qi), and the therapist's job is to get the qi moving. It's a less aggressive approach than deep tissue massage. In Japanese, shiatsu literally means "finger pressure." Shiatsu practitioners press along meridians, and often spend as much as an hour stretching problem areas in ways dancers can't do themselves. Tears or joint injuries are treated with shiatsu only when they are further along in their healing process. But according to Tim Sutton, a shiatsu specialist whose clients include Broadway dancers, the advantage of shiatsu for dancers is that the injury is not treated in an isolated manner--the whole body is addressed, speeding recovery.

Acupressure is a compressive massage that falls between acupuncture and shiatsu in intensity--acupuncture without the needles. It's done without lotions or oils. Compressive techniques are used where there's a reduced range of motion in the injured muscle. Russ Beasley, who was backstage massage therapist for Twyla Tharp's hard-driving Morin' Out, uses acupressure techniques with a wide range of dancers.

As with shiatsu, pressure is key, but here the therapist uses the thumb, fingers, and elbow on two points only (shiatsu uses the whole meridian line), temporarily reducing blood flow to the area. When the pressure is released, the blood flow increases, reducing the muscle spasm and easing pain. Then the muscle is gently stretched.

Like Golden, Beasley thinks dancers should see a doctor when they first sustain an injury. The massage therapist should then speak with the doctor to establish the proper treatment. Acute injuries like labral tears aren't treated with acupressure at first, because muscle fibers can't be spread, but treatment can begin once it's slightly healed. And because acupressure is a dry, not gliding, massage technique, it's also effective before or during performances. "It doesn't matter if they're already in costume, because you don't have to work skin on skin," says Beasley. Acupressure can even be done during a performance, because it takes minimum time, and can help the dancer make it through by relieving pain.

But you don't have to be injured in order to enjoy the benefits of these highly effective therapies. Using any or all of them preventively could extend the length of your career, not to mention the height of your extensions.

Nancy Alfaro writes, practices yoga, and lives in New York City. Advice for dancers