Cirque combines extreme athletic performances, diverse artists, and breathtaking spectacles to create a show that has a global appeal.
The circus is exciting and unpredictable, but it can also be thrilling. Injury can happen at any time during rehearsals, performances, or travel.
Looking after the health and well-being of circus performers is a unique task. We’ve had the privilege of doing that as physiotherapists who treat and coordinate artists’ medical needs.
This has been done in over 100 cities across 30 countries, including North and South America, Europe, Australasia, and Asia. We’ve mostly toured with professional cirques, but we have also advised junior performers and circus training centers.
Here’s what it’s really like to be behind the scenes at some of the most famous shows in the world.
A diverse crew
The circuses themselves and the performers they employ are very diverse. The disciplines include ground acrobatics, such as tumbling and hand-balancing; aerial acrobatics, like trapeze, silks, or straps; manipulation (juggling); clowning; and music. Fire, ice, or water may be used in rehearsals or performances, as well as a variety of props.
The cast of a big show could be compared to an Olympic team, which has a wide range of age, size, and body shape.
Performers at the elite level may have a variety of cultural, linguistic, and national backgrounds. It can create challenges due to different belief systems, attitudes, and training methods.
There are many different types of injuries.
Fortunately, while headline-grabbing injuries and falls do happen, they are rare. The majority of injuries are chronic injuries (long-term injuries) and not as serious acute injuries.
Most commonly, injuries to the back and ankle are reported. Also, we see strains, sprains, and sore shoulders and lower backs.
Many of these injuries may be well-known to you. Circus performers are unique and require extraordinary strength, coordination, and range of movement. Their bodies must function differently than ours. We work differently with performers in order to help them get back on their feet or hands.
Circus injury rates are 7.37-9.27 per 1,000 artist exposures (the number of training/performance hours or number of training sessions/shows). Acrobatic injuries are the most common.
The limited research we do have suggests that the circus is safer than many other sports. This includes lower injury rates compared to contact football (rugby Ame, American football, and Australian Rules) and gymnastics.
In the professional circus, injury tends to be minor. It usually requires seven treatment sessions or less and results in one or no show being missed.
Injury reports are probably underreported. Injuries are often defined by the fact that artists miss training, show, or seek formal medical attention. These criteria don’t apply to all damages.
In our research, we looked at the self-reported lower limb problems of performers regardless of whether or not they had missed work. We asked about symptoms and injuries such as pain, stiffness, and clicking/catching.
We found that more than half of the performers had reported lower limb problems in any given week. Over 18 weeks, 86% said that they had experienced at least one work-related lower-limb problem.
A diverse range of issues
Some performers face additional barriers in recovering from injuries. According to the report, financial issues and lack of support for health care were problems.
Full-time artists, for example, may have access to medical personnel who are on the road and have experience with circus performers. These artists could also be entitled to paid leave for injuries and comprehensive health coverage.
Artists who are on short-term contracts or do gig work may have to pay for their medical treatment and will suffer more financial losses if they miss a performance.
Researchers have reported that aspects of circus culture can influence the way we treat circus injuries. In a study, circus performers stated that they did not always trust the knowledge of healthcare practitioners about work demands. It includes the circus skills required, as well as training and show schedules.
Some performers will prioritize the advice of their coaches and colleagues over medical recommendations. It may be because the circus is an ancient art form where training methods are passed on from generation to generation.
This knowledge is valuable for health care practitioners. Clinicians and artists must work together to develop a common understanding of injury management.
Recognizing the uniqueness of circus training and performances and the lack of evidence to guide medical decisions in the field can help build rapport and ensure that a collaborative approach is taken to managing injuries.
Preventing injuries is the goal.
Circus performers have a good understanding of how to manage their bodies. They use strength, flexibility, and conditioning training in order to improve their actions and prevent injury.
We have used techniques that are more well-established in sports medicine and dance medicine to help performers self-manage.
We looked at the possibility of adding endurance exercises that can be self-directed to a touring show. Many performers were pleased with this.
A lot goes on behind the scenes.
Artists and support staff are required to put in a lot of work behind the scenes for the show to run smoothly.
This is a unique and challenging workspace for those who care for circus artists. It also offers a fascinating view of some of the most amazing shows on Earth.