Dutch National Ballet’s Marijn Rademaker on injury and recovery

‘Being injured is part of our job, it happens, we will get back stronger!' That's what we say when we try to sweet talk ourselves and make it ok. But it always hurts.

Being injured means dealing with letting go what you love. Its sounds really dramatic, I know… but it is. Of course, one time can be more dramatic than another time. Maybe one time you can't enjoy the summer holidays fully because you ripped the ligaments in your ankle and have to walk on crutches. That's not too bad. You will have to use your free summer time not being free to make your ankle stronger. But at least you can dance again after the summer.

To let go what you really love, dancing, is the hardest. At least, for me. Dealing with cancelling performances, both at home and guesting abroad, that you were really looking forward to. And that comes with disappointing people. Your director, your colleagues, all who will have to jump in all of a sudden; gala organisers who have to find a replacement. And dancers hate to disappoint. That's in our blood. And then you just miss the dancing, the physicality of it. Watching class being injured and see the guys jump is the worst. ‘But hey, I'll be back in no time!' But still this injured feeling is there.

I have spoken to many dancers about being injured over the years. It is an interest of mine, because I've been injured quite a bit myself. And many dancers feel guilty and have the feeling they are disappointing people around them. There are some who just say, ‘I don't give a shit, I did my job, I got injured and I have to get back'. I wish I could have that mind-set. I used to be more like that.

When I had just started at the Stuttgart Ballet I was very eager to work hard. I came from a school where they had no boys in my class or above me to look up to. So when I came to the Stuttgart Ballet, I suddenly saw all these guys and they were all amazing. I was like, ok, I really have to put my shit together and work my ass off. Which I did.

But I can see now – like one always realises things in retrospect – that I pushed myself the wrong way. Also, I had just the wrong ballet technique and wasn't strong enough. One day in the centre I did a double tour from 5th and in the preparation plié there was an extremely loud bang. Even friends standing in the back against the barre heard it.

Ripped meniscus was the diagnosis after an MRI. I went to ‘one of the best' clinics in Germany. They always say one of the best. That doctor advised me to sew my meniscus together because I was 19 and still so young and I would still need it a lot in my career to protect the cartilage. I understood what he meant it and sounded like it was the best option for me. It meant not dancing for 6 months. A meniscus is tissue that has basically no blood circulation so it takes a very long time to grow together again. Or not at all… which happened to mine. It didn't grow together. The thread was loose and floating around in my knee and there was a constant clicking sound. I went back and they decided to cut a part of the meniscus out… Op n°2. This was my right knee.

Op n°3 happened on my left knee. I was compensating, of course, by not putting weight on my operated leg which automatically increased the pressure on the left knee. Again a meniscus tear and the same clinic sewed it together. Before the operation the nurse recognised me because I was on her table for the 3rd time and said, ‘Don't you think it's time to find another job? I don't think your knees are going to be ok for this line of work.' I couldn't believe it, I was so angry inside. Of course I didn't show it at the time. Anyway, that op didn't work either because the meniscus didn't grow together.

I decided to look for another clinic and via a friend I came across the Schelztor Clinic in Esslingen with Dr Degenhardt, a doc who took his time and really listened. He said they should have never tried to sew those menisci back together. So it was time for Op n°4 and he cut a piece of my left one out. Finally, I could start back.

However, because of all the operations and use of crutches the muscles in my upper legs where basically all gone. The pressure on the knee increases when there is no muscle to support for the knee. One day in class I ripped my right meniscus again! So Op n°5 was cutting out another piece of my right meniscus. We all thought being in a wheelchair for some time would be good. We didn't want to take the risk of putting too much pressure on my knees again, because I didn't have enough muscles in my upper legs. So I spent three weeks in a wheelchair, at home in Holland, slowly building up my muscles ‘til it was time to get up and start again. My father was very worried and thought I would never dance again. During that year, with 5 operations, it didn't cross my mind once. Not even when that b*** nurse made that comment. I was young I guess, and just took it day by day.

What helped me a lot in that period, were my family and friends, but also my director at the Stuttgart Ballet, Reid Anderson. He told me I should take all the time I needed. There was no pressure… or guilt for that matter.

I've had several injuries in my career. A recurring one was twisting my ankle. I did that like five or six times. It became a problem. So Reid said that he wanted me to go to this special dance physiotherapist in New York. I am still so thankful that he made me go. I spent four days in New York, a city that I had never been too! The therapist looked at me walking, we did class together and she tried to find the deficit in my body, to discover the root of the problem. She found out that my turn-out muscles were way too weak and that I had no centre, which makes everything weak anyway and puts more pressure on the joints. So she gave me exercises to do at home. Well, I did those every day and I never twisted my ankle again. And I learned a lot about my own body and started to change the way I work.

What one hears often is that you get back stronger from an injury. Which is true. But you also get back smarter. And I think that's more important.

One year ago I had a problem with my Achilles tendon. I had to stop dancing because I couldn't go on relevé anymore. It was hard for me to stop that time because I was preparing for Béjart's Song of a Wayfarer, a piece that I'd always wanted dance. I guess you can't do everything.

Nobody in Germany knew what the problem was. I went to several doctors. I heard of Prof. van Dijk, a Dutch ankle specialist with a very good reputation. So I went there with my MRI and in two minutes he said, ‘Oh, it's your plantaris tendon that is bothering your Achilles' tendon.' Not many people have this tendon. Evolution is leaving it out most of the time. Monkeys used it to grab tree branches. I guess I can't climb a tree like I used too because he had to cut it out.

After this operation I went to a new rehabilitation centre, Stuttgart's VfB Reha-Welt which deals with the city's soccer club. It blew my mind. I was used to a 20-minute treatment and then ‘exercises'. At VfB I got a one-hour treatment and after each a training session with head trainer Frank Haine. He made me work so hard and was very strict. He made me do exercises I had never done before and he opened my eyes to something new. Maybe everyone else knows these amazing physiotherapists, but I hadn't experienced them. I improved fast and felt better and more stable than ever. I learnt a lot and I got smarter from this injury.

I am one of those people who think that most things happen for a reason. Although most of the time you don't understand why it happens until sometime after. I'm in that situation right now, dealing with a knee injury. It's a complicated one and I had trouble finding the right treatment for it and a doctor who knew a lot about this problem.

It is so important to have a plan. Important for the mind. Otherwise you are floating in the air not knowing if the wind will blow you forward or backward. Without a plan there is the not knowing, insecurity and sometimes even panic. The most important thing is to find a doctor that you trust and who is truly interested. The most frustrating thing is to deal with somebody who you feel is not really into it. Better someone who says, ‘I don't know enough about this problem, but I will call around and will help you find somebody who does'.

I did research myself and found a treatment that could work. I flew to Germany to see a doctor who had done studies about my specific problem and has had very good results and was confident that this will speed up my recovery. When I showed this new treatment to some doctors in Holland, they said they weren't familiar with the treatment so they couldn't help me, so that was it. I would have thought that a good doctor would be interested to find out what this new treatment was about, and what kind of effect it has on this specific problem. But, as someone said to me, they have also other things to do…

The status now? After traveling to Vienna to see another professor, a call to a cartilage specialist in Zürich and a visit to a soccer doc I had a lot of very good opinions. This is one thing that is hard for any patient: ask eight doctors and you get seven different opinions!

I finally found trust in a doctor and I ended up in Holland after all. With one of the best in his field, Prof. Daniel Saris at the UMC Utrecht, who is known for his stem cell treatment and studies on cartilage. He is treating me at the moment and I am confident that with him I will be back fully, as fast as I can.

It is interesting for me to observe how I am dealing with my injury now, being older. As I said before, when I was 19 and had five knee operations in one year, it didn't cross my mind once about quitting dancing or missing opportunities. I was just trying to get better. Now I'm older and well, ok, I hopefully still have 7 more years to dance, but sometime thoughts like, ‘Oh, maybe this is the last time I will dance this ballet,' pop into my head. I missed out on Song of a Wayfarer because of an injury, and I don't think that will ever come my way again. I would have never thought about that at 24. Don't get me wrong, I'm very grateful with what I have danced so far, and I have danced many beautiful things, but we dancers always want more. Our career is short after all and time is ticking…

Going back to that ‘injured feeling', of disappointing people, of feeling guilty… are we really disappointing people? I have spoken to many dancers during my career who were injured, and many have a fear of disappointing. And they feel guilty for being injured. Myself included. But, should we feel that? Or is it just paranoia?

I think it's wrong to feel those things; that's what I tell myself. People are disappointed not to see you on stage, yes, but they are not disappointed in you as a person. You can also disappoint yourself; that's even trickier. Most of the time it's not your own fault if you get injured. As long as you took care of your body in the best way you could you have no blame. Ok, if you go on stage without warming up properly and you rip your calf, then you can be mad at yourself for a while. But then you know that won't happen again, right?!

And feeling guilty? Guilt appears if you have done something wrong. Getting injured is not committing a crime. You haven't killed anyone. Being injured is shitty enough. We just have to make sure we do everything in our power to get back fast and healthy.

Fast means not too fast… That's also a known problem in our injured world. How do you know when it's time to get back? How do you know you're strong enough? If you are lucky you have a good team behind you who really know what they are talking about. And then you have to trust them and just do what they say. We always want to get back early, of course, and miss as little working time as possible. Sometimes the medical team is too conservative, but sometimes they are right and sometimes you are right going back. The thing is, are you willing to take the risk getting back earlier and then realizing it was too early and having to take another two weeks off? I still haven't answered that question myself!

It is also difficult for us dancers to say stop. When is the time to stop? A colleague in Stuttgart once said to me, ‘If you can still walk you can dance!'. She is the living proof of that. But I don't know if it's healthy!

From a very young age we are pushed to excel in a competitive environment. Pushed to be the best. The best aren't weak, they say. So we don't want to stop. Some dancers keep pushing because they want to dance a certain ballet so badly. Me too. Then it's too late and you are off for a long time. But on the other hand, there are dancers that stop too soon. Sometimes you have to work through the pain and the pain will disappear in a few weeks or even months. It is difficult to know which pain will go away and which pain will only get worse and will make you have to stop. Most dancers will just block the pain out and keep going. In our world, that is seen as being professional and strong. Is it? I think it's very personal. Everybody is different and has a different body and mind-set. Let's not judge.

So I say, if you're injured, make a plan, do everything you can to get back fast and try to be smart about it.

And yes, being injured is part of our job, it happens, and we will get back stronger!

Marijn Rademaker 2016

Gramilano( Editor )

Graham Spicer is a writer, director and photographer in Milan, blogging (under the name ‘Gramilano') about dance, opera, music and photography for people “who are a bit like me and like some of the things I like”. He was a regular columnist for Opera Now magazine and wrote for the BBC until transferring to Italy.

His scribblings have appeared in various publications from Woman's Weekly to Gay Times, and he wrote the ‘Danza in Italia' column for Dancing Times magazine.