*While the article is explored through the lens of circus injury, it is relevant for all athletes, dancers, gymnasts, and movers

This blog explores understanding and navigating injury in circus through a psychological and neurobiological lens.

Personal Context:

In October 2018, I sustained a significant shoulder injury (torn labrum and bicep tendon) while training. After failing to make adequate improvements through physio, I had shoulder surgery (SLAP repair and a bicep tenodesis) in February 2019. While the surgery itself went quite well, I experienced a host of medical complications directly after surgery that my doctors weren’t able to explain. I was admitted to the ER the day after surgery due to a pancreatitis, a liver that was shutting down, an inability to keep pain meds in my body, and a high fever that wouldn’t break.

Hooked up to a post-surgical ice machine and sporting my sling

Docs assumed that some unrelated medical issues were surfacing, and things got worse from there. Between a few different stays, I spent over a month in the hospital and an additional eight months on the couch. I started having seizures, some of my organs bottomed out, I had a bajillion scopes and scans, I had inflammation markers that were off the charts, I had another pancreatitis episode, and I contracted C.Difficile, which I battled for nine additional months before having a fecal transplant. (Yes, this is a thing. Yes, I’ll tell you about it if you ask. Yes, a doctor put my friend’s poop into my body so that her good gut bacteria could fight against the evil bacteria that had taken over my guts. Yes, I pooped poop that she had already pooped. Yes, we’re bonded forever.)

Within a few months, I had gone from a circus human who trained five days a week to someone who couldn’t independently stand up from a hospital bed, keep food in my body, change my own clothes, or take a shower independently. And even once I stabilized a bit, I remained quite sick, and my life was dictated by physio appointments 2-3x a week, sleeping, and non-stop medical appointments. I was thrust rapidly into the world of injury and chronic health issues, and the year was HARD.

Not. A. Good. Time.

(While my experience was drastic, this article will be relevant for anyone facing injury of all kinds. Also, please note that my experience was one in a million, and if you’re about to have this surgery, it is HIGHLY unlikely you’ll face the complications I did. Once my body had energy to throw at shoulder healing, things have gone well for my shoulder.)

TLDR: Injury and being forced away from your sport is a bad time. Been there, done that. Got the t-shirt, the hospital bracelet, months of physio, lots of pain, and got to participate in twice-baked poop. 0/10 - Do not recommend. 10/10 - Did survive, and am now rebuilding on trapeze and doing much better.

Onward!

The Impact of Injury:

This section explains several key functions that circus plays for many of us to provide a context for understanding the impact of injury.

LOSS OF IDENTITY:

Humans are meaning-making creatures, which means that we develop stories to convey meaning about our internal and external experiences to ourselves and others. This meaning-making process is part of being a human, and is a huge part of how we construct our identities.

The Cycle of Identity Creation. Rinse & Repeat.

When I talk about the idea of “stories” in the context of identity, I mean it in the simplest way: as an account of something that has happened, not a well-crafted “once upon a time” fairytale with a clear beginning, middle, and end.

Most of the time, we don’t even think about the stories we’re creating, because our brain creates them automatically. We constantly take in sensory information from the world around us, our brain processes it, and the words-and-idea parts of our brain spit out an explanation for what we experienced. Voilà - Story!

Doing physio exercises with a cord tossed over a hospital room bathroom door during a hospital stay. My max range in April 2019. I worried I’d never get back on a trapeze, or even function normally in my daily life. (Don’t mind my hospital bed hair)

You probably have a LOT of circus-related stories that span a wide range of categories, including:

Your circus community and what it means to be a part of it
What it feels like when you train
Times that you’ve struggled and overcome
Times that you’ve goofed off in your circus space with your friends
The feeling of nailing a routine or a trick
Etc.

The list goes on, and your stories probably run deep.

The first you walked into a circus studio, you probably didn’t feel like a circus artist or identify that way. You were a person with other identities who was coming to take a class. But, as you spent more time in the studio and created stories about what it meant to be there and how you felt about being there, it became part of you who you are, and these stories became woven into what it means to be you.

This is how identity is built.

WHEN THINGS CHANGE:

While some identities come with a sudden start date (like becoming a parent), most identities are created over time, and we slowly morph from “person taking this trapeze class” to being a “circus artist.”

And yet, injury does the reverse. Suddenly, being a circus human - and many of the things that go along with it - are inaccessible.

After I got injured, most of my life changed. I stopped going to the studio five days a week. I couldn’t work my body in the same way. I couldn’t get on a trapeze. My schedule was dictated by medical appointments rather than training hours. I stopped seeing my circus-friends everyday. The list was never ending.

And I found myself wondering who I was if I wasn’t a circus human. And whether I could still be a circus person if I didn’t have access to all of the things that were previously part of this identity. Along with this, there are so many other things lost:

LOSS OF REPETITIVE ESTEEM BUILDING MOMENTS:

In a supportive circus studio, the potential for building and maintaining self-esteem is huge: we achieve new things, we exchange support with our peers, we push our limits and find success, and we’re brought into the fold of something. These experiences provide a constant source of data that reinforces that we belong, are worthwhile, can struggle and achieve, and that we’re capable, powerful, and persistent - the building blocks of self-esteem.

When you’re injured, you may suddenly be without one of your biggest sources of esteem. Sure, you may struggle and overcome in your physio exercises, and you may still see your circus friends - but you likely won’t get the same reinforcing repetitions of esteem the same way that you used to.

LOSS OF A CONSTRUCTIVE WAY TO COPE WITH STRESS:

For many, circus is a constructive and healthy way to cope with stress. (Yes, circus life can also be a huge source of stress, which is a post for another day).

For many, circus provides an opportunity to experience regulating movement (see my article on PVT for more about this), and a chance to engage in physical activity that releases brain chemicals that play an important role in regulating your mood. (Looking at you: endorphins, dopamine, norepinephrine, and seratonin).

If circus is your creative or physical outlet, or the place you went to blow off steam - it can feel devastating and disorienting when that outlet vanishes.

LOSS OF INVINCIBILITY

It is no secret that circus artists are tough on their bodies. Even if you’re doing an excellent job of taking care of yourself, chances are good that you push yourself hard and have the sore muscles and bruises to prove it.

When we’re not injured, our bodies reflect our hard work and progress, and our recovery after training hard reinforces beliefs that we’re strong and capable. When we’re injured in a way that takes us from our sport, these feelings of invincibility are shattered.

While I had experienced my fair of short-term circus injuries, being injured in a way that was going to take me out of circus for months and require surgery felt really different. I was angry at my body, and felt like my body had failed me.

My hard work no longer correlated to outcome, and I felt compromised and defeated. I did my physio religiously, and yet, I didn’t get better, and I needed surgery. And after I was cleared to do post-surgical physio, the progress was incredibly slow and painful, even though I was working incredibly hard. I found myself feeling like I was no longer in control of my body, and like my “input” of energy didn’t correlate with the “output” of progress, which was very uncomfortable.

LOSS OF INDEPENDENCE:

I have always prided myself on being independent. While that has softened over the years as I’ve come to understand the neurobiological importance of co-regulation and connection, being faced with a sudden loss of independence is challenging.

Even if you don’t experience complications after surgery like I did, being injured will likely change things for you. Once I had largely recovered form my worst period of complications, I still needed a lot more help than I used to need, and everything was a few degrees more challenging. Carrying groceries was hard. I couldn’t hang a picture high on my wall because my range of motion was limited. Even cooking required some creative planning, because I couldn’t hold a pot with two hands.

Being injured requires you to sit with yourself and your relationship to others in a new way. You may need to ask for help in ways you didn’t before, and you may be dependent on others for information that you don’t have yourself (but need to get better).

ISOLATION:

Some people who are injured may be able to cross-train in other disciplines, or they may enjoy going to the gym to socialize despite their injury. For me, this wasn’t the case.

After injury, and before surgery, it felt hard to be in the gym. I was angry and sad that I couldn’t train the way I wanted to, and it felt worse to be there than not. I planned to return to a ground-based cross training schedule after surgery, but that plan was quickly foiled by the complications I experienced after surgery. As circus felt further and further away for me, it felt more painful to try to be a part of a world that I didn’t feel like I fit in, and it was easy to feel isolated.

GOT IT. INJURY IS REALLY HARD. GOT ANY TIPS FOR SURVIVING THIS PERIOD?

YES! SURE DO!

Finding a new way to roll out my thigh with a lacrosse ball when I couldn’t put weight on my left shoulder. This remains my favorite way to roll out my thigh!

Find people who have been through what you’re going through: One of the most valuable things for me throughout this process was my connections to circus friends who had had shoulder surgery and come back from it. Their reassurance and understanding resonated with me in a way that no one else’s compassion could, and I was forever grateful for my small cohort who deeply understood all aspects of this process. They provided excellent reassurance, and unbelievably useful concrete tips that I needed as I navigated life post-op. One friend even took a train up from the states to spend the week after surgery with me. The solidarity ran strong. If you're grounded and injured, harness the power of the internet to find other people who have been there - even if. youdon’t know anyone already. It is worth it.
Fight the urge to isolate: Yes, you might not want to be in the circus studio right now. And that is okay. But, you’re going to need people through this process. Maybe they’re your circus friends, maybe they’re not. But, make sure you have people. If staying connected to your circus friends doesn't work in the same way -either because it feels too hard, or because they were friendships that lived in the studio - be prepared to feel some feelings about it. It is okay and normal to feel sadness and grief that things are changing.. AND, you still will need people. So call your people in. Or, go find new people if you need to.
Feel the feelings: You may feel mad and you may feel sad. I sure as hell did. Making room to mourn and feel is important. If you ignore the feelings, I promise they won’t vanish. When ignored, feelings have a special way of becoming louder and more intense until you acknowledge them. Trust me, it is better to face them sooner rather than later. How will you know when you’ve felt them “enough” and it is time to “move forward and mobilize?” Great question. There likely won’t be a singular moment in which you cross into a place of “done feeling” and “ready to move on.” However, when we process our feelings and give them space to exist, the way that we experience them changes in intensity, and they take up less energy and brain space. This freed up space enables us to shift our energy and attention to other things - which may feel like “moving on” in some ways. If you find yourself tanking for a long time, or feeling unsure if you should be feeling how you’re feeling - this is a great time to get a therapist involved. Actually, anytime is a great time to get a therapist involved. If you, reader, don’t have one, may I strongly encourage that you consider getting one?
Take an active role in your healing: Yes, physio sucks. Yes, it is boring. Yes, it hurts. No, it is not anywhere near as fun as anything you do in the gym. Yes, it is a constant reminder of the fact that you can’t do the things you *actually* want to be doing. AND, it is important to find as many ways as you can to feel like you’re an active participate in your healing. When we feel like we’ve lost control of our bodies, it can be easy to resign to being a passive participant in our recovery. Figure out what taking an active role means to you, and try to take it. If you’re into researching and understanding everything you can about your body - get cracking on google. If you want to create a spreadsheet that tracks your physio exercises - you are my people. If you want to make a spotify playlist to serve as the background music for post-physio-crying-break-downs - please share it with the rest of us - we need you. Whatever it is - try to find ways that help you feel like you are participating in your treatment, and that treatment isn’t just happening at you as a result of this awful thing that happened to your body. If you find. this hard, you’re not alone. And you’re not failing at doing something right. This is HARD.
Do stuff you like: You won’t be able to replace circus, and you shouldn’t try. Circus is likely a huge piece of your identity, and you can’t slot another activity into that “identity chasm.” BUT, you *should* try to fill your time with things that you like. Fight the urge to feel like nothing is good enough or fun enough because it isn’t circus. I know, I get it, easier said than done. This mindset won’t make the pain you’re feeling go away. But, both things should exist: It is unfair and sucks that you can’t have circus right now AND you still deserve to be a person who has access to fun things and gets to enjoy themselves whenever possible. Now is a good time to take the improv class you’ve been thinking about, to join a book club, or to sign up for a ribbon dancing seminar.* You do you. (*If you sign up for a ribbon dancing seminar, please consider this my request a full report.)
Set new goals based on the current you: This one is tough. When you’re hurt, it is *really* easy to only see how your current life compares (and sucks) compared to what it was before. The challenge is to set new goals for yourself that are based on your current life. They may or may not be circus related. But, spend some time figuring out what you want to set your sights on during this period. This is NOT a “just be positive and focus on other stuff and it will feel better!” piece of advice. I get that it isn’t that simple, and shifting attention isn’t the only thing that needs to happen. The goal isn’t to dismiss or replace the feelings you’re having about your loss of circus with warm and fuzzy excitement about something else. That likely won’t work. The goal is to sit with those feelings AND try to figure out what else you want to work on right now. Yes, this will likely feel hard. Yes, lots of feelings may come up about not being able to do what you want to be doing. You’ll revisit the “acknowledge your feelings” part of this tip list MANY times throughout this process. An annoying amount of times - Brace yourself.
Find your path: It might be different than mine, or anyone else’s. Figure out what works for you, and lean in. A few months after surgery, I went to a circus show with a circus friend. I wanted that to be a good idea, but it was not. I’m not honestly sure if the show was any good, because I was too busy crying. All I could see was everyone’s healthy shoulders, and I realized that it wasn’t productive or useful for me to try to immerse myself in circus at that time, and that I needed to listen to that instinct and pull back further, though it was painful. It is okay to be where you are and to know what you know to be true - even when it is uncomfortable. Find your path, lean in.

More than anything, be nice to you. This is *hard* work. You may feel like you’re doing well some days, and tanking on others. Your life just got flipped upside down, and it is very reasonable that everything feels awful. Give yourself some time and some grace. Buy yourself your favorite snack, and give yourself permission to swing back and forth between hopeful and devastated. Remember that healing isn’t always linear (physically or emotionally). There will be days that you feel good and hopeful - And days that you feel hopeless.
Feel the feelings, and recognize that this is a huge change to be sorting through.
It is okay if you aren’t sure if you believe that you’ll come out the other side, and it is okay to struggle and feel lost.
Everyone’s journey is uniquely theirs, and wherever you are - it is okay to be there.

From a person who has been there, I send solidarity.

-Lacy

Surviving Being Grounded: The Psychological Impact of Injury in Circus