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.
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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.
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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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