Ballet and Bones

Kathy Challis speaks about how taking up ballet has helped with her osteoporosis.

This story is about me – my osteoporosis, and the amazing and beautiful journey that ballet is taking me on, and how it pulled me out of the depths of despair.

It’s more usual to take up ballet as a child, and develop osteoporosis as a senior citizen. It seems that I’ve done it the other way around. It’s not certain that my osteoporosis has been with me since childhood but it seems likely. My first fracture occurred at the age of two, when I broke my femur (thigh bone). From what I’ve read since, generally a femur needs high impact to break, such as you might get from falling from a height, or being hit by a car. You wouldn’t expect to break your femur by kicking a soft beach-ball, as I did. I spent six weeks in hospital, but there were no investigations done at that stage to find out why this large bone had broken.

I was finally diagnosed in middle-age, before menopause, with osteoporosis in my spine and hips. It was discovered by chance after an xray on a swollen knee. The knee got better on its own, but the poor bone density revealed by the xray triggered a series of investigations, tests, and eventually treatment.

I had a great stroke of luck when I was referred to a most awesome rheumatologist, Dr Poole, at Addenbrookes in Cambridge. After some sharp detective work and observation, he diagnosed me with a connective tissue disorder, Ehlers Danlos Syndrome (EDS), which he believes caused the osteoporosis, due to faulty, or inadequate production of collagen.
I was started on treatment with bisphosphonates, an expensive, I believe, treatment on the NHS – to my eternal and undying gratitude. And he encouraged me to stay active.

Enter ballet

I think I took up ballet a year or two after my osteoporosis and EDS diagnoses. Now that I’m writing this, I realise that there is a connection. Discovering that I would probably become immobile much earlier than I expected is, I think, why I decided to “seize the day”.

I’ve always loved ballet – to watch. It transports me to another world where I’m absorbed and moved. After a lifetime of injuries thanks to my hypermobile joints, and fractures from my osteoporosis, I firmly believed myself to be clumsy and accident-prone, and learning ballet seemed as remote from me as my other great dream, cycling along the rings of Saturn.

But something about the osteoporosis suddenly said to me, why not have a go? See how far you can get.

I googled “adult ballet”, found a class, and couldn’t believe how much I loved it. There have been many lovely ballet teachers along the way, who encouraged me and helped me, and many friends who joined in my journey. Early on, Lwena, from M&L School of Performing Arts in Newmarket, particularly encouraged me and got me taking ballet seriously, and taught me for my first RAD exam – Grade 1. And what’s more, she became a friend, and made me feel part of her family.

Meeting Angela

Angela is a year younger than me, and I never let her forget that. Angela was also interested in doing RAD exams, and after a move to Colours of Dance in Cambridge, we were taken under the wing of the fabulous Principal, Imogen Knight, and her equally lovely and dedicated colleagues, as we worked towards Grade 2.

Working on, and passing our Grade 2 exam was a wonderful experience – every moment of it, and it was with high hopes that we started to work towards our Grade 3.

With new confidence in, well I guess you could say, performance art, I also branched out and joined a Gilbert and Sullivan group, singing in the chorus. There was some dancing in the show and I was amazed to discover that people saw me as dancer. I never expected that.

But it was several months into our Grade 3 studies that problems started, for me.

Nagging pain

A nagging spinal pain appeared, in my neck first, and then my upper back. It wasn’t constant, but became progressively more frequent. At times the pain was bad enough to bring me to the brink of passing out.

I contacted the osteoporosis nurse at the hospital. She booked me in for spinal x-rays, in case my brittle spine had started fracturing (always a possibility with my condition). She also warned me about some ballet activities, particularly doing jumps, and anything involving leaning forward, although she was most encouraging about doing ballet in general.

The xrays gave me an unexpected result – no fractures, but degenerative disk disease. That was it. A result and no follow up. A GP surgery that seemed reluctant to see patients. This was a devastating time for me.

It made me realise what a lifeline ballet had been for me. And it seemed that my dreams of doing Grade 3 were shattered, with the restrictions of no jumping or leaning forward.

Despair

To be quite honest, it felt like the beginning of the end. I’ve rarely felt such despair, compounded by the almost constant pain in my spine. In the midst of this, I contacted Imogen to update her. She invited me to come to her office so we could talk in person.

Just having a meeting coming up started to make me feel a touch more positive. I started hatching a plan where I could work on selected parts of the grade 3 syllabus, with perhaps a simulated examination organised by Imogen.
I was right to feel more positive. As soon as we met, Imogen was in equal parts constructive and sympathetic. She was happy to expand on my idea of a custom-made examination. She emphasised the need to get expert opinion on exactly what I could and couldn’t do, encouraging me to go back and seek further medical advice.

She, most importantly, convinced me of her commitment to continue teaching me, no matter what, saying lessons can, and have been, adapted many times to accommodate a student’s physical needs.

I left our meeting feeling considerably encouraged, but the over-riding feeling was that here was someone who wasn’t going to abandon me, and was going to work with me on a plan for the future.

Around this time I also had a helpful conversation with a colleague, a former GP. I told her what had happened and how disconsolate I felt at the advice to stop doing jumps. She said emphatically that she believed that I had been given poor advice. Her view was that jumping could only be beneficial.

She suggested that perhaps I’d misunderstood the osteoporosis nurse’s advice, and that perhaps she had only meant to avoid jumping until I had the results of the xray.

This made sense to me. I could see that the nurse would have wanted me to stop jumping until it was established whether there were fractures present or not.

My former GP colleague echoed Imogen’s advice to get medical advice.
I braved my GP surgery and virtually begged for an appointment with my GP (which they really didn’t seem to want to give, but gave in eventually).
On hearing my story, my GP’s advice was clear and concise “jump all you can”.
I resumed my ballet classes with Imogen.

Over the next year, she meticulously planned a programme of building up to jumps and rélévés. We continued to work on basic foundations like pliés, and building safe and good technique.

Life was on again

The time came when I re-started my Grade 3 journey. It was quite long, enjoyable, sometimes painful, sometimes tough, but ultimately rewarding.

The first of January 2024 came around. It was a moment to take stock. I decided that, two weeks off turning 67, I had to commit to doing my RAD Grade 3 exam in the upcoming year. I felt that if I didn’t do it that year, I was in danger of losing momentum and giving up completely.

I told Imogen and Angela of my plans, and they were right on board with it.
It took work and determination but it was all such fun – the ballet classes followed by lunch in the café downstairs, the friendship we continued to develop.

There began a gradual improvement in my spine. It still hurt sometimes, and sometimes it hurt quite a lot, but there was no doubt in my mind that mobility helped. Gradually I noticed other things. My formerly weak, and hypermobile ankles, became stronger and more stable. People commented that I held myself better. My balance improved.

Of course none of this was measurable.

Until, a couple of weeks before my RAD Grade 3 exam, I got the results of my latest routine bone scan. It showed that between the ages of 63 and 67, the bone density in my spine actually increased by 5%. In the past, I was very happy with a scan result which showed no deterioration. This was phenomenal!

As my awesome rheumatologist said in his summary letter “Your bone density increased by about 5% between 2020 and 2024, while most women are losing bone at about 1-2% each year”.

Ballet as medicine

During our consultation, he asked me questions about how much ballet I did, and where. I asked him how much of my improvement did he think was due to the ballet, and how much to the treatment. He said “probably about half and half”. That means that ballet has quite likely contributed as much to my improvement as the fabulous expensive treatment the NHS provides me with.
He even put it in the letter “This is probably the combined effects of your regular ballet at Colours of Dance and your zolendronate infusions…”

It seems to me that this improvement quite likely will prolong my active mobile life by a matter of years – perhaps even my life, as we all know how often elderly people die following hip fracture (the bone density in my hips has also improved).

This news put me flying high for my Grade 3 exam. Angela and I passed with the same marks which we were both thrilled about, but for me the bone scan results were equally joyous.

Ballet has had such amazing benefits for me. I can’t describe it adequately. And I’ve realised that the benefits I’m experiencing with my bone density are also there for Angela, even though she doesn’t have osteoporosis. For both of us it’s setting us up for mobility and good health in our mature years.

Hope for the future

In particular for me, I’ll never forget how ballet helped pull me from a trough of despair, and provided hope.

And the future… Angela and I are working towards Grade 4 now. I continue with my Gilbert and Sullivan group, enjoying the buzz of performance. Sometimes I think that without ballet, I’m not sure I’d even be able to walk by now. I’d certainly be a far less happy person.

I never want to stop…