Ballet, knee surgeries, and middle age: a 42-year-old charts his recovery and progress
I am a 42-year-old coming back to ballet following a 15 year absence. I had studied and performed during my 20s. But professional necessities and soccer injuries forced me out of ballet for far too long.

My interest dates back to when I was seven. I saw a classical pas de deux on a morning TV program before school. My sister declared it "mush," but I was captivated. The partnered steps were so flowing and musical. And the solo variations were athletic and exciting. As expected, my expressed interest was not acceptable to my parents, and so diverted. They did permit me to try gymnastics and diving. But I always wanted to try ballet.

I declared adulthood following graduation. And while awaiting the start of college I finally approached a local dance teacher. She offered me an individual class. I took to it very naturally as I was athletic and had watched as many televised dance performances as the Midwest allowed. My teacher was very encouraging and gave me a very sound introduction to the basics.

During my first year of college I was not able to continue. I was attending Kalamazoo College, and they had folded the few dance classes offered due to low interest. During my sophomore year I was sent to Denver for a research internship at the National Asthma Center.

While there I visited several studios. I settled for the Colorado Dance Center (then in Denver). At that time (1978-79) the center was run by Lillian Covillo and Friedann Parker. They directed me to a class taught by one of members of the Colorado Concert Ballet. She was a wonderful teacher and really encouraged me to push. Within several weeks I was offered a scholarship to unlimited classes and a chance to be developed for the company!

I took classes six days per week and developed rapidly. They offered me a chance to try dance as a profession. But I was committed to a career in psychology. It was a difficult decision to turn away from a fantasy. But I reasoned that, given my late start, I would never advance too far and would have to retire too soon.

I continued to dance during the remainder of my college years. I took a few classes in France during my junior year abroad. And during my senior year I studied and performed with Western Michigan University's ballet group. A highlight of that time was my invitation to dance in the Grand Rapids Civic Ballet's production of Carmina Burana choreographed by Ruth Page. The chance to work with Miss Page and Larry Long was truly memorable, and I got to dance corps and soloist roles.

After Kalamazoo College I attended Michigan State University for graduate studies. I found a studio that was reasonably close to my apartment. My teacher was a gem. I performed with her best girls at recital-time for the next few years. To this date we remain close friends. And I am returning to her classes now.

The demands of my work as a therapist have always been offset by my physical activities. Simultaneous with my pursuit of ballet was my pursuit of soccer. It was my version of heroin. I progressed very rapidly as a player and competed at a high amateur level. But I was later felled by a devastating knee injury in 1994. I extensively tore a lobe of articular cartilage in my left knee. The surgery to repair and reattach it was successful, but left me considerably diminished athletically.

In the seven years since then, I have mellowed my athletic energies. I have become a pretty good golfer and limited my soccer to age-appropriate leagues. I had long-considered going back to ballet but never quite made it. I finally announced my retirement from soccer last fall. I looked up a teacher in the little rural community where my wife and I now live. She offers an adult class, though most of the students are in their late teens. I felt mighty overmatched the first few classes. But they were very accommodating to a middle-aged man, and I persisted. Then I tore the ACL in my left knee.

Luckily, it didn't happen in class. But it was another devastating knee injury . . . and the same knee! I delayed my surgery, not wanting to be on crutches during a particularly bad winter. During the intervening time I worked hard to build up muscle mass. I had the reconstructive surgery on 7-26-01. The operation was a very good one, with no complications.

Recovery and rehab for this procedure are lengthy and painful. I went to work immediately on reducing inflammation and restoring range of motion. My surgeon is quite conservative in the rehab program he prescribes. I am currently nine weeks post-surgery and have been in formal physical therapy for five weeks. I am augmenting this with Pilates mat work. My physical therapist is excited with my recovery and progress. She works me as hard as the protocol permits and I am an all-too willing grunt.

As my muscle loss has arrested and my strength is coming back I have finally returned to class once again. I have returned to one of my favorite teachers. She knows me from my performing days and is willing to work with me in my present state. I must wear a mechanical brace to guard against twisting. It limits full extension, but my surgeon insists. I've had four operations on this knee and want no more. I am grounded to the barre for two more months. But I have made it through two classes and feeling a bit more comfortable.

My experiences and injuries have taught me a great deal of respect for good technique. I imagine that many men who pursue ballet get caught in a common snare. We tend to start late and perform too soon. We learn to perform before we develop a sound technical base. I learned to do double saut de basque long before I learned a proper demi-plié. An abundance of muscle can allow us to perform difficult steps and jumps. But, without proper alignment and movement, injury is sure to follow.

I try to spin my current predicament positively. I now have an opportunity to map good technique onto my recovering body. I have a lot less muscle to conquer. But moreso, I have a chance to build muscle back in a better way.

I have little desire to perform again. My wife used to direct a South American folkloric group, and we occasionally kick around the idea of re-forming it. Or maybe a chamber group with a balletic base. For now, I primarily look forward to getting back to center floor. It feels good to be back among dancing friends and I do feel a tangible sense of progress. I hope to be able to continue this, and will post updates along the way.

Update (10/01): I've been back to class for four weeks, now. I do feel a sense of progress, but it is a humbling experience. I have to be very cautious about turnout, and my ACL brace is cumbersome. My physical therapist has been very helpful in a couple of important areas. First, she is working all major muscle groups, not just my legs. Secondly, she gives a lot of exercises that stress proprioception. I can work up a tremendous sweat in some of these. Physical therapists are as cruel and sadistic as everyone says! The results at the barre are starting to show. My strength and speed are clearly improved. And a sense of fluidity is also returning. The pain in my knee is negligible. The pain is everywhere else.

I'm at the halfway point in my recovery, a month away from center floor and light years away from what used to be. But I am really enjoying the process of rediscovery. My class is a long drive for barre work only. But my teacher is very supportive and encouraging. Next week I see my surgeon for my three-month status check. I hope to be cleared to start small jumps and some combinations at center. Patience, boy, patience.

Update (12/01): I am now five months post-surgery. I've just been discharged by my surgeon and given my running program. I have looked forward to this greatly, for fitness and weight loss. But three days into the first phase I pulled a calf muscle. I fault my brace, as it has always aggravated my calf when running in the past. It was not such a problem in ballet class, though an encumbrance none the less. A pulled calf muscle is much like a pulled groin muscle in that the injury is slow to heal, and prone to re-injury. This is my first significant setback in my recovery. My class has been off since early December and does not resume until mid-January. I had planned to use the month for strengthening. But it's back to Pilates exercises until this injury heals.

My progress in class was very positive during the first three months. I have been able to do some center floor combinations, mostly adage and small jumps. Turns and large jumps are still some time away, contingent on my ability to keep reclaiming muscle and strength. This is where age can be really cruel. I do not know whether I can be performance-ready by recital time in six months. But, again, my interest in performing is nowhere near as great as my interest in returning to dance as a discipline.

Update (2/02): It took nearly two months, but my calf strain is finally resolved. I have ditched my brace, at least for ballet class, and use a compression wrap around the calf to guard against re-injury. I'll wean myself away from this within the next week, as the muscle feels strong again. I'm working my way back into turns, limiting myself to singles and doubles. Petit allegro jumps are coming back nicely and help me to feel a bit more like a dancer again. Larger jumps are still off limits without the brace, and will have to wait another four or five months.

I have read recently about advances in ACL procedures and am amazed to hear of athletes coming back in three months. Youth has much to do with this, undoubtedly. But these procedures have come a great distance in recent years. Not too long ago an ACL tear was career-ending, required a full leg cast for several months, and came with few assurances of a full recovery. For any of you out there contemplating or needing this surgery, take heart. Good surgery plus good rehab can yield a very full recovery.

My surgeon has said that I was wise to have a "clean-up" procedure before the reconstructive operation. True, it delayed the inevitable and took me out of action for a long time. But he has seen cases where having the two procedures done simultaneously results in more complications and a longer recovery period. Plus, in anticipation of the reconstructive surgery I devoted six months to building up as much muscle as this old body can still generate. More typically, patients have the procedure done following acute injury, as soon as inflammation subsides. A lot of muscle mass can be lost during that period, especially in middle-aged bodies.

Be a knowledgeable patient. Research the procedures and inquire of your surgeon what techniques he/she uses. In particular, ask about the recovery and rehab protocol to be prescribed. It amazes me that there are still surgeons out there who do not prescribe any rehab. I can only imagine the arthritic tissues that would result from such inactivity. Some surgeons opt for a next-day start of physical therapy, while others delay this for several weeks. My surgeon prescribed the latter. My physical therapist said that I could have been a great candidate for the former. In truth, I did start some exercises the second day, and I think that it was helpful in preserving range of motion.

Ballet has served as an extension of formal physical therapy for me. My surgeon was very iffy about this, not having worked with dancers before. But he was very impressed with my recovery, especially the range of motion and strength I was able to rebuild within a few short months. I hope that my experiences may serve as a guide to any of you who may be faced with ACL surgery. True, it involves copious amounts of blood, sweat and tears (more sweat than anything). But anyone who has studied dance for any amount of timme is no stranger to such challenges. To dance is to live!

Update (4/03): Greetings! I'm still among the living, and dancing. It has been over a year and a half since my ACL surgery. I continue to take class weekly and my progress continues. I am still reluctant to do some grande allegro steps, especially those that overly stress or torque the afflicted leg (e.g. grande pirouette a la seconde). But overall, I am back to a fairly advanced level. I have agreed to participate in my teacher's recital. She is staging excerpts from Coppelia and asked me to dance the role of Franz. The pas de deux are tough on me, especially overhead lifts. Obviously, I have stressed leg strength to the relative neglect of my upper body. I foresee a lot of pushups in my immediate future. We'll see!

I have received quite a number of messages/inquiries about my posting to your site, from young students as well as adults. It has been interesting to compare injuries, surgeries and recovery methods, and I hope that all can continue to improve. Ballet has been an integral part of my rehabilitation and I am very happy to be able to continue. -- Jay VanderKlok