The Doctor is In: Knee Health with Dr. Emily Rausch

Knee injuries are common among dancers. To reduce injury, dancers should practice good technique—for example, not forcing turnout, which stresses out the joints.

In pole dance, we also practice safe techniques to reduce injury. However, the most widely circulated techniques primarily concern the shoulders, with hips at a distant second. The conversation concerning knee health is beyond weak.

For an expert opinion, I turned to Dr. Emily Rausch, a Certified Chiropractic Sports Physician and self-proclaimed body nerd. Dr. Rausch went down a “rabbit hole” to find any kind of research on knee pads and injury rates. “I assumed that sports like volleyball would have a lot of research around what type of foam or knee pad design protected the knees best,” she said. “I was shocked to learn that there are very few studies around the force distribution when wearing knee pads, and that the studies available were around roofers!”

Lots of pole dancers swear by knee pads and wouldn’t dream of doing floorwork without them, but there are still some pole dancers who are resistant to wearing knee pads. Obviously, I want people to wear my knee pads, but the conversation has to start with why we should be wearing any knee pads at all.

Some pole dancers might not like the way knee pads look, while others view knee pads as reserved for novices. I’ve seen comments on social media from one pole dancer to another advising not to wear knee pads in order to toughen up knees over time, which is most concerning to me. I’d rather break in a knee pad than break in a knee, but that’s just me! So I asked Dr. Rausch about the idea that not wearing knee pads can condition knees or make them tougher. Is this true? Can you break in a knee so you don’t need knee pads?

Dr. Rausch explained that there have been some studies done around the injury rates associated with pole dancing, but she’s unaware of any studies comparing the knee health of dancers who wear knee pads versus dancers who don’t.  “Most of the long term dancers that I've interacted with have some level of knee pain. Would going back in time and wearing knee pads change this? Maybe,” she wonders. “But until we develop a time machine or start studying pole dancers currently, there's no way to know.”

What Dr. Rausch does know is that the body adapts to what we throw at it. She points out that moves we once thought were so painful, like superman or a pole sit, become more tolerable over time. “The same can be said for doing floorwork,” she explains. Floorwork generally requires sliding, pivoting, and kneeling, while tricks like kips have dancers flat out landing on their knees with significant force. “You can desensitize the nerves so you don't feel as much pain with repetitive load.  However, unlike the nerves on your inner thigh, your knee has more structures, tendons, ligaments and menisci that can be impacted with the repetitive load.”  Dr. Rausch points out that the repetition isn’t necessarily bad, as once thought, but compared to thighs or other areas of the body impacted by pole, knees appear to have more at stake.

Pole dancers will most likely experience small but regular and repeated pain with their knees, rather than a major singular trauma or injury. Dr. Rausch describes these injuries as an accumulation of microtraumas that we don't allow to recover properly before training again, which is why tracking our training load and recovery is so important. In other words, we do a little bit of damage each time we dance, which if ignored, could become a more significant problem later on.

In pole dancers, the most common knee complaint Dr. Rausch treats is a general knee pain that’s a combination of knee cap pain from floorwork or pain in the knee pits from gripping the pole.  She recommends reducing the load on the knee cap by either wearing knee pads or not doing as much floorwork while the body adapts to the load, in addition to strengthening the muscles that move the knee.

As for longevity, what we do today impacts how our body will function in the future. Here are Dr. Rausch’s top three recommendations for everyone she works with:

  1. Move your body in a variety of ways as much as possible.  The phrase "use it or lose it" applies to our joints, so the more you can move your body through its entire available range of motion without forcing your body into positions, the healthier your joints will be.
  2. Get and stay strong.  Strength will decrease your risk of injury and help you feel like a badass.  I'm a huge proponent of lifting weights.  It won't make you bulky, unless that's your goal AND it helps with improving your flexibility.  Plus, it will help increase your bone density, leading to a decreased risk of fractures when you're older.
  3. Control the controllables.  Sleep, nutrition, hydration, and stress management are key for long-term health.  You can work out a lot, but if you aren't sleeping enough or eating for your activity level, you are going to have issues.  The more stressed you are, the less stimulus it takes for you to experience pain.  As much as we want to separate our lifestyle decisions from our health and performance, they are directly related. We can't control everything.  Do the best that you can with the resources you have access to.

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Dr. Emily Rausch (@dr.emilyrausch on Instagram) specializes in treating pole dancers and aerial artists. She runs Empowered MVMT Chiropractic and offers worldwide virtual assessment and health coaching. Follow Empowered MVMT on Facebook, Instagram, and YouTube to learn more.


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