Fortnightly we invite a colleague to share a clinical tip with our community. Today, Liz Bayley is on the stage.
Who are you?
I am Liz Bayley, a specialist dance physiotherapist in the West End of London. I also work with The MTA (Musical Theatre Academy) as their consultant physio and ‘Conditioning for Dance’ coach. After doing the sensible thing and gaining a Bachelor of Arts in Psychology, I went on to follow my childhood dream and danced professionally for 15 years. I trained from the age of three in Ballet, but eventually specialised in Latin and Ballroom. My years as a dancer sparked my interest in sports injuries and I obtained an advanced diploma in sports therapy in 2009. I graduated from Kings College London in 2016 with a master’s in physiotherapy. I spend most of my time with the cast and crew of ‘The Lion King’ with the company West End Osteopathy. In my 12 years of clinical experience with performers, I’ve worked on most of the big shows in London, including Matilda, Wicked, Jersey Boys, and Singing in the Rain.
What clinical tip would you like to share with the community?
The ‘Show Ride’! My clinical tip is how to target cardiovascular fitness in a very show-specific way. The cast member can use a static bike/elliptical or similar, while listening to the soundtrack of the show they are performing in. They then increase and decrease the resistance of the equipment to mirror the demands of the show as they experience it. If they also have a singing track, they can sing along as well. It is an extremely useful way to maintain a dancer’s fitness when they are signed off for an extended period owing to injury, or when the goal is to improve fitness for a specific role. Theatres are notorious for having quite restricted backstage areas, and this can be done with very little space, or at a local gym (although some performers prefer not to add the singing part when in a public space for obvious reasons)! I like how it keeps cast members focused on their track when they are not performing, because maintaining a connection with the production and their role within it can be important for mental health, especially for injuries with longer rehabilitation times. It also helps performers visualise the role from start to finish, including backstage ‘traffic’, which can be just as demanding as the on-stage performance, such as with very quick transitions and costume changes. While I was explaining it to a dancer, we jointly came up with the term ‘Show Ride’ to describe it, and I still use that term when I explain it today.
Where does it come from?
I started using it after I had some dancers with long rehabilitation periods who needed to maintain their cardiovascular fitness but were unable to tolerate full weight-bearing plyometric load such as running. Examples of the type of injuries that require more time ‘off’ are bone stresses, calf tears, and plantar fascia ruptures. I was explaining to these performers how to use equipment for high intensity interval training (HIIT) by ramping up the resistance and then lowering it, rather than just sitting on a bike for 30 minutes at level 5 (for example). HIIT is important for performers because productions vary so much in their intensity over the full duration of the show. I realised the best way to recreate the demands of a show was to literally ‘do’ it while on the exercise equipment. I posted about the ‘Show Ride’ recently on social media and the Performing Arts representative for the ACPSEM, Alexander McKinven commented that they also use something similar for cast changes, pre-performance fitness, and to build specific role stamina, so I’m not the only physio working with performers to use techniques like this.
What is its scientific evidence, if any?
There is evidence to show that dance practice alone does not prepare dancers for the demands of performance. The stamina they require is often built as part of the rehearsal and performance process rather than being part of the training that precedes it, which is a potential risk for injury. Inadequate cardiovascular capacity has been linked with higher injury rates in dancers owing to the effects of fatigue. The huge variety in roles undertaken by performers means that by tailoring programmes to match the individual requirements of these parts, we can start to make more of a difference where it really matters. Susan Mayes, the Director of Artistic Health and principal physio for the Australian Ballet, has led the way in tailored injury prevention programs. Additionally, the University of Chichester, University of Wolverhampton, Trinity Laban, and other institutions, in association with the International Association for Dance Medicine & Science (IADMS) continue to publish research which promotes the benefits of specific cross training in performers.
References and Further Reading:
The IADMS Bulletin for Dancers and Teachers
Volume 8, Number 1, 2019 https://iadms.org/media/2948/iadms-bulletin-vol8n1.pdf
Cardiorespiratory Considerations in Dance: From Classes to Performances
Rodrigues-Krause J, Krause M, Reischak-Oliveira Á. Cardiorespiratory Considerations in Dance: From Classes to Performances. J Dance Med Sci. 2015 Sep;19(3):91-102. doi: 10.12678/1089-313X.19.3.91. PMID: 26349502.
The Australian Ballet: Injury Risk Management Program (2020)