The brilliant Katy Keller is
Clinical Director of Physical Therapy Service, The Juilliard School,
60 Lincoln Center Plaza, New York, New York.
In her previous job, she was the physical therapist (PT) for the New York City Ballet
and traveled the world with them for a couple of decades.
Before that, she was the Senior Therapist, West Side Dance Physical Therapy.
Her BA is from Cornell University, and her MS is from
Columbia University where she studied dance and psychology.
She pioneered (and coined the term) dance medicine, a sub-specialty
within sports medicine.
Keller's career has evolved with new developments in dance medicine.
Keller grew up in Europe, where she had the opportunity to study dance at a young age, first at the RAD-affiliated Centro di Danza in Italy and then at Centre de Danse Internationale (CDI), a dance academy run by American Rosella Hightower, in France. At CDI, she took classes in ballet, character, mime and other techniques, but the class that had the greatest impact on Keller was anatomy.
Twenty years ago, dance medicine as we know it today did not exist, and Keller had to chart her own course. "There was sports medicine and trainers for athletes and even remedial classes for dancers," relates Keller, "but there was no specialization at that point, very little in-house physical therapy and certainly not the body of knowledge about dance medicine that exists today."
Keller attended SUNY Purchase, but later transferred to Cornell University as a pre-med major. "I wanted to do medicine for dancers," she says, "but I'm glad I didn't become a doctor because there is very little hands-on manual intervention." After graduating with a BA in dance and psychology, she went into dance therapy, which uses movement to address emotional issues. "It was a medical model based on the psychiatric vocabulary and issues of body image," she explains.
Keller discovered physical therapy when she started working in a hospital pain management center, where movement was used to alleviate physical discomfort rather than psychological pain.
She would run classes, getting people to move and feel their necks and backs and actually have a relationship with their bodies again. "That's where I first saw physical therapists," she says, "and I thought, ‘Oh, that looks right. It looks like they're dealing with the tangible issues of injury and healing.'"
She decided to do her master's studies at Columbia University in New York City, knowing that one of the faculty members had a background in dance. She also had a strong desire to work with Marika Molnar of New York City Ballet, one of the few physical therapists working in-house at a dance company.
When Keller was ready to enter the field in 1984, dance medicine was still in its infancy.
"I feel fortunate that I was early in the field because it required that we codify a lot of exercises, develop many of the approaches and apply knowledge specific to dance."
This entailed figuring out what it is about a ballet dancer that's different from an athlete: the different ranges of motion required in the joints, the different muscle patterns and how the requirements of choreography place unique stresses on the body.
The most obvious difference is a dancer's use of turnout (external rotation), which changes the whole alignment of the leg and its relationship to the hip and, consequently, how the back functions.
"That's what has been fascinating, this puzzle of what dance does to the anatomy and the injuries that result.
In a brief span of 15-20 years, it's really evolved as a knowledge base for what is different for dancers."
Keller and her colleagues are constantly educating themselves and refining their skills to keep up with changes in the industry.
In 1995, Keller teamed up with Jean-Claude West, a kinesiologist with a degree in motor learning, to develop rotation devices.
"We use them to bring awareness to how dancers are moving -- where they're initiating from, what areas of their bodies they're holding stable or moving," says Keller.
"These devices give them a sequence where they get in touch with their alignment and take that knowledge to class with them.
Just a little bit of work on something like this can bring their attention to something they've long thought they had mastered."
Keller and physical therapists like her are in demand at ballet companies, performing arts schools and even behind the scenes at Broadway shows.
For example, Westside Dance Physical Therapy has a contract with the New York City Ballet and the Juilliard School.
Keller has a contract with the Juilliard School as well.
Through their work with these organizations, they are actively involved in helping dancers and other performers recover and learn from their injuries.
Behind-the-scenes duties for the New York City Ballet include pre-performance quick assessments of immediate or acute problems, but a physical therapist is at the theater long before curtain, working in rehearsal beside the dancers.
"The dancers may be involved in new ballets being choreographed and extensive rehearsals for the huge repertoire, so there is potential for injuries all day long," explains Keller.
"People think that therapists only work backstage during performance, but actually, it's more helpful to have someone there in the course of the workday to assess what happened and to determine how to respond."
It might be first aid (ice, elevation or compression), but usually the injuries are overuse injuries, where one side of the body serves as a support, becoming compressed or twisted.
There are a lot of foot and ankle problems for the women and knee and back issues among the men, due to the large number of jumps and lifts they perform.
Broadway shows entail a unique set of problems.
"Because they repeat so often -- eight times a week sometimes -- the overuse factor becomes paramount," says Keller.
Sometimes, not moving is more of a problem than moving.
Dancers might have to sit still for 20 minutes and then get up and do something extravagant after cooling off.
Most patients come to Westside Dance after a referral from a doctor, whose role is important in the diagnostic stage.
"Many conditions can mimic each other, and we need to know, for example, if a nerve is involved as opposed to a musculo-skeletal disorder," says Keller.
"When injury does occur, it's important to go back and analyze what happened."