Foot and Ankle Patient Story: Jennifer Laux
Ballet Dancer Back on Her Toes
She was well past her prime when she started ballet lessons — age 12 is considered "old" to start dancing if you expect to be serious about it. Despite her advanced years, Jennifer Laux loved ballet and quickly excelled at it. She studied at the Makaroff School of Ballet in Appleton, her hometown, and by age 14, began spending summers studying at the Milwaukee Ballet School. She performed all over the Fox Valley with the former Children's Ballet Theater.
Her trouble began in 2003, the summer after her junior year of high school and what would be her last summer at the Milwaukee Ballet School. She was dancing all day, every day, and ended up with a third-degree sprain of her left ankle after the first week. "It was an immaturity on my part and not taking care of my body as much as I should have and ignoring the signs," Jennifer said. "It was due to just basically overworking."
That sprain brought her to Craig Young, MD, Medical College of Wisconsin orthopaedic surgeon and company physician for the Milwaukee Ballet. She took the rest of the summer program off – helping with choreography and other non-dancing responsibilities — while rehabilitating her ankle at the Froedtert & the Medical College of Wisconsin's Sports Medicine Center. "I was antsy, but it was the best thing for my ankle at the time," Jennifer said. She recovered, but knew that ankle would always be vulnerable.
At age 17, at the urging of her ballet teacher in Appleton, Jennifer auditioned for and was accepted at the North Carolina School of the Arts (NCSA) in Winston-Salem. It's a high school and college, and Jennifer spent her senior year of high school there.
All went well until her sophomore year of college at NCSA. During the spring semester, Jennifer was preparing for a week of performances. She had noticed problems with her ankle, "but just being a dancer, I think your body gets trained and you learn how to compensate," she said. "I would roll and just find myself on the ground. If I found uneven ground between the grass and the sidewalk, any slight glitch like that put me on the ground."
Then during one dress rehearsal, Jennifer fell again. "It really threw me when it happened. It was a flat-on-your-face kind of moment," she remembered. Still, without an understudy, she danced the entire week of performances. "I have no idea how I danced with my ankle taped all week, but it was sort of a false security blanket."
After the week of performances, Jennifer realized she had a serious problem with her ankle. Her mom contacted the Milwaukee Ballet about Jennifer's ankle instability, and they put her in touch with Dr. Young again. This time, Dr. Young told Jennifer therapy wasn't going to help her ankle instability, and that she likely needed surgery. He recommended Richard Marks, MD, FACS, Medical College of Wisconsin orthopaedic surgeon because of his extensive experience with foot and ankle disorders.
Ankle sprains are the most common musculoskeletal injury, according to Dr. Marks. Ankle instability can happen to anyone at any age and can be caused by a severe sprain that doesn't respond to rehabilitation. But, 90 percent of sprains tend to rehabilitate without surgery. The decision to correct the problem surgically depends on each patient's circumstances, expectations and other factors.
In June 2006, Dr. Marks performed a lateral ankle ligament reconstruction on Jennifer's left ankle to correct her instability. The procedure involves making a small incision along the lower outer part of the ankle, identifying the torn ligaments then suturing the ligaments to tighten them. Dr. Marks takes a minimally invasive approach, and is one of the few surgeons in the region who does the procedure in a way that allows for accelerated rehabilitation of the ankle.
Jennifer's recovery and rehabilitation took several months. She was in a cast and off her foot for four weeks after the surgery. She eventually went to a partial weight-bearing boot with crutches, then to an air cast. She did about two weeks of physical therapy at home before returning to school in September. She was still undergoing physical therapy and not dancing. "It was a little like learning to walk again," she said.
"The first time I realized the procedure was really effective was when I stepped on something, I had a slight bobble, and it was terrifying, because typically I would have found myself on the floor and it didn't happen," Jennifer said.
She was truly back up to speed by January 2007, nearly seven months after surgery. She worked hard to get back into overall shape and to rehabilitate her ankle. As it became more clear that she had done all she could to get her ankle back in shape, she wavered about getting back into her demanding school schedule and continuing to dance. She waited to talk to Dr. Marks during her 2006 Christmas break.
"I'd made really good progress but the question was ‘How do you transition from therapy to fully dancing?'" Jennifer said. "Do I ease into it or do I just go for it because I'll never do it otherwise? Dr Marks said ‘Go or you'll never go.' That was all I needed to hear, but I knew I needed to hear it from him. That's what I did, and he was right."
Jennifer credits Dr. Marks with understanding how important dancing is to her. "He's everything you look for in a doctor. He spends time with patients and he took to heart that this is something important to me."
Jennifer is back at school dancing again, and looking forward to a career as a dancer.