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First, you cry: discovering you need a hip replacement doesn't have to mean the end of a career.

I went to college eager to dance. I knew then that my body wasn't built to do what it was asked to do in training--I didn't have sufficient turnout, and my hips were tight, but I pushed myself physically to rise to every challenge. Years after I left SUNY Purchase as a dance major, I danced 10 seasons with Donald Byrd/The Group. Every rehearsal and performance was thrilling, but it was like working out on a technical battleground with no medics and no relief in sight.

One day I was a healthy 39-year-old dancer, the next day I was a crippled 40-year-old. It happened that quickly, and just as dramatically. I left Byrd in 1998 with minor pain in my right hip. I was frustrated by being the lone 40-year-old among a company of 20-somethings, so I thought the pain in my hip was stress-related. After Byrd, I signed a year-long contract with the road company of Joseph and the Amazing Technicolor Dreamcoat. Halfway through that year, after having jumped off a three-foot platform eight shows a week, the ache that I thought was stress-related became more serious. At first the pain in my hip inhibited me from working fully. Eventually it stopped me from working altogether. I went to two doctors, who concurred: I needed to stop dancing and consider hip replacement surgery. My career of more than two decades was over.

I cried for a month. I hid in my apartment, drinking heavily and watching movies on TV. Without dance, I didn't want to live. What other skills did I have? I had never waited a table in my life (which I shamelessly boasted about during my career). I went from being the lucky dancer who was always working to someone who had no income.

Since that depressing day in the doctor's office, I've heard of other dancers who have had hip replacements, including Judith Jamison, Arthur Mitchell, Gelsey Kirkland, Gary Chryst, Bebe Neuwirth (see "Vital Signs," page 20), and, as I've come to realize, many of my friends.

Is there any significance to the recent number of 40- to 50-year-olds who have arthritis of one or both hips? Does dance cause arthritis of the hip? I began to wonder if this was a dancer-specific generational thing, or coincidence. I asked those questions of three of my peers. The answers had a common theme: We were dancers performing a painful dance.

Tricia Toliver, 47, began her career in 1967 with Ballet Pacifica. After dancing with several companies, she joined Chamber Dance Company in 1991. A few years later, she stopped dancing entirely and discovered in 2002 that she had an arthritic hip. At first, Tricia was in denial. "I didn't trust the diagnosis," she says. "I thought it must be something else, so I started trying to figure out what else it could be."

Tricia pointed out that in the old days ballet schools used to pick dancers at a young age purely by body type. By doing this, they weeded out bodies that weren't suited for dance. She suggested that these days anyone with a pair of ballet shoes and tights can train in dance, opening up greater possibilities for injuries.

Alberto (Tito) del Saz, 46, danced with Alwin Nikolais and Murray Louis for 23 years and now stages Nik's works. What began as knee pain in 1999 (that was misdiagnosed as a back injury), later was diagnosed as severe arthritis of both hips. Although Tito had been an ice skater prior to dancing, he was surprised by the injury. "I never had any serious injuries or setbacks due to joint or muscle strain," he says. He suggested that the current demand on choreographers to shock and awe their audiences has led to "intense, grueling rehearsal schedules" that add to physical wear and tear.

Sara Rudner, 62, worked with Twyla Tharp from 1965 to the mid-1980s. Even after dancing with Tharp for two decades, Sara doesn't think that Tharp's highly technical and challenging work was the cause of the arthritis in her hip. She believes that she was predisposed to the disease, based on her family history of arthritis and a hypermobile hip joint. "If I had known the importance of rest back then," Sara says, "some of the wear and tear might have been prevented."

After Sara's hip replacement she continued to perform and choreograph, but not at the manic pace she was used to. Dancing wasn't the same as it had been before the operation, but she was able to do everything she wanted to do. Now the director of dance at Sarah Lawrence College, Sara has this advice for dancers: "Know your body! Understand how to work with your body, and how to manage your work to maximize your longevity."

When my own arthritis became unbearable, I went to see Dr. Robert Buly at the Hospital for Special Surgery in Manhattan. When Dr. Buly looked at my X-rays, he remarked that I probably had impingement between the femur and acetabulum. This is due to abnormal anatomy, which, says Buly, is a common cause of arthritis in young people. Apparently even those who are basically sedentary can develop this type of debilitating arthritis.

Neither the Arthritis Foundation nor the American Academy of Orthopedic Surgeons has statistics on the number of dancers with hip replacements. However, Dr. Robert Buly adds, "If a patient has a predilection to develop arthritis, it may be hastened by a prolonged dance career, which puts significant stresses on the body."

Orthopedic surgeon Dr. William G. Hamilton, who treats dancers from both New York City Ballet and American Ballet Theatre, says that it's a mistake to draw conclusions about the source of hip pain. "Although arthritis of the hip seems to be more common in dancers, there is little hard data to support this. The classic story about Suzanne Farrell is a good example. When her hip went bad at the end of her career and she had to have it replaced, the press blamed it on the severity of the Balanchine technique that she had danced all of her life. She said, 'No one bothered to ask me about it, but my father had bad hips and had to have them both replaced.' Shortly afterwards, her other hip went bad and also had to be replaced."

In an interview years later, Farrell has said that the Balanchine technique may have saved her from needing the surgery earlier.

According to Dr. Hamilton, we know now that certain conditions--acetabular displasia and a torn labrum (see "Hip Tips," page 110)--can be exacerbated by forcing turnout, leading to arthritis later in life. But we also know that hip arthritis is very common in people who don't dance.

So no one is immune to the pain of arthritis of the hip. Dancer or not, like it or not, we're given a body that may or may not endure the stresses of our lifestyles. I have forced myself to see a positive side to my ordeal. I may have lost an identity I worked hard to attain, but through that loss, I learned that I am not alone. We may have been burdened with arthritis of the hip or hips, but we're relatively young. We're as active as we can be, and we have the rest of our lives to live with or without the disease.

Is arthritis of the hip a sign of the times in the dance business? No one knows the answer, but we do know that many of us have it. It may have been a painful dance, but it's not painful anymore. I'm still dancing!

Michael Blake, who has danced with Murray Louis and Jose Limon, teaches movement for actors at Rutgers University and HB Studio. He continues to dance with PARADIGM.
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Author:Blake, Michael
Publication:Dance Magazine
Date:Jan 1, 2007
Words:1302
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