Concussions & Pole Dance with Laruen McIntrye
Show Notes:
On this episode we're joined by Lauren McIntyre, a certified athletic trainer & clinical specialist at the NYU Langone Medical Center’s Harkness Center for Dance Injuries. (IG: @harknesscenterfordanceinjuries)
In this episode, we talk about:
What concussions are, how often they happen in dance & why they can be so ard to catch
What to do if you think you might have one
The revolution in concussion care (recommendations have changed drastically!)
How to reduce your recovery time by five days (or more!)
Advice for pole students & teachers on what to do BEFORE a concussion happens
Transcript:
Rosy Boa: [00:00:00] welcome to Slink Through Strength, the Evidence Based Pole Podcast. Today I'm very excited. This is a topic I've been wanting to do an episode on for a while, and Lauren McIntyre has very graciously agreed to join us. So Lauren is a certified Athletic trainer and a clinical specialist at the Harkness Center for Dance Injuries in New York.
So, dealing with injured dancers, kind of her whole thing. And I know, like, none of us like to think about getting injured, right? Like, nobody sits there being like, Can't wait to, you know, fall on my head. Hopefully that's not your goal. Hopefully you're trying to avoid that if at all possible. But, you know, sometimes stuff happens, especially as pole dancers, you know, we're spending time upside down.
And I think it's really important for everybody to be informed specifically about concussions. But Lauren, do you want to start by telling people a little bit about, you know, your background, what it is you do and then maybe starting to talk about some of your, your recent work on relevant research.
Lauren McIntyre: Yeah, sure. Thanks, Dr. [00:01:00] Rosy. So yes, Lauren McIntyre and I. Came into dance medicine straight out of college. My last rotation. So in athletic training, you have to do clinical rotations where you kind of immerse yourself was at the Harkness Center. And then I essentially never left. And so my background was in all sorts of active folks, mostly sports athletes training, and then integrated into dance medicine.
I was interested in it just sort of as an alternative to the traditional sports realm. My background is in vocals and in music. So I did, you know, musical theater, but I was definitely like the musician who moves rather than that being my primary form, though I love to dance. And I got into concussion research through a mentor.
She saw an opportunity. Gosh, probably at this point, well over a decade ago you just like, there's nothing out here about dance and concussion. Like you should, you should do it. I was like, I guess. And so I sort of then fell into it. And I'm so glad I did. Cause it's definitely become a topic [00:02:00] that I'm super passionate about.
And I'm excited about all the work that has been coming out to help folks who are in the performing arts. navigate this this, you know, it's a serious injury. So I'm glad you're talking about it and I hope this will reach lots of folks who maybe are wondering what to do or, or are struggling through that injury because it is definitely a difficult one.
And so that's, that's kind of how I came into it. And then, yeah, I can definitely dive into like the studies or I could talk about like what it even is. I don't know what you kind of are interested in or want to chat about first.
Rosy Boa: Yeah, I think talking a little bit more about what it is would probably be helpful because I mean, I think a lot of folks like Kevin, you know, I've talked about it.
I was trained about it during my personal training certification, during first aid training before then, like, it was like, oh, in fiction, you know someone's bonked their head, and then maybe they pass out for a little bit, and then they, they gently lay on a couch and are administrated to, and then they're fine in like a week.
But then also, I've had people in, you know, my personal life who have received brain injuries, and [00:03:00] that's not been their experience of it. Let me put it that way. So do you want to talk a little bit about what the injury is and what it might look like in the real world if we're not, you know fainting Victorians?
Lauren McIntyre: Yes, exactly. A slight ding. A sea star. So, a concussion is a subset of traumatic brain injury. It's It's a subset of a mild traumatic brain injury so there shouldn't be anything like brain bleeding. Those kind of severe things are not concussions, right? So this is a, we call mild though, as you sort of alluded to many times the symptoms are not mild and the life effects are not mild.
So we don't mean that as sort of a disc to anyone who's having issues but they are just compared to other brain injuries. It's of the mild spectrum. And they happen from forces to the brain, and that's very vague, but it's vague on purpose because that can happen from a lot of different things.
Yes, of course, you could hit your head against the pole. You could fall from the pole and hit your head on the ground, but you could also fall and hit your tailbone on the ground, [00:04:00] and that force could shoot to the head. Or we even think about, like, rotational forces and how perhaps just, like, the repetitive rotation could cause some sort of axonal shearing or something that would cause concussion like symptoms.
So there just has to be a force to the head that then results in sort of a symptom cascade. Because at this point, that's, that's all we have. We don't have you know, unlike other brain injuries, we're not going to see anything on a CT scan. We're not going to see anything on, on imaging. So, you know, you have this mechanism that you think, Oh, Yeah, maybe I was doing XYZ repetitively, and maybe I did hit my head a few times, and now I'm having these these symptoms It's important to note that not every head impact either is going to cause a concussion, right?
Like, how many times have I hit my head on things? Like, I am such a chronic hitting my head on airplanes. Like, you know, I'm putting the suitcase away and then bonk my head or I stand up and hit my head. These have not resulted in a concussion. So. You know, I think sometimes we get the information and [00:05:00] then we panic.
We're like, oh, my God, it's like, it's coming for me. It's not coming for you. You know, it's just kind of either bad timing situation, or it's sort of an accumulation. Right? So if this is the 1st time you bonked your head on. The upper head been on a plane and you don't repeatedly hit your head all the time.
You're probably going to be fine. And so we get this force to the brain and then we have this symptom cascade and and, you know, alluding to the Victorian situation, most people are not going to lose consciousness. They're not going to pass out. But what they might experience is a headache. That's, you know, one of the most common, if not the most common symptom, but they might also feel dizzy, fatigue, have mood changes light sensitivity, almost like a migraine, or it's just like you want to be in the dark, the noises are bothering you you know, cognitive changes.
So it's complicated in that way as well, because how many of those symptoms could be from other things? Right? Like, even having a cold, you know, like, I feel kind of run down, my head hurts, and my neck is a little sore, like, [00:06:00] these symptoms are not unique to concussion, which again makes it really challenging to sort of, okay, well, is it concussion or is it something else?
One of the things that, that sort of classically comes along with a concussion is exertion symptoms. So that's sometimes how we can tease that out. When you exercise with a concussion, it does not feel good. Versus, you know, if you had a cold or something like that, and you're like, Oh, actually, it felt kind of good to like, get going, get my heart rate up.
So that's always something to look for. If like that happened, you didn't think anything of it. And then you took a class the next day and you're like, Oh, wow, that feels terrible. Sometimes that can be a decent indicator of, of a concussion. And you know, I think something else that's important to say is they don't happen a lot.
And I think that's probably why the research on the performing arts side is so. So minimal, because unlike certain sports activities where they're, you know, very prevalent, ours are not when we have looked at prevalence rates specifically at the university that I am at, it's usually about 3 percent of new [00:07:00] injuries.
That's really low. You know, like we're not getting that many of them. The kids always feel like the students, I should kids, but the students always feel like it's a lot, right? There was like, Oh my gosh, there everyone's getting a concussion. It's like, no, it's literally like. Two people, but it feels like a lot.
And I think that's because it's like a low frequency, but high impact meaning that like You're going to notice that person is not in class, right? Like that injury is very visible and it's invisible nature, right? Because it's a major shift in their sort of day to day. But they do, they don't have it a lot.
So it's like, I always feel it's important to say, you know, we're talking about it and the severity and how important it is. You only get one brain. But it's not, you know, the odds of it happening are very, very low. So we don't need to, we don't need to panic. It's not coming for you. But it is really important to know because we.
We do only get one brain and we do really have to protect our central nervous system, right? It's, it's the epicenter of everything that we do from movement to thinking to eating, breathing, all of it.
Rosy Boa: Yeah, absolutely. And just for, for pole [00:08:00] dancers, just a helpful point of information there. So based on sort of norming studies we have on clinical populations of pole dance injuries, about 37 percent of those are shoulder injuries.
So you are like 10 times more likely to hurt your shoulder than you are your head. Assuming, you know, that that rate holds for pole dancers as well.
Lauren McIntyre: So we don't know. I mean, it's, you know, it would be, would be great to know. Cause it could be higher the nature of the activity that you're doing. Right.
So I'm thinking about. What we were studying is mainly contemporary modern ballet dancers who, yeah, they do take some classes that are more, you know, acrobatic in nature, but the things that you all are doing are far more, far more, maybe likely to end up in something like that. So it could be higher, but you know, we don't, we don't know at this point.
Rosy Boa: Yeah. Yeah. That is a, I don't know, I think a challenge of dance in general and pole dance in particular is that there's just a lot of things that have not been looked at, or maybe we have, like, maybe one study, right, like, maybe somebody in, you know, as part of their master's program did one [00:09:00] study, and that is all the information that exists in the, the scientific realm.
So we really have to rely on, you know, knowledgeable experts in the field to, to know more and what's happening.
Lauren McIntyre: Absolutely. I think there was a study now remembering it may have written it down because I was like, I wanted to come prepared. They didn't do concussion pole dance research, but there it was.
They did look at injuries in pole and they had 3 dancers self reported history of concussion. And I can't remember what the overall end was, but it, you know, it's probably even lower than 3%. But again, that's not great quality is Lee at all in 2020. Oh, yeah, yeah. Yeah. So it was just in there. It was part of their intake.
Like they were just collecting sort of the injury history. And I remember pulling that out. So I was like, oh, I want everything that mentions concussion and performing arts dance. Like I want to pull all of it for an article that I had written with Jeff Russell in 2021. And That popped up, but it wasn't, that wasn't the center of the article.
What we were just like, okay, but there were [00:10:00] three, there were three.
Rosy Boa: Yes. Yeah. And I, again, like in my personal experience, I know more than three people who have gotten confessions doing poll. It is at which I've been doing it for a very long time. And I've worked with hundreds and hundreds and hundreds of dancers.
So dance with even more. So I'm not, do not, do not take that as a you know, coming from a very small sample of listeners. Yeah. So, I mean, we talked a little bit about what it is, right? Your brain has force applied to it, but not to the point where, you know, you see like internal bleeding or something that would show up on a scan, and then you get these sort of collection of symptoms.
So I think the first question is, if you are starting to have those symptoms What should you do?
Lauren McIntyre: That's a great question. So, you know, I think this is, this is an area of interest for so many reasons. And we can, we can dovetail in so many directions. It seems like such a straightforward question, but there's so many nuances here because, you know, as we said, you may not have thought anything of that head bonk, right?
Like, You bump your head, you're like, I'm [00:11:00] fine. It's hard to say, like, let me pull the trigger on this sort of what feels like a very aggressive protocol for something that you don't think is going to result in anything. Right. This is something I try, I struggle with as a healthcare professional at times because it's like, wow, it's.
It feels like a lot that I'm going to have to do to this dancer right now to tell them they can't dance for potentially nothing. But you know, I think education here is critical. One in that symptoms are often delayed. So a lot of folks will hit their head, they got adrenaline going, you know, they're, they're, they're, In the middle of exercise, they're not thinking about it.
They don't feel it. But then the next day they sort of like, Oh, I don't feel so good. And sometimes the risk or annoyance of having to remove oneself from activity for no reason is worth it. Because what we see is if you don't take care of it right away, it's going to, you're going to suffer on the back end, whether that means your symptoms get worse or it takes longer.
And I actually did a really, I mean, I'm just. Unfortunate but fascinating case study. I had two dancers who are very similar in sort of their baseline measures and same [00:12:00] age, hit each other's heads. And one of them stops dancing right away and came to see, you know, text me, came to see me the next day. I find out that the mechanism was hitting another dancer's head during her eval.
And I'm like, Wait, where's the other dancer? This dancer's like, oh no, she's in class. I'm like, what? And sure enough, she also had a concussion, but because her treatment was 24 hours later, she came back five days later than this, this other dancer, meaning it, you know, she almost had an additional week of recovery time.
And that's basically what they show in the literature with other sports is, you know, for this delayed recovery, we're tacking on about five days of additional recovery. And so. I guess in summary there, the science tells us that we really should sort of let caution be our guide. We really should be like, okay, this happened.
I don't know. It felt like it was maybe a little bit hard. I'm just going to like, I'm going to stop what I'm doing right now. Make sure I don't put myself in further danger. I'm not going to obsess, but I'm just going to be like, all right, [00:13:00] let me just see how I'm feeling because you might wake up tomorrow and you're fine and you probably are fine.
But if you're not, you'll be super glad that you stopped and that you told somebody and got care because it's going to make your recovery so much faster. So that's kind of the first thing. It's like, if it happens, we're going to start a cost benefit analysis of do I keep going, do I not keep going, let's not keep going, you know, especially if we're talking in a poll environment where you fall from the poll and you have a pretty nasty spill or you like ram your head into the poll, like, even if you don't feel something right away, let's just, let's just sit down and, and, and sort it out.
And then from there, The nice news is that we've really evolved from where we started, you know, I think some of us probably still remember or are still sort of operating in that idea is like, oh, you have a concussion, like, just lay in a dark room and don't do anything. And we've kind of learned from every injury that that doesn't benefit anything.
Like, to do nothing is really counterintuitive to how the body heals. And it applies to the brain, you know, we gave a lot of bad advice to tell people [00:14:00] to cocoon themselves and it's like, I'm not getting better. It's like, yeah, I wonder why you've been socially isolated and doing absolutely nothing for days.
This, this is terrible. So we really want to reintegrate actually and sort of what we call like symptom titration. So, you know, we. Sort of shut us, we do scale back, just shut down, but we scale back, right? And we're like, okay, let's take care of our sleep. Let's take care of our nutrition. Let's, you know, see how we can do with daily activities.
Let's just give ourselves like a day or 2 of just like chilling out. Right? It's really important during that time to avoid screens. That is something that came out of the literature was a recommendation that folks were making kind of generically, but really in that, like, 1st, 48 hours, if you can really scale back the screens.
Then you can have Adam, like it doesn't make a difference after that, but just like shut down the screen use, chilling out, you know, activities of daily living, meaning like go do your dishes, you know, hang out, [00:15:00] whatever. A lot of my, you know, college students will be like, go ahead and color, or like do, you know, like do some knitting, just like whatever feels good to your body, go on like a gentle walk.
And then after that period, we actually really want people to start getting back. Right? So you have that 24 to 48 hour sort of slow pause. And then we're like, okay, what what's feeling good? What can we do? And the goal is not to ever, you know, bother someone, right? Like, life is a symptom provoker, right?
Like, every so often you're like, oh, that bothered me. That's just a human experience. So we sort of say, okay, and this was in the a most recent paper that we published about return to dance guidelines that was published at the end of last year just this idea of, okay, if you don't have any symptoms with an activity, it's probably great to go.
If you have like a little symptom increase, like we call it like a 2 on a, you know, a 10 point scale, and it goes away within an hour, that's okay to do. We're just going to stay there. We're not going to progress it. [00:16:00] Right. And if it's more than that, then that's like we got to scale back and it's a little bit of an experiment, you know, or it's like, okay, I'm going to like, try a little bit of that.
Oh, that was a no. I'm going to adjust as as tolerated. You know, we know some things are not a good idea to do right off the bat, like climb up a pole where you could potentially fall again, bad ideas going upside down. Bad ideas but doing, you know, gentle aerobic exercise tends to help the brain.
So that could be, you know, folks can get back into fitness work. And the sooner we do that, the better, because a lot of the research that had come out was saying, well, yeah, you recovered from your concussion. Now you have an ankle sprain because you came back and you were so deconditioned. That now something else is hurt or your shoulder, you know, for you all would be a perfect example.
Like, yeah, I got over my concussion and then I hurt my shoulder because I haven't done pull work and X, Y, Z amount of time and I'm D condition. So I'm hopefully these new guidelines will help us get back sooner in terms of into [00:17:00] activity so that when we're fully cleared to invert on a pole, we have this strength.
We've maintained some of that strength. So, yeah, it's really just about, like, What can you be exposed to? What is feeling good? What's safe? And then let's just keep building upon that little by little so that you can get back to doing what you like to do safely and, and quicker, honestly, than like waiting for everything to be perfect.
And certainly sometimes a concussion will kind of, you know, be a pain in the derail a system or two to where we do need more like formal rehab. You know, especially for a pole dancer with the amount of, and I know you've done podcasts on like the vestibular effects or training, you know, that's definitely affected by concussions, or we see a lot of folks that have effects.
That may be something you actually need to do vestibular physical therapy for a while to get that, you know, accommodation back to being able to tolerate that, but not always, you know, some folks, again, they. They're okay. You know, they, they, you know, practice a few times and we break down the movement, which is kind of your thing.
Like, I was reading a [00:18:00] bit about you and just that idea of like, Oh, I want to be a scientist about this and like, see, like, okay, how do you do this? What's the steps to get there? That's exactly concussion rehab. What's the step? To do that move. Okay, I'm going to break it down into its basic components and we're going to slowly get there and you know, I would say if things are not really turning the corner between two to four weeks, it's really that's where you need to get somebody else to help you.
But there's a lot you can do in between on your own to see what you can slowly start to increase. Yeah,
Rosy Boa: I think that you're sort of talking about the, the revolution and, and changes in recommendation and care really mirrors. I mean, just sort of more generally, the, I mean, I'm not, I'm not a clinician, but sort of the guidance that I received as a fitness practitioner around how we think about injury generally.
I think we talked about this with Stephanie Greenspan on the Circus Injuries episode as well. That's sort of like, it used to be rice, I'm sure. Anyone who, like, was doing, you know, fitness in the, you know, 2000s, 90s heard about rice. Like, rest is the number one thing and you can't do [00:19:00] anything and you got to be, you know, swaddled until you're all better and then you can return.
And the sort of transition to the peace and love model where, yes, absolutely some rest, but then really focusing on loading and like progressively you know, increasing load, although I will say my understanding is for things like chronic fatigue syndrome that is not the recommendation at all.
Just an aside, because I know some of y'all listening have have fatigue related syndromes.
Lauren McIntyre: Yeah, absolutely. It doesn't always apply to everything, but in general, this is kind of the direction that we're going with most things is, you know, what can you do? What is feeling good? What load can we apply?
Because tissues heal with load, right? The only way they adapt and change is load. So we can't expect you to improve if I don't load you. Same is true for your brain. I can't accept, you know, expect your brain to remember how to do all of these things if I don't challenge it. It can be frustrating to have to continually deal with symptoms and, and, and be like, okay, I'm a little symptomatic now.
I got to [00:20:00] rest, but it's really the only way forward. Yeah. Yeah.
Rosy Boa: But I think most people would prefer not to have to deal with it at all, which brings me to sort of my, my next sort of bucket of things, which is just general recommendations for avoiding concussions in the first place. And these may be for, you know, dancers, or they might also be for, for instructors possibly.
Things to keep in mind.
Lauren McIntyre: Yeah, I mean, gosh, wouldn't it be great if we could avoid all all problems? I was giving a workshop yesterday talking about how, you know, the best things in life come with inherent risk. And certainly when we think about pole dancing, I mean, there is risk everywhere. And that doesn't mean we shouldn't do it, but it means that we should have good things in place to manage that risk or mitigate or be prepared.
And so I think that's really a starting place is acknowledging that the risk exists. And so what plans do we have in place? So yeah. Yeah. Yeah. You know, I know that you do a lot of like working with folks that are doing whole home poll things and you know, I've talked about this back in the pandemic.
I, I did a podcast about emergency prepared [00:21:00] ca was it, was it a podcast? I think it was something like that about emergency preparedness and the idea of like, oh my gosh, what if I'm teaching an online class and someone like has a seizure and I am seeing this on video, but I have no idea where they are and like, what do I do?
So you've been thinking about things like that. Like, okay, I'm doing this thing. What if I fall? And I mean, these are terrible things to think of, but you know, what if I fall? And then I'm unconscious. And then like, what do I do? So, you know, is there a thing where you're like, Hey, to your friend or your spouse or your partner, whoever your roommate's like, Hey, I'm going to go take my poll class.
If I don't come out at this time, can you come check on me? And, and having those emergency things set in place know what you would do. Who would you call? Like, let's say you're not unconscious, but like you fall and something happens. Like, who is the person that you go see? Where is your local urgent care?
Do they know how to manage? Musculoskeletal injury or concussion. So just kind of having that stuff in place, I think is really critical because it's going to help you receive care faster and make sure that we don't have anything catastrophic happen, [00:22:00] which that's just my mind as an athletic trainer.
You know, that's what we're prepared to do is to deal with acute injuries as they happen. And so I'm always, you know, where's the AED, where's the exit, where, who am I calling? What am I doing? So that's just part of kind of my. I'm okay with those kind of things. I know they're scary to talk about, but I think it's it's a good thing to have in plant and in place.
And I think also from a risk mitigation standpoint, you know, why do most injuries happen from fatigue? You know, that's that's what we see. Right? So how can we mitigate risk? Well, should I really have taken that class? I was, you know. I really should have rested today. Like, today was not the day. And I knew that.
Or I didn't have time to eat. Or maybe it is, I do fuel myself well. Like, I am sleeping well. Like, taking care of oneself can mitigate so much risk. Because the more care that we apply to the body, the more fatigue resilient we are. And then we're able to do these things and, and, you know. And mitigate the risks that might be associated.
You know, similar with cross training, the stronger that you are, the better you are [00:23:00] able to grip yourself on that pole and reduce the risk of falling. So those would be things kind of off the top of my head for like what we could actually do. Cause a helmet's not really going to, you know, something silly like that, like that's not going to prevent a concussion and we know that from football.
So, you know, But ways to prevent falls or accidents as much as we can. We know that things happen. So one, maybe those easy button. They're not easy, but fatigue related things. How can we make sure that we have the energy that we need to have to do the thing that we have asked our bodies to do? And then how, what, how prepared am I for things to happen and making sure I have those in place so that I can get care kind of.
As soon as possible. I would say those are definitely two areas that we can focus on to help with risk in this area.
Rosy Boa: Yeah, I know when I started teaching online, when I taught in person, I did hour and a half to hour 45 minute classes. But when I moved online, I shortened everything to an hour [00:24:00] to partially that and partially that.
Usually when you're training in a suit, you'll have multiple people on a pole. So you have more built in rest. And usually when you're training by yourself at home, you can just, you can spend the whole hour doing, doing high intensity stuff. So, or moderate intensity for me, usually. Yeah.
Lauren McIntyre: Yeah, good point.
That built in sharing, right? Of that rotation, that built in rest that's not there by yourself. And yeah, it makes a difference, right? I mean, this is, we're talking like, it's like power lifting, right? You need a lot of rest between sets in order to do those max, max efforts. And I mean, part of your work is so amazing because you're bringing those principles into this for folks who probably may not have ever encountered those principles of conditioning.
So yeah, that's, that's so important.
Rosy Boa: Definitely. Yeah, something you you mentioned I'd like to pick into a little bit is, I agree, I don't think, pole dancers are not going to wear helmets, right? Like, A, just kind of not part of the, not part of the aesthetic. No, no, no, no. And B, you know, not super [00:25:00] helpful for, for concussions.
I think we also like hockey is another example of a sport where helmets are used and They're really
Lauren McIntyre: helpful for things like skull fractures. Great. We don't want to crack our skull. Yes, fabulous. Just not going to prevent your concussion. But I don't want your skull to crack, so if you're biking, wear a helmet.
Rosy Boa: But I'm interested if you know of any work on mats or crash mats for things where you might fall. So maybe like gymnastics or climbing or what the sort of what, if anything, you know about that.
Lauren McIntyre: Great question. I mean, I would say I probably know not very much about that in comparison to someone who is managing circus athletes often or gymnasts, but I mean, when we think about most of those things, they're usually to prevent catastrophic injury, right?
We're trying to provide some sort of cushion. So your tibia doesn't snap in half or again, your skull doesn't crack. Yeah. Probably not going to do anything from a concussion standpoint, but it probably does [00:26:00] absorb some force when we think of other musculoskeletal injuries or other catastrophic injuries.
So, yeah, it sounds like a good idea. Probably is going to help you, you know, if you fall, have less of a bruise or, you know, potential for injury. I don't think it's. Negligible like, or, yeah, I think that's what I'm trying to say. Like, I don't think that the, that the point of it is moot. But there's only so much that a mat is going to do.
Right. With so much force.
Rosy Boa: Yeah. Yeah, I think that makes makes a lot of sense. I, I'm trying to remember where I ran across this, but you know, I don't know if anyone else did like brain dissections and like college or high school or anything, but like on those preserved brains and they're like.
They're pretty, they're like sort of kind of like feta, I guess, is kind of the texture. Sorry if that's a little bit gross. And so I'd sort of assumed that, you know, that's what brain was like in head. And I didn't learn until many years later that, no, it's really goopy. It's, it is not. Real goopy.
Lauren McIntyre: You could like [00:27:00] pour it out the side. I love the feta image. That's great. Yeah, it's, it's. Floating in there kids. And that's really where that concussion stuff comes from, right? Because it's, it's moving. And so if I move my head this way, and then I suddenly stop, your brain is still going that way. And then it kind of bonks into the wall, right?
And then sometimes it can Head back the other direction and bonk on that side too. We call it coup contrecoup. And so yeah, that's really how it happens is it's floating around and these sudden head movements. That's why you don't necessarily need to be hit because a sudden head movement transition could absolutely cause your brain to keep going when your head, your skull has stopped and sort of hang around in there.
Yeah, kind of like whiplash, right? Like whiplash from the neck, but it's often difficult to. sort of parse out, well, is that the neck that's talking or is that a concussion? Because they have similar mechanisms and similar symptom cascades. Yeah,
Rosy Boa: yeah, that's a really good [00:28:00] point. I think the, the thing where that would probably be the most of an issue in pull would be obviously if you're spinning and like you come off and fall, that would be clear.
But then maybe if you were spinning really fast and you stop suddenly I think that's also an area where I would be potentially, potentially concerned. So, yeah. You know, I mean, pole dancers, you, you want to like, I think most people aesthetically tend to prefer sort of like smooth entrance and exits of spinning regardless but also, you know, maybe, maybe just a little extra care for, for your brain.
Lauren McIntyre: Yeah, exactly. And, and, you know, things, things happen. And again, with wrist, like, Things will happen, you know, like you're, you're taking a risk, you're exploring. That's part of the art of it too. And so, you know, to say these aren't going to happen or they're going to happen and it's okay, right? Like, there's no need to have, you know, that we're going to get permanent damage or we're never going to be the same.
We're just going to take care of it, and we're going to take care of it appropriately, and the sooner that we take care of it appropriately, the better the outcome's going to [00:29:00] be. And so yeah, it's okay to take those risks. If you're feeling things that maybe feel abnormal, we're going to talk to somebody about it.
Rosy Boa: Yeah, I think that is a great attitude to have. And a wonderful thing for us to take with us into our movement lives in general.
Lauren McIntyre: Absolutely.
Rosy Boa: So I know that you've worked on a number of research studies on concussions and dancers, sort of your, your area of expertise. Is there anything that you think we haven't brought up yet from your research that you think would be particularly interesting or relevant or cool, or you just wish people would know about?
Lauren McIntyre: That I want to stand up on my soapbox. What area do I want to pick? Yeah, no, I, I love so many things. I, I really think that, and I, a lot of the education that I deliver tends to center on this, this idea of changing culture and changing sort of injury culture within the, You know, the dance realm is really where I'm living, but but every performing arts realm and just the idea of like they're going to happen right as you intro to this episode saying like nobody's sitting around saying I wonder, you know, like I can't wait [00:30:00] until I get hurt, but it happens.
We see a lot of injuries. And we still have so many barriers to properly addressing these and creating a culture of acceptance and compassion within, you know, definitely the dance realm. You know, and so when we think about how that translates into concussion, we already know that this is an invisible injury, right?
Nobody can really see what's happening, and there's a lot of stigma associated with that, and people already don't want to stop dancing or doing what they want to do. And so we have this sort of perfect storm of you can't see it, so I can hide it. And people don't want me to, to fess up to having an injury because it's an inconvenience for them.
And this is not normalized and, but we know we're going to get better the sooner that we say something. And so we have this sort of, like, sort of battle between what should we do. Right. And I think that's something that I am passionate about that. Our research is showing that research and other things are showing, like, we need to get this.
We need to get people [00:31:00] to get care. But there's this huge barrier because 1, they may not think it's that serious, or they don't want to, or they're, you know, they're afraid they're going to lose income, you know, or you're going to you don't even have health care, right? I mean, how many of our performers don't have health care, right?
There's so many barriers to getting help. And yeah, it's like, we need systemic change, right? To where we have the Better access. We have more compassion for folks who are suffering with injuries or chronic pain. And we normalize that not in a good way, but, you know, like normalizing is saying, like, hey, I'm going to check in on you and hey, it's okay that you got hurt.
Let's get you help. Let's, you know, Let's let's figure this out. And one of the first study that we ever did was about knowledge and behaviors when it related to concussion in dancers. And we found they knew what a concussion was like. So giving them education about, Oh, this is a concussion. It's like they already knew what they were for the most part.
But what they did was have horrible behavior when it when it came down to the taking care of [00:32:00] themselves. Right. That culture of caring for oneself, like 19 percent have that locked in my head of our respondents had knowingly danced with a concussion, which is, Oh no, exactly. It's staggering. It's like, this is that good.
But it makes sense. Because hustle culture and I'm going to lose my job and somebody's in the wings ready to take my place and then I'm going to get fired and I don't have health care anyway and I don't have money and you know, it's, it's, yeah. So that's something like, I think it's really important, that culture of self care, the community care, like how can we support each other when we're hurt?
How can we encourage each other to take good care of ourselves? Because society right now, doesn't care, right? They're not, they're not caring for my performers, right? They're cutting, they're slashing funds. They're, you know, want to cut all these, you know, access to care. So we kind of need to stand with each other right now more of a grassroots support.
So yeah, I think that's really important. Just knowing that like knowledge alone is not going to [00:33:00] help us. Treat ourselves better. We know how we should treat ourselves. It's more that we don't have the sort of social support to do so. And so how can we to get people to take care of concussions better or take care of themselves?
Any injury better. We have to create a culture in which that makes sense. I hope that went a direction that made sense to you.
Rosy Boa: No, yeah, absolutely. Yeah, and I think there's you know, things are a little bit different in the recreational pole dance realm specifically, but I mean, certainly if you're dancing in a club, like, you don't get tips if you don't show up, right?
And there's very much a kind of. treating people's bodies like they are disposable and I'm going to extract all the, the use from it and then throw it away. And then it's, you know, 100 percent their, their problem. Which, I mean, a reflection of, I think, a larger societal problem that we can work to address.
Yes. If I show it up.
Lauren McIntyre: Yes, exactly. We have to, we have to say no until it's right. But yeah, I mean, that's, I think that's really at the crux of it. Like when we think about how we're going to [00:34:00] manage these concussions better in the performing arts, it's really, it's so much bigger than us. It's not, you know, we can't point at the person like, Oh, you're not reporting, you know, you didn't come see me.
And, you know, I have to catch myself. Cause I'm like, in my head, sometimes I'm saying that, like, why didn't you come? And it's like, well, I know all the reasons you didn't come. You're afraid you're going to fail school if you're taken out for two weeks and you're, you don't want to miss out on all this stuff.
I totally get it. And so, yeah, from a, especially like club workers, there's so much stigma there and not, you know, not making what they should, and there's no income. If you don't show up, that's so common in the performing arts. You know, there's no pay for a sick day. So, you know, why would you take care of yourself?
Yeah. And so I think that's, you know, not concussion specific, but it is definitely an injury where we see that problem prevalent across the board. Because there, it's just an invisible injury with a lot of stigma attached to it.
Rosy Boa: Yeah. I feel like so, so many of these podcast episodes come down to there's a societal program that a societal problem that is [00:35:00] leading to Outcomes that could be better.
Lauren McIntyre: Yeah, that's how every conversation these days probably should be. Like, why do I feel myself always heading that direction? Ah, yes, because that is, that is the answer. I think something else that was in a totally different direction that was interesting The second study that we ran was on university and professional dancers, and we wanted to look at their baselines and our dancers were very much the same as athletes.
If you look at their balance and their rapid number naming and their cognition, but their symptom scores were like, leaps and bounds higher. So a baseline, the average symptom score was 16 and if you look at and like, you know, studies have been done on athletes, it's like 2, you know, and so we're talking like 8 times higher.
And I think only, it was like 4 percent of our dancers had a zero, like reported no symptoms at baseline. And that was really interesting, you know, and you've talked about this in your podcast before too, I was looking through and listening to episodes, like [00:36:00] the perfectionism and some of these mental traits really affect how our performers are moving in the world and are experiencing the world.
And so the reality of saying like, Oh, you needed, you know, this is. Why I'm so glad the guidelines have changed, like you need to be at a zero before you can progress is hysterical because my dancers are, you know, some of them are like, I have a symptom score of 32 and I feel great because they're taught to overly analyze constant body evaluation, you know, everything they feel everything.
And so, you know, that I, that was one thing that that study was really mind blowing for me. And. It makes me very grateful that we're not waiting around for folks and that's that's important for them to know, too. I'm not waiting around for you to be at a zero. I want you to start moving. So, you know, if you've got a headache of a three, great.
What can we do with a headache of a three? That doesn't make it that much worse and makes it go away, you know, within an hour. So that was something [00:37:00] else like just thinking about some of the information that we've gathered over the years that our performers definitely should not be given the advice to wait till they're symptom free because, you know, They probably were never symptom free.
What humans are symptom free?
Rosy Boa: A good question. A good question. Yeah, very few. Especially if you know, you know, spend a lot of time reflecting and noticing like this is probably not like a great thing but for several years I just had a headache all the time and it's because I needed glasses. Oh my gosh, I was just like, I have a little bit of a headache,
Lauren McIntyre: you know, the normal amount of headache.
You are making me think a hysterical, I mean, again, they're not funny, but they are funny. I had a patient this year who needs glasses, but doesn't like wearing them for dance, which makes sense, but got a concussion and like her eyes, it was like, What is going on? Like, I'm like, do you have an eye issue?
Like, we couldn't get her to focus. And I don't know why I hadn't asked, but [00:38:00] all of a sudden she's like, oh, well, I need glasses. I was like, where are your glasses? Like, oh, my gosh. And so we had wasted all this time, like, thinking that she had all these eye problems. It's like, she just needs to wear her glasses.
So yes, it goes back to the concussions are multi sort of symptom. You know, these symptoms are multi. There are many different things. You can have a chronic headache because your eyes don't work because you need glasses. You can have a concussion and a chronic headache because you also need to wear the glasses you have.
Rosy Boa: Yeah. Yeah, and I think it's a it brings up a great point, right, that like, if you're like, maybe I have a concussion, what you're looking at is change from whatever your baseline is. Because, again, I know a lot of my students are, you know, they're dealing with chronic pain or disabled in some way, right?
And if I came up to, you know, someone with chronic pain, I was like, are you in pain? I mean, yeah, the answer is yes. So you're looking for change, not just, like, existence.
Lauren McIntyre: Yeah, exactly. It's the same with a dance. I mean, any dancer, they're all in pain. It's not good. And I think that relationship with pain that's [00:39:00] perhaps a little bit complicated, it can be problematic in recovery and, and I think sometimes that can cause concussion recovery to last a little bit longer.
Right, if we're coming in with chronic conditions, I mean, we know that from the literature anxiety, depression migraine disorders. I mean, a lot of these things are going to make concussion recovery slower. Just because they involve the brain, right? And so our brain baselines a little bit different.
It's going to be a little different on the back end. And that's, you know, frustrating. It's definitely frustrating. But something that, that we see and why it's important to take those things into account, because they are going to, they are going to change things. For that person.
Rosy Boa: I understand. All right.
Well, I want to be mindful of your time. I know you've got a lot on your plate but before we head out if folks wanted to follow your research or, you know, I guess if folks are in New York and are looking for you know, working with you possibly, I don't know if you're taking on on, on patients where can folks find you and [00:40:00] learn more about your work?
Lauren McIntyre: Yeah, I'm going to make my Harkness plug here. So if folks are in New York City or not in New York City one of the things I'd love to lift up is the Harkness Center offers something called an injury prevention assessment. It's a free 1 hour wellness consultation where you can do virtually or in person and get to know a little bit about your unique strengths or imbalances or weaknesses and get a home exercise program to work on those.
It's a great way to continue to be well and to continue. Continue to grow in your practice, so I would definitely lift that up there. They're free. I mean, it's great. So and again, you don't have to be here to take advantage of them. So we definitely love you to do that. And you can call us at 212 598 6054 to schedule, which is annoying because everyone wants to schedule online.
There's a great reason and that's because they are for our performers. So if we have this out on a public site and we want it to be public information, anybody could schedule and we don't want anyone to schedule. You [00:41:00] want performers to schedule them. So we need to have our fabulous medical office associates.
screen people when they call to make sure that that free service stays for the folks who need it. So please come see us for one of those and you can follow us on our Instagram which I believe is the Harkness Center. I'll put it in the description. Yes, please do. I'm, I don't manage our Instagram.
I just follow it. So I'm pretty sure it's Harkness Center for dance injuries, but if you want to tag our social media, that would be awesome. And yeah, that's, that's where you can find us and the work that we're doing because Yay for concussions, but we're also doing all sorts of other fabulous work and programs and we do rehabilitation for injuries here.
So if you're in New York and your shoulder hurts we'd be happy to do rehab. We definitely have rehab to many a pole dancer. So yeah, come see us stay in touch. We would love to continue the conversation.
Rosy Boa: Absolutely. Thanks so much for joining me today. I've certainly learned some stuff.
Hopefully everyone who's learning has also learned some stuff, know what to be on the lookout for, for [00:42:00] concussions. And you know one, one takeaway, right? Like one day earlier looking for help, because I know pole dancers, I know y'all, you're like, I'll just, I'll suffer through it because I'm tough and you are tough and you are strong, but would you rather spend five fewer days recovering?
Yeah, because you showed up a little bit earlier. I think, listen, that sounds like good math to me, so ask for help.
Lauren McIntyre: That's a great take home.
Rosy Boa: Absolutely. All right, well, thank you so much for joining me today, Lauren. Thanks so much to everybody who's listening. I hope you found something interesting and useful here to take with you into your practice, and I will talk with you very soon.
Bye. Thank you.
