Natya Magazine | Vol 001

N A T YA M A JULY 2020

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Knee Pain

Dr. Divya Raghavan from the editor’s desk

Sarabhai Speaks FEATURED

Kanha School of Dance

No More Chronic Pain

Vartika’s story of battling knee pain

R i g h t S ta c k P h y s i c a l T h e r a p y

NATYA

My tryst with knee pain From the editor’s desk Dr. Divya Raghavan, PT, DPT, OCS

Knee pain is extremely common in the general population especially in dancers. The cause of knee pain can be varied ranging from simple acute ligament sprains to chronic Grade 4 osteoarthritis. Repetitive strains endured by dancers on a regular basis can predispose them to risk of knee injuries and subsequent pain.

As a dancer and orthopedic physical therapist, I have endured as well as treated several types of knee trauma. The most common diagno-

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sis that I have seen has been patellofemoral knee pain. This is the same knee condition that I was diagnosed with years ago.

I dislocated my right kneecap in 11th grade while I was doing postgraduate training in Bharatanatyam (an Indian Classical dance form). My entire right leg was put in a cast for 6 weeks. After the cast was removed, I was ‘suggested’ to do rehab before returning to my usual activities. Being young and naïve, I didn’t give rehab its due importance, nor was I told about the longterm consequences of returning to dance too soon.

Initially when I resumed dancing, I would find my right knee get swollen after every dance practice. This swelling would subside with rest, so I continued to dance with some rest breaks in between. Few months later, I started to feel a sharp pain in my right knee when

tors and orthopedists, got scans done which

dancing, so I started wearing a knee brace.

showed “early patellofemoral arthritis”. I was

The knee brace would make my knee feel

told by most of them to STOP DANCING. This

strong and stable, but I didn’t know at that

response infuriated me! Although I was not

time, that long term brace use would also

a dancer by profession, I identified myself as

make the muscles around the joint weak-

a dancer more than anything else. At that

er. This meant that I was predisposing my-

time, I made a resolution....no dancer will

self to arthritis by not building muscles that

ever be told not to dance again by a medical

are necessary to support the joint. A year

professional. It’s the healthcare team’s job to

later, when I was still feeling knee discom-

get people back to the activities they love,

fort on a regular basis, I went to several doc-

not drive them away from it.

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After completing my Bachelors in Physio-

thopedics & Natya Physical Therapy. Natya PT

therapy, I moved to United States and did

will be geared towards educating dancers

my residency in the field of Orthopedic

of various ages on the importance of body

Physical Therapy at New York University.

awareness and self-care, as well as provide 1-1

New York is the hub of performing arts in

rehabilitation care to injured dancers so that

the nation and NYU is affiliated with big

they can resume dancing without having

hospitals that provide care to different

chronic pain.

world-renowned dance troupes. I learnt a lot at NYU and made some meaningful

I hope the readers of Natya Magazine find

professional connections which furthered

value in the information that is shared in this

my interest in the field of Performing Arts

first issue.

Physical Therapy. After completing my residency, I pursued to become a Doctor of

In Health & Harmony,

Physical Therapy (DPT). I did my final year

Dr. Divya Raghavan, PT, DPT, OCS

dissertation on ‘patellofemoral knee pain’the specific knee pain that I had suffered from for more than a decade. And what I found was hopeful. There are several factors that influence mechanical knee pain and this knee pain can not only be treated but also prevented in most cases.

When I moved to the Bay Area, I was overjoyed to learn that there is a sizable dancer population here. I wanted to spread my knowledge about injury prevention and pain management to these dancers.

After working at the Google Wellness Centers for several years, I decided to make the move and start my own practice-Right Stack

Physical

Therapy.

RSPT

has

3

wings- Corporate Wellness, Concierge Or-

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Bharata Natyam Knees Revanta Sarabhai Dancer, Choreographer, Actor

I am a third generation dancer in my family and the story goes that my mother was dancing until she was nine months pregnant with me and started again days after I was

Rooted in traditional dance and performance forms, Revanta combines his classical dance training with a contemporary practice to create cutting-edge work that is honest, immersive, and relevant to the society and times we live in .

born, when she would strap me to her chest while practicing. I was literally born dancing.

I started my formal training in the Indian classical dance style of Bharatanatyam at age four and started performing professionally at age eight. All through my early years

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of training, lessons and rehearsals were al-

and injuries of the knees. To add to this, sever-

ways on a stone or a concrete floor, with a

al dance teachers focus on opening the knees

focus on slapping your feet on the ground

for the perfect open stance posture, push-

to make the loudest sound possible! It

ing students to get a complete 180º turnout

wasn’t until I was an adult and had taken

which is often extremely difficult, if not im-

to dance as a career, that I really began to

possible for those without adequate natural

think about the impact that this had on my

hip opening. The focus is often on how the

body, and especially my knees.

posture looks and lesser on how an individ-

ual dancer’s body naturally assumes it. Even

Over several tours and performances in

in the tradition of Bharatanatyam training,

different countries, I had rehearsed and

there is very little focus on body conditioning.

danced on sprung wooden floors and

The strength and conditioning of the dancer’s

had experienced the ease on the knees

body are a by-product of learning the dance

from it. However back home, it was just

as opposed to being a separate and integral

accepted that the four hundred year old

focus. Dancers often have to rely on their intu-

Bharatanatyam tradition started in the

ition to stop pushing themselves in the pur-

temples, and the temples had stone floor-

suit of perfection, lest they injure themselves

ing—so that’s just the way it was. This has

for life.

come down as part and parcel of the “tra-

dition” of Bharatanatyam. It is only in the

In my own work as a Bharatanatyam dancer, I

last fifteen-twenty years or so, with the

have broken away from what are considered

widespread development of contemporary

‘traditional subjects’—typically stories of Gods

dance in India, that the idea of a sprung

and Goddesses and based in mythology. I tru-

wooden dance floor has become more

ly believe that Bharatanatyam is an incredibly

prevalent. Yet, a majority of Bharatanatyam

versatile language and the arts have a respon-

dance schools continue to practice on con-

sibility to be reflective of a changing society.

crete or stone floors. In my years of dancing,

In my more recent work, I use the classical

I have encountered many senior profes-

language of Bharatanatyam to explore top-

sional dancers who have been practicing

ics such as gender equality, climate change,

for decades, struggle with knee pain and

and globalization, all the while sticking to

say, “oh, it’s just Bharatanatyam knees.” So

the very traditional Pandanallur style of the

many of my own peers struggle with pain

dance form. While I am a firm believer that a

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tradition that is four hundred years old has its inherent wisdom that sometimes cannot be codified, I also strongly believe that it is our responsibility as dancers and practitioners to help the form evolve and not have it ‘stuck in tradition’. To this end, I also believe that it is our responsibility as dancers to learn and apply newer and newer research, especially to do with body conditioning, incorporating the latest from sports medicine and exercise science, into our own practice and to the way we teach Bharatanatyam, so that younger dancers and students who are just starting out don’t have to go through the same troubles that we did. And if we do it for long enough, it will become a part of the tradition.

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No more chronic pain Vartika’s Story Patient, Right Stack Physical Therapy

I have a chronic knee pain for more than

much it had improved my knee condition.

10 years now. I did go for therapies in

I can stand for longer period of time, I can

the past but nothing helped much. This past

walk for long without any knee pain, my legs

year I got serious and decided to fix my knee,

are much stronger then they used to be and

I guess the timing was right and that’s when

most importantly no more chronic pain. And

I met Dr. Divya at one of the workshop and

this week I’m going to start jogging I am so

told her about my knee problem and within

excited. All the credit goes to Divya, she is an

a week I was in her office. I saw her a week

outstanding PT, DPT, OCS :-) She is a good

right before the shelter in place began. She

listener, detail oriented and keeps you mo-

evaluated my condition during the first visit.

tivated to do your exercises :-). I still remem-

And there after I had 4 virtual sessions with

ber her words from 1st virtual session, “I’m so

her. Initially I wasn’t sure how will the virtu-

excited to get you back to being more active

al session help? And when I told Divya my

and without knee pain. This is not only your

concern, her honest response was to lets try

goal but my goal too.” I wish I had found her

one session and if it doesn’t go as you ex-

long time back.

pect then we’ll see what we can do. I must

Thank You so much Divya

say that was the best decision, from my 1st virtual session to my 4th I could tell how

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R i g h t S ta c k P h y s i c a l T h e r a p y All round care for a healthy life At Right Stack PT, our trained Doctor of Physical Therapy specializes in assessing and remedying the root cause of pain, caused by an injury or lifestyle choices. Our goal is to provide you a comprehensive evaluation and tailor a specif ic plan for you to lead a pain f ree life.

Orthopedic Physical Therapy

Performing Arts Physical Therapy

Our expert orthopedic physical therapist can help you with conditions like sprain, strains, tendonitis, inflammation, joint stiff ness, rotator cuffs repair.

Performing Arts Physical Therapy is an injury prevention and injury recovery program for dancers, artists and on-stage performers.

Corporate Onsite Physical Therapy

Tele-Medicine Physical Therapy

We curate Physical therapy programs based on Job site specif ic ergonomic analysis. Our expert team of physical therapist, massage therapist, health coach and personal trainer helps employees overcome pain and injury.

Tele-Rehab or Tele-medicine physical therapy is a program designed for people to avail physical therapy benef its f rom the comfort of their home or anywhere else. These are oneon-one PT session to evaluate, assess and regulate your physical therapy routine.

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Kanha School of Dance

Kanha School of Dance is a non-profit organization dedicated to teaching and performing Bharata Nrityam- an ancient Indian classical dance form. It was established in 2011 in San Jose, CA. It was founded by Ashwini Srivatsan, the artistic director of the company. The company strives to bring the eastern tradition of Bharata Nrityam to the west. Dance, music and culture are an integral part of building a community that one can feel a strong connection with and this is Kanha’s mission. At Kanha we use our gamut of talents to make people feel part of a larger community - one they can count on, stand by and feel inspired by.

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What injuries or pain complaints due you

es which are specifically designed to help

specifically see in your dancers?

Bharatanatyam dancers. I can see my danc-

Most Bharatanayam dancers have knee in-

ers bodies changing through improved flexi-

juries or foot related injuries. Lower back is-

bility, stamina and strength. Many of our stu-

sues are also common in dancers. Longevity

dents can vouch for the benefits of Yoga and

of our body and mind is key to learning and

how it can positively impact their practice.

practicing dance. Often I see people who have just started learning hurt themselves

What are you doing to promote wellness

causing them to stop dancing. This is unfor-

in the dancer community?

tunate and preventable.

At Kanha we have created a forum of sorts for knowledge sharing by bringing in speak-

How are you educating your dancers with

ers related to health, nutrition and fitness.

regards to injury prevention?

We have student led Yoga classes where

Focus on strength, flexibility and stamina is

students put together a workout and lead

key. The first step to educating dancers on

a class. As part of this forum we invited

injury prevention and the benefits of caring

Divya Raghavan from RSPT to come talk

for your body is to constantly talk about it

to us about Injury prevention for dancers.

to bring about awareness. At Kanha, we con-

Divya’s expansive knowledge on the subject

stantly emphasize the need to cross train.

combined with her personal experience as

The next step is to incorporate cross-training

a dancer makes her one of the finest PT’s

into our daily training. We do this through

for dance related injuries. Several of my stu-

yoga and body conditioning courses open to

dents and myself have sought Divya’s exper-

all students of Kanha. Despite a solid fitness

tise to help with specific issues that affect

routine, dancers are still prone to injury. So

our dance and daily life. These are some of

the third step would be to ensure that danc-

our first steps in building awareness of well-

ers stay informed about common dance re-

ness within the Kanha community. There is

lated injuries and provide resources to help

a lot that can be done in this area and we

them recover from the injuries.

are looking to expand this program to include topics related to wellness and reach

Are there specific classes/routines you

out to other dancers who may be looking

teach/recommend to your students?

for a community that provides a holistic ap-

We offer Yoga and Body conditioning class-

proach to becoming a dancer.

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Natya Rehab Program

By Dr. Divya Raghavan

Right Stack Physical Therapy

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