14. Stabilizing the Hypermobile Body through Circus Arts with Emily Scherb, PT, DPT

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00:00:00 

Jennifer Milner 

Welcome to bendy bodies with the hypermobility MD, your podcast to learn all about the benefits and  complications of being bendy. This is your co-host Jennifer Milner here today with host Dr. Linda Bluestein.  Before we introduce our special guest, a couple of quick reminders, please subscribe and leave a review. This  really helps grow the audience. Please also email your questions or call the number in the show notes and leave  a voicemail. We may answer it in the next episode. Today's special guest is Dr. Emily Scherb. Emily is a  physical therapist specializing in circus and performing arts medicine through her almost 30 years of training  and working in the circus arts. She has gained deep insight on how circus bodies work in the air and on the  ground. Emily now teaches workshops for circus artists, instructors and healthcare providers. With the mission  of improving health and safety in circus training and performance.  

00:00:53 

Jennifer Milner 

Her best-selling book applied anatomy of aerial arts was published in 2018. Dr. Emily Scherb. Welcome to our  show.  

00:01:17 

Jennifer Milner 

Yay. I'm excited.  

00:01:30 

Jennifer Milner

You cannot see us, but we are all wearing sparkly costumes right now. Perfect. Emily, you started out as a circus  artists and aerial dance performer. Can you tell us about that experience?  

00:01:44 

Emily Scherb 

Absolutely. I started out as even further back as a gymnast, as a young kid, and I was exposed to circus, as a  hobby or a fun thing to do at a summer camp when I was still pretty young. It turned out that I really enjoyed  performing a lot more than I enjoyed competing. There's similar demands in the body and kind of the culture of  training and I kind of slowly shifted over to circus. By the time I finished high school, I was both doing a little  teaching and doing a little performing and ended up taking some gap years to go out and do some performing  before going on to college. Taking more time off before going back to grad school. So, kind of a long and  winding road that it's always circled back around circus since I was pretty.  

00:02:34 

Jennifer Milner 

Yeah. Nice. Well, so what did you learn about before we get to how you treat other people's bodies? What did  you learn about your body while you were performing and studying aerial arts?  

00:02:43 

Emily Scherb 

Oh my goodness. I learned that bodies are complex and fallible even if, your 20 something year old self feels  like it's all gonna be. Okay. Just like a lot of us that grew up as athletes, artists, dancers, gymnast, performance  performers in general, we're always looking to present our best selves. Especially when we're younger, we don't  realize how those repetitive movement patterns might be influencing our longterm lives or how, any injuries that  we assume will just go away, may stay with us for awhile or reoccur in different parts of our body in different  patterns. Also as a circus artist in particular, when I started circus was still really small in this country. The  knowledge about how to teach it was still evolving and is still evolving as all good pedagogy should. But it was  really nascent. We knew kind of what the body should look like and not necessarily how to get it there, similar  to dance, even after all these years, we're still talking about, well in Puerto bra in ballet, like how are the  shoulders actually working to achieve that long line? And what does a healthy way for our shoulders and bodies  to be working? But in circus it was kind of accelerated faster because you've got end range of motion and high  demands on the body.  

00:04:09 

Emily Scherb 

We're still trying to figure out how to actually teach that to another person versus like the family handing down  and passing of knowledge. That was more traditional prior to circus being available on a recreational level like it  is now, or having schools that are training people to professional level.  

00:04:28 

Jennifer Milner 

In all of your experience, as you were going through it yourself, is that what made you think, Hey, the things I'm  learning about myself, I want to use to help other people, like what pushed you into the PT area and wanting to  specialize in circus arts?  

00:04:43 

Emily Scherb 

I, as a person who's always been a mover. I always knew that I wanted to do something with the body. I wanna  do something with orthopedics. I wasn't sure if I was going to go and be an orthopedist because that's Oh,  doctor, like when you're 10 and you're like, Oh, that I know what that is. Or if I want to go chiropractic or I  wanted to go physical therapy, but I always knew from the time I was pretty young, that I was fascinated by the  body and movement was kind of the highest priority for me as a kid. I never stopped moving according to my  parents. Movement was always such a high priority. I knew I wanted to do something studying the body, even  before I found circus. With circus, it just kind of expanded my knowledge of movement and through circus, I  really learned how to teach as well.  

00:05:34 

Emily Scherb 

That's probably what drew me to physical therapy in the most direct line was that love of teaching and that love  of explaining how bodies work to another person and instructing movement and observing movement, was kind of how I got into PT. When I got to PT, then I realized all the things that were doing in circus that were  questionable. That made me go back into the realm. I mean, I always wanted to work with circus performers  cause I love my community and it's such a big part of my life. It wasn't like, Oh, I'm going to go to PT school to  be a circus PTs. Oh, I'm going to go to PT school because I love movement and bodies. Learning more about  bodies brought me back to circus.  

00:06:13 

Jennifer Milner 

Interesting. It was your love of it that got you into PT school. When you're in there, you're like, Oh, Holy crap.  Maybe we should revisit how we're doing some of this and how I can help them move safely and be healthy. So,  so as you were going through PT school and moving through that, what training did you find for wanting to  specialize in circus and performing arts?  

00:06:39 

Emily Scherb 

Yeah, so I went to Washington University in St. Louis, for my graduate training and, their program is very  heavily centered on movement and movement systems. It was actually a really great fit for someone coming  from a movement background. That idea of looking at movement impairments and how the movement pattern  may be imperfect and how that might relate to the actual injured tissue. So it was very relevant for me. It was a  great mix of my using my circus training, I and watching movement and being able to pick up on that in a  normal person, who's doing a step up on a stair or a forward bend or raising their arms up over their head. I, my  brain was kind of used to slowing down movement and watching the pieces. I think it was almost like, I felt like  at least in the movement observation parts, I had a leg up on my classmates because I was so used to watching  bodies, few other people in my class also from kind of a dance performance background that kind of was the  same thing we're so used to watching movement and, kind of taking it in and feeling what that feels like in our  bodies that kinesthetic learning that it is I think easier for us who are used to that versus just the academic side,  to learn that component, to really see what our patients are doing and how they're moving.  

00:08:02 

Emily Scherb 

The type of training that I got was actually very relatable for me. I know not all schools are going to be as  focused that way. They're going to look more tissue in structure and function. This was much more movement to  get that bigger picture. For me it was a great fit, and I almost lucked into that, but it was a really great  experience and a great program for me.  

00:08:26 

Jennifer Milner 

Excellent. Well, and some of the best things to have happen, you look back and you're like, Oh, that was kind of  lucky that happened or very fortuitous. Right. Okay.  

00:08:34 

Emily Scherb 

It didn't really understand the differences in types of PTs and types of training that people could get. I just was  like, Oh, this one's good.  

00:08:40 

Jennifer Milner 

Right. Well, and Linda and I are both very familiar or more familiar, I should say with the world of dance  medicine then, and helping dancers then with circus arts specifically. So, it's interesting to me to have seen just  in the past few, IADAMS meetings that circus arts are starting to come into their own as a distinct subset or  even distinct different set of it. What do you see as some of the differences between specializing in circus arts  rather than performing arts?  

00:09:11 

Emily Scherb 

Yeah. One of the, so I'll start with what's similar between the disciplines is the artists focus their treatment of  their body as a tool and an instrument that, they're always going to go above and beyond. You need to tell them,  no, really I want you to do this, but I don't want you to do this. I want you to only do five of those 30 is not  better. Also with that, the fear and anxiety that comes from your body, being your instrument and being your  tool that you perform with, and the fear that can come along with that, especially in a professional artist, but even in many hobbyists, they, it becomes so much a part of the identity of the person, especially when you're  using your full body to do something in your brain as well. And that's where the similarities lie. The difference  in differences lie in that so much of circus is happening, at end range of motion.  

00:10:14 

Emily Scherb 

Much of circus is happening, in a environment where we're still learning a lot about the body it's grown. Very  rapidly versus Stanford has a much longer history, circus, at least in its current form. Again, in the United States  around the world, it's of a different culture, but circus in the U S has exponentially grown in the last 10, 15 years  in about 2007, there were about 10 schools in the U S. Now there's almost 800. I'm hoping that wow, locked  down and pandemic does not take too many of them out. I know a few of them are really suffering and  struggling right now, but, there's really been a lot of schools cropping up of instructors of huge different  backgrounds and varieties. There's, not as much teacher training, there's getting to be more and more over the  last couple of years, but again, with growth that rapid and that extreme, it's really hard for there to be consistent  messaging, from the teaching aspect and from the students and with Instagram and YouTube and all the social  media ways of learning, keeping a consistent message of how it should be done is harder.  

00:11:24 

Emily Scherb 

There are some things about form that have been getting more spread far and wide, but it's also the interpretation  of that form on the body and what that feels like and looks like. The other thing that's really different about  circus is, I mean, in some ways, similar to dance and that there's a wide variety of things, but if we think about  circus can be an Acrobat tumbling, a dumbest, be an aerialist in the air, hanging from their hands, their knees,  their feet, their ankles, depending on what apparatus they're on. It can be a juggler standing on the ground and  moving their arms in a rhythmic pattern and using all that brain work. It can sometimes be even be a musician or  the circus can really encompass so much. Even within circus, you kind of have to pick and choose what you're  actually looking. But, for me, what I tend to specialize in circus are my more acrobatic elements.  

00:12:23 

Emily Scherb 

Ground acrobats and aerialists, and leaving some of the more like, vocalists and dancers and the rest are a little  further a field, but circus is just so big and what can be defined as circus keeps changing as well as circus moves  into theaters as an of, and, or back to tents in a lot of cases.  

00:12:46 

Jennifer Milner 

Or into a big, huge pool swimming pool, right? And now they have to be divers and swimmers,  

00:12:55 

Emily Scherb 

Or, you've got artists that are, used to maybe doing theater work or nightclub work. There all of a sudden an  attention, cause those are kind of getting a revival back in the U S and now they have to help set up the tent and  the physical labor that's involved in that. There's a huge range of what's demanded on a circus body. It very  much depends on the artist and their discipline and, even within that discipline their apparatus and their  environment.  

00:13:23 

Jennifer Milner 

Yeah. So, as you have worked with this whole spectrum of circus artists, this is such a stupid question, but I'll  ask anyway, have you encountered a lot of people with hypermobility because, ,  

00:13:40 

Emily Scherb 

We sometimes think of people with hypermobility as fragile and not able to do things, but realistically, just like  in dance, hypermobility is incredibly common in circus because I think a lot of people look at it as an extreme  movement thing and they're like, well, my body can do that. Yes, I'm a ton of people with hyper mobility and  those who have normal mobility, or even kind of leaning on the edge of hypermobility who look at  hypermobility as the norm that they're trying to achieve. There's the kind of the messaging and the cognitive  aspect of what is mobility in this population dancers, like it's normal to have your extension of your leg to be more than 90 degrees, but our normal ranges of motion for an average Joe off the street is 90 degrees is plenty,  and it's our perceptions of what's normal.  

00:14:34 

Jennifer Milner 

Right? It's very different. I'm sure. Well, and we've spoken a number of times on the show, Linda and I have  about that whole spectrum of hyper-mobility disorders, and it's still kind of a moving target trying to get it  codified and pins down and, the definitions change every month, it seems. In general, what do you see more  people with asymptomatic joint hypermobility? Do you see systemic hypermobility? Do you see connective  tissue disorders? Like where do most people with hypermobility fall in the circus work?  

00:15:07 

Emily Scherb 

Most of my patients and clients are more in the asymptomatic, hypermobility spectrum because they don't, a lot  of them don't realize how hyper mobile they are, began because the normalization of that sure. In the circus  community, even in, again, even in the recreational level or especially in the youth performers or youth,  recreational artists as well. Most of them are kind of falling in that category. Some have a little more of a  connective tissue issues, but that's honestly more rare, I think still because circus is newer. Because so many  people are getting into it as adults, there are a lot of the schools that are opening up are almost exclusively adult  or exclusively Ariel. Because of that, you don't see the kids that kind of have grown up in it and kind of found  themselves there. We're, I think there's still of a fear of accessing circus.  

00:16:07 

Emily Scherb 

If you are hyper mobile, which personally I have had great results using circus as a tool to work with people  with hypermobility. Oh, interesting. Because as long as you're training, while you're training strong and you're  training with good form, you're learning to control your range of motion through its full range. Contortionists  don't just sit on their heads, they have to lift their bodies up and over to get their butts onto their heads if they're  doing it right. They're learning to control all that spinal articulation all the way through the range of motion  instead of just kind of collapsing there again with good coaching and not learning from YouTube, but with good  coaching, you're learning as a contortionist, as someone who's demonstrating the hypermobility to really  articulate and control the motion, which gives these artists, a better, billability of their proprioception. It seems  like to me, granted, that is not scientifically documented clinical experience.  

00:17:10 

Emily Scherb 

I feel like I'm teaching these bodies who have started to learn movement like dancers, their brains are starting to  wrap them, wrap around, running, moving pathways and teaching them how the body actually works, where the  movement should be coming from. They're able to get better awareness of where the, all of that is and learn to  have better control and mid range as well.  

00:17:33 

Jennifer Milner 

Well, and what I notice, a lot in the dance world, and I think Linda, what you've seen as well is that there's more  connective tissue disorders and systemic hypermobility in the younger population, in the pre-professionals. It  has a tendency to self-select as they move up professionally, it's too hard for them not to be injured. It's too hard  for them to kind of keep going. I, but then when I see them retire, because I work with professionals and  professionals, when I see them stop dancing, it gets worse and it hurts even more. So I love that. You're saying  don't be afraid of working with someone who's trained in it, to help you strengthen what you have and to kind of  help you stay there. But I love it.  

00:18:14 

Emily Scherb 

Yeah. With some of the physicians, at least in my community who have gotten to know me when they have a  kiddo, because circus in Seattle, Washington, where I am, is actually getting pretty large. We have a couple of  really large schools, here in the area. They do work with people of all ages. When I've had physicians come up  to me and ask like, Oh, I have this kid who came into my office are hyper mobile. They're working, you know,  on Ariel. I'm telling, should I tell them not to do it? Or parents are even better. I'm like, no, please tell them to  continue training, make sure they work with so-and-so or so then your training, it's going to really give them a  better strength and a better starting place. 

00:18:52 

Jennifer Milner 

Right. I love that you mentioned appropriate, and I love you mentioned proprioception as well, because that's  such an important part. For people with hypermobility is to continue trying to train their proprioception. That  seems like such a great way to help them work with where is my bone in the socket? Like where is my joint in  space and how can I continue training myself that way in a healthy way, as you said,  

00:19:19 

Emily Scherb 

Right? One of my earliest, yeah, she wasn't that early in my career, but kind of middle of between when I started  now, I guess she came into my office and she's a new patient of mine. She's an aerialist. She said, okay, I can do  one pull-up, but I can't do two. I can't figure out why I can't do the second pull up. She came in and she showed  

me a pull up and she did one, okay, pull up, the best, but it wasn't the worst. As she lowered, she actually  subluxed both her shoulders. She was no longer stabilizing in the socket. That's why she couldn't do the second  pull-up and it didn't hurt her at all. And she had no idea. Her coach at the time didn't really understand what was  happening because it's not necessarily something you're familiar with seeing. As soon as she learned what that  was and that I had to verbally tell her, that's not the end of your range is here.  

00:20:15 

Emily Scherb 

You need to control that. You can control that with the rotation of your arm and by lowering this way, right.  Within 10 minutes, she could distinguish the difference and stop going there and stop putting her shoulders and  our joints in that position, because she had the strength, just didn't have the awareness of knowing where she  was and like helping her identify those different things. Yeah, the proprioception of being an aerialist in space  and knowing even without reference to the ground where your foot is, where your hand is, where up or down as  I think that also helps with that brain training too. Absolutely.  

00:20:52 

Linda Bluestein 

Okay. I think that when they're younger, if they can work with somebody like you, that probably really helps to  prevent injury rather than just getting them after they've been injured. I'm curious as someone who is often on  the front line of the medical intervention for these circus artists, you might be the first medical professional in  their life that has seen signs that they do have some kind of hyper-mobility disorder, hypermobile Ehlers-Danlos  syndrome or some other disorder. Although as you're mentioning, sometimes a medical professional will have  been involved in the another medical professional, excuse me, will have been involved in the process. How do  you handle that? If you see somebody who you're working with, and this is not been raised by anyone else on  their team?  

00:21:35 

Emily Scherb 

I haven't had it with a kid yet. I've had it with adults, which is interesting where they don't quite realize what's  going on. I think, with kids, it's still raising awareness, both in the kids and the parents and the instructors of,  what pain is normal and what pain is not normal and circus, because there's a kind of a phrase in circus Hertz.  

That education of circus hurts because there's pressure on different parts of your body. It may bruise you, as  you're getting used to things, and circuits hurts as in my joints hurt or something is wrong and educating and  working on that knowledge. And then part of what I do. I'm kind of tangentially addressing your question, but  part of what I do is go in and work with educators. I, I, I'm really trying to increase the knowledge in circus  educators on what to look for in bodies, including hypermobility.  

00:22:37 

Emily Scherb 

That they're aware that this kid might need a little more queuing to know where their body is in space to take  things slower. To work with them in my community. I have a couple of physicians I work with and might refer  out to them. If you need to, depending on kind of what's going on with the body, but it's a lot of education and  giving permission to slow down the education process with learning because I'm hyper mobile people tend to  have lower proprioception. I know we keep coming back to appropriate separates. They tend to have lower  proprioception. That learning process just takes longer. Sometimes it's saying to them, Hey, it is okay. If people  in your class are doing X, Y, Z, and you're doing ABC, and kind of explain to them why and how I like to frame  it as your body will allow you to do these really cool other things. 

00:23:32 

Emily Scherb 

You just need to learn how to control it and use it. That their strength and their control is going to take a little  longer to catch up.  

00:23:42 

Linda Bluestein 

Great. That's a great explanation. And, and, yeah, people don't like to feel like they're falling behind or are not  doing what they feel that they might be capable of doing. So that's, so that's helpful. And, and speaking of what  they might be able to do, if you're hyper mobile you're, as you have mentioned, your joint end range is going to  be different than someone else's joint and range. Where, as in some other areas of life, we might tell someone  who's hyper mobile, not to maybe work in their end range in circus. The artists actually have to do just that,  right. How do you help artists stay strong and healthy while pushing their body bodies in the way that they need  to for circus?  

00:24:26 

Emily Scherb 

So, one of the things I work on with people is telling them when to push into that end range and when not to.  For example, a dancer standing in first position, I've in our, we have a dance medicine or performing arts  medicine group that worked together here in Seattle. We see performing artists, and a free clinic, which is a  wonderful resource, but it also means we get to work with our, other partners in the community. I get to work  with at least usually another PT and maybe an MD. And, we all see an artist together. This is one of those times  were seeing a ballet dancer and her first position, her knees were together and her feet were turned out. If I told  you only that you would say, okay, sounds pretty good. She's turning out well from her hips, but her knees were  so hyperextended that her feet were almost like in second with her knees together.  

00:25:20 

Emily Scherb 

She's like, well, my knees are together, so it's fine. We can kind of make that analogy with his stamps. In a  handstand with an artist, they can lock their elbows out and hyperextend their elbows and kind of hang on the  joint, or they can learn where that neutral is. They're not locking out their elbows or staying in a straight arm,  which is gonna be a lot more muscle for them. But again, they need that strain. So they don't want to do it.  When they're usually weight-bearing on the joint, when we want to explain that it's just like in dance, when  you're doing a leap and you want that gorgeous line with of knee hyper extension, and you've got that beauty,  but you don't want to do it in first position where you're like landing and load bearing in it. The same thing holds  true in circus.  

00:26:04 

Emily Scherb 

We look at arms and we're looking at, and that enhanced and same thing with standing one leg and is the knee  locked back, it's very similar in that way. It's just when you're in the air and you want a beautiful split position,  maybe that's when you go into more of your hypermobility, but even then I want you to be able to actively get  

there and control on the way back. Encouraging that active control and making sure they know where normal  ranges in a healthy way, not like in a sedentary adult way, but in a healthy performer way, normal range and  when they're choosing to go past it. Again, that awareness and proprioception increasing their active strength  

and mobility as well. I hope all of my dancers are listening and just heard that is like one of the things I talk  about so much of the time, first position your heels are together, and we're going to figure out how to make that  happen.  

00:26:58 

Emily Scherb 

I talked so much about the difference between closed chain and open chain straight, right. How your developing  leg can be hyperextended and fabulous. Your standing leg is going to be not locked. Yes. Same thing with the  arms. I, I feel like I should just like staple it to my forehead. Thank you for saying that somebody else has said  it, Oh, it's so important. And, but like having that strength in that straight leg not locked straight, right. That line  gives you better balance gives you better control will give you the ability to move in and out of that position  with more power and strength and race, and you'll have a longer career. It's a, win-win when it just stinks for  right now, while you're learning it. Yeah. Preach it, girl. 

00:27:43 

Linda Bluestein 

And, and while we're on that subject of long careers, we want to catch people before they're injured. Right. Or at  least, while we still can have some really meaningful interventions. If you're fortunate enough to be able to do  that, then what do you prioritize as a way of keeping them from getting injured?  

00:28:03 

Emily Scherb 

Yeah. So, again, this comes back to you for me. I don't always, I am currently just one person. I try to champion  great work everywhere else in the world, but my, it's not, thankfully it's not just me. There are wonderful other  humans that are also working on this, but I really am prioritizing education or instructors trying to also teach  workshops for students who are learning, just on how the body is supposed to work. We teach anatomy and  dance as well. How is this supposed to work? Where's my emotions supposed to be coming from why is it that  my upper back doesn't move the same way as my lower back? And how much of that is my shoulders and my  upper back. The shoulder is one of the most important joints in circus. We stand on our hands behind from our  hands. We hold other people above our heads with our hands.  

00:29:00 

Emily Scherb 

We pick people up with our hands. We're juggling with our hands and the shoulder in the community is such an  understood joint. There's such a lack of knowledge on how it works and how it moves. There's kind of the  weightlifting adage of, squeeze your shoulder blades together. When you do everything really doesn't work  when your arms overhead really think it works all that well when your arms are by your side either, but just  starting with an education of, Hey, how is this joint supposed to work? And what is it supposed to look like?  Cause I, I agree. I think if we can change the technique and the Language around technique and the way we talk  about learning the basics of movement, we can an entire generation of performing artists to have more longevity  in their careers. Again, that idea and the adage of circus hurts and what does that mean? And in young bodies,  giving them the, self-efficacy and autonomy to ask for help, and that knowing when something is wrong with  their body and that it's okay and it's not weakness.  

00:30:03 

Emily Scherb 

It's, it means that you're going to be doing this longer and better, and changing, hopefully changing the  conversation about what an injury is and the opportunities that an injury might present. That it's not just a bad  thing, or it's not something you need to hide because you're a performer, or that it's not career ending, if you  seek good advice and good care. So, hopefully catching them before by doing education and reaching out as  much as I can with that. With others that are spreading the word. There is so much more of that going on now.  It's really interesting to see, again, as we're all in this little more lockdown situation, how things are moving  online and how those things are being amplified. I'm sure other things are also being amplified that I would not love as much, but I'm sure there's somebody out there showing a video of hyperextended news.  

00:30:55 

Emily Scherb 

I'm sure there's more than one of them, but I'm seeing a lot more conversations about how the body should work  getting, making the rounds and having more conversations about it. That's great.  

00:31:06 

Linda Bluestein 

Yes. Yes, absolutely. How do you rehab a hypermobile artist differently from someone who's not hyper mobile,  if at all?  

00:31:17 

Emily Scherb 

It's not that different. I think there is, again, sometimes depending on the artist or the individual it's maybe a  little slower, or it's more, controlled. I might work with them more in mid range before we get to end range. I  know what they're developing their strength, that full range, depending on their injury and what's going on, but  it's not going to be that different because for my less mobile people, often their goal is getting more of that  mobility, which involves getting active control at end range. Cause that's what it really is. With my hyper  mobile people, they've got the mobility, but they need the active control. I I'm working on active control through a full range of motion with both populations. It's just kind of a question of where do I start them? How much  load am I putting them under and how much range are we working through, where they're kind of coming at it.  

00:32:09 

Emily Scherb 

Not hugely different, but, probably just with a little more understanding and a little more education, even  beyond the knowledge I'm generally trying to impart on people.  

00:32:21 

Linda Bluestein 

Sure. We have a really wide range of listeners. Some are going to absolutely know what you mean by active  versus passive range and control, but would you mind just briefly explaining what that is for those that don't? 

00:32:35 

Emily Scherb 

Yeah. So, I will give you an example of a common circus stretch to take care of you to give you a clue. So,  passive range of motion is when you're just kind of pushing into that range and possibly holding it or using  resistance or the ground or the wall of floor to push your body. In circus, a very common stretch because  everyone wants what we call open shoulders, meaning your arms as far back over your head as possible, is to  put your hands on the wall and walk your feet back and stick your butt out and try touch your chest also to the  wall. Hands up, overhead up the wall chest, trying to get on the wall, but trying to get out. Hopefully that makes  sense. You're really pushing your shoulders open kind of arching back, like, a puppy pose or like a, they call it  moose stretch often.  

00:33:25 

Emily Scherb 

That would be a very passive stretch for the shoulders because you're using your body weight and resistance of  the wall to kind of push into a relatively, mobile joint to make that more active and an active control, meaning  that you're using your muscles throughout the full range of motion to make that more active. What I could have  someone do is tie a resistance band around the wrist. They're pressing outward against that resistance band  activating their rotator cuff. They're actively controlling the range of motion as they then also push into the wall  to make themselves go down there. They're using their muscles to get into the end range of motion, as opposed  to using their body weight or worst case scenario, somebody else pushing on their body too. The more control  you have of your muscles as you approach those end ranges, the more access you're going to have to actually  use them in your performing arts or daily life.  

00:34:24 

Linda Bluestein 

I feel like that's such an important concept because the difference between just sinking down into something or  somebody, like you said, somebody pushing you, there is so different than you actively getting there. Yeah.  

00:34:39 

Emily Scherb 

What I look for is for people's active control to be able to actually move through almost all of the range of  motion that they could push their own body into. I want, I want those two to line up as closely as possible.  

00:34:52 

Linda Bluestein 

Sure. That makes sense. What other members of an artist's team do you think are non-negotiable so, would it be  a nutritionist or a strength and conditioning coach or, who else do you really like to have?  

00:35:08 

Emily Scherb 

This is such a great question because again, circus in the U S is such a, kind of in its relatively early stages as  developed developing and with funding, especially. There are very few circus companies that have any support  at all for their artists, zero. Luckily some companies might have some funding put aside. I luckily get to work  with two companies here in Seattle, and help them on with their bodies, but the funding and the importance just  isn't there. I don't usually get the opportunity to work with other practitioners. In some larger companies, like  historically with sleigh, they will have an athletic trainer or a physical therapist on the team. They often usually  also have some psych help available, to the artists. I believe in their training programs, they have other facilities as well, but, it's, it hasn't been, again, it hasn't been normalized, that bodies need care, which is so stupid because  they know it does right, the artists, but it hasn't been financially viable, even for artists led companies to be able  to provide those resources and artists are, unfortunately again in this country just not paid well and they don't  have the funds and they don't have the means to often to do what they need to do.  

00:36:35 

Emily Scherb 

For professional artists, I really think a sports psychologist in a lot of ways would be a lovely partner, a  teammate, because it's so important to, acknowledge all the things that our bodies do for us and all the things we  have tied up emotionally with our bodies, because some of what I see and thankfully not too often, but so many  of these artists, have dealt with their injury for so long that they're used to their shoulder hurting them. That's  part of how they identify themselves. How do you let go of that? And how do you even get treatment? Because  what if someone tells you that your shoulder is never going to be okay, even though it hasn't been okay for four  years, how do you get past that? So I think, if I'm talking about just who would be the best for me to work with,  I think a sports psychologist to help deal with the cognitive aspects of the stress that these performers are under.  

00:37:33 

Emily Scherb 

I mean, I'd love a nutritionist. Heck yeah. Again, the physical demands that these bodies are under, they need to  understand the nutrition. I feel like there's just like in dance and just like in other performing arts, there's so  many stresses, you've got the wa the artists that are, I work out all the time so I can eat whatever I want. Or the,  I I'm so restricted from my diet that I don't have good options or I'm vegan. I don't know how to get enough  protein or I, there's always those issues. When I was at the Adams conference, this last one in Montreal, a group  of us circus research areas and circus interested nerd minds, got to get together. Were talking about the, students  at the national circus school there. Apparently when they come back from break, they've trained so hard their  fall semester and they go home for break for winter and they come back and most of them have been binge  eating on all the snacks and the food and the stuff, and they come back and their injury rates up and they're,  cause their bodies aren't tuned into, but they're also teenagers like 18 to do any, so yes, nutritionist would be  great, but it's for psychologists would be really wonderful.  

00:38:50 

Emily Scherb 

I love that.  

00:38:51 

Linda Bluestein 

Me too. Me too. I think that's great. And, you've written a book applied anatomy of aerial arts. Who is this book  geared towards and what made you want to write the book?  

00:39:03 

Emily Scherb 

Yeah, so the book came out of basically conversations that had have happened, over the last about, eight, nine  years. I started teaching anatomy and biomechanics at a national circus conference, the American circus  educators conference. Actually back then, it was still part of ICO, American youth circus organization, that  you're both different organizations that have split off, but American circus educators, is a group of circus  instructors and educators and school owners that get together every other year and have a conference to share  knowledge. They had asked me about eight years ago, to do a talk on anatomy and biomechanics and from  developing that then other people were asking me to come give kind of a similar talk. I got hip to getting the  same questions. I kept coming back to basically the basics of the fundamentals of movement, the movement  vocabulary. So, just like in dance, you've got your positions, at least in aerial, there are some basics that are  relatively universal across apparatus.  

00:40:07 

Emily Scherb 

You're going to hang from your hands. You're probably going to hook a leg and hang from a leg. You are going  to turn upside down. Though we kind of know what these things should look like that we didn't really have a  shared vocabulary to talk about how the body is actually moving through space. The book's audience primarily  who I was writing it for were instructors and maybe a recreational body nerd and maybe a PT or a medical  professional healthcare side of someone who didn't know anything about circus. Kind of coalescing around the  instructor level, to get an idea of how to talk about the body with other people, kind of from a kind of nerdy anatomy perspective, but, hopefully getting to be able to translate it back to, the general population, but because  there's so many universal themes in aerial that keep coming back, I thought it was really important to talk about  what muscles are actually working when we're hanging, what muscles are in what order should we be kind of  firing to put the least amount of stress on our joints and ideally allow us to perform better when we're done,  because if we're in good alignment, we can have more power.  

00:41:17 

Emily Scherb 

We can develop more movement from that position of control. It kinda came out of the conversations from  teaching and being asked to teach that eight years ago, and that slow development, maybe it was more than eight  years ago, but about that a while ago, it was either eight or 10, cause this is one of our annual years, again,  somewhere in there, but yeah, so it came out of that and then it just through conversations almost wrote itself  kind of, or at least the general ideas were there. I was lucky enough to find a publisher who would pick it up and  that took a bit of work because people don't know that circus is here and growing and has become a recreational  thing for hobbyists to do. And it's not just the professionals. It's, the, Microsoft employee, who's doing it after  work here in Seattle or whomever.  

00:42:17 

Linda Bluestein 

I would like you to repeat one piece of that I feel like was so important. You, you said a phrase in there about  when you are working properly, that actually also helps you to perform better.  

00:42:31 

Emily Scherb 

Absolutely. If you're using the right muscles, that gives you good stabilization, it gives you a good anchor point  to start movement from. If you're hanging, I'm going to use hanging as an example because it's the absolute,  most fundamental movement of area. If you're not hanging, you're not off the ground. You're hanging from your  hands and your shoulder girdle is in a good position, which in this case is your shoulder blades are rotated  upwards. Your arms are overhead and you're stable there. You're then able to move your body around that. If  you're hanging more off your joints, your shoulders are pulled down on your back, which is in dance. If you're  in fifth and you've really sunk into your shoulders, that can be a little, to pull down on the joint. If you're  hanging lamp like that too, you don't have the ease of movement to get into the next position.  

00:43:23 

Emily Scherb 

If you're in a stable, open, controlled position, you can almost do anything from there.  

00:43:30 

Jennifer Milner 

You're saying that stability encourages healthy mobility. Are people listening here, you have to do the hard  work and find that small range of motion before you can get bigger. Putting in that work in that small range of  motion and not going straight to the end range will help you be in the end range, stronger and bigger. Yes,  absolutely. Yes. Okay.  

00:44:01 

Emily Scherb 

Yes. Learning to find the smaller muscles, the stabilizers allows you to save the powerful, big muscles, powerful  and big and not stabilizers, and they already have firing and then you want them to do something else. That's  really hard. Instead the body can use the small muscles to stabilize and those big muscles to create the power  and the energy to create bigger movement. Beautiful. Okay.  

00:44:26 

Linda Bluestein 

Because we can create a movement that would look on the outside, like it's using the same movements, but if I  did it say muscles, excuse me. If I did a movement and Jen did a movement, she could be using the correct  muscles and I might be using the wrong muscles and to a less, perfectly trained eye than your own. It might look  like it's the same.  

00:44:46 

Emily Scherb

Is that absolutely. Yeah, absolutely. It can be very similar looking with only a small few details that can make a  huge difference. The difference between someone who's going to have pain or difficulty with the next skill that  they're trying to learn and someone who's not. Maybe in hanging this artist doesn't have any pain or problems,  but all of a sudden they're learning the next skill they're trying to turn upside down and which is what we call  inverting. All of a sudden they're having pain or they just can't do it and they can't figure out. Sometimes it  comes back to, are you hanging correctly?  

00:45:23 

Linda Bluestein 

Fabulous. Fabulous. Where do you hope circus arts research goes next?  

00:45:29 

Emily Scherb 

Oh, there's so much on the horizon. I'm so excited. There's, circus arts is absolutely, kind of hitting its stride and  hitting its peak, not peak, hopefully, hitting its stride. We now have researchers and we have people looking at  stuff. I know that there's a lot of research that should be coming out in the next couple of years. I really would  love to see, more first of all, good epidemiological study. Really understanding where our injuries are coming  from, which hopefully we will be seeing. Looking personally, I love the recreational population because that's  the biggest group of people that we get to work with. I find it's always easier for researchers to go to a  professional company and say, I want to study your artists. Most of the limited research we have in circus right  now is from the slate data that they have amassed over the years and years of their performers, which is  wonderful data, but it's professional artists who are already trained, who are in a performance schedule, and may  have years of history or not, or how, and I'm very curious in how the recreational population and our  recreational population, isn't just necessarily someone who's popping in and taking a class.  

00:46:47 

Emily Scherb 

Many of the artists I'm working with here in Seattle have been training for years, and this is part of their life.  And, looking at that population because that's where as healthcare providers, we really are interacting the most.  That's where I'd like the research to go and what I'd like to see. I have so many other ideas, but realistically that's  the biggest one.  

00:47:11 

Linda Bluestein 

How can aerial artists find someone who can understand and work with their unique needs?  

00:47:17 

Emily Scherb 

Word of mouth is how a lot of artists are learning everything these days. So, and it's been true in the community.  There's been a, a shared knowledge that's handed down between performers, whether it's, the old Russian coach  saying rubbing up rubber, raw onion on it, and that will help with your bruise or your injury. That was one of  them. There, there is a lot of shared knowledge in the community. Asking around at your studio, if you're a  circus artist, go into your studio, ask around, ask your instructors, who they have seen. If they have seen  someone, usually that shared knowledge gets passed around and when someone's good and wants to listen and  hear that is helpful. I also have a, at least a limited list of people that have expressed to me that they want to  work with circus artists on my website under resources.  

00:48:07 

Emily Scherb 

The circus doc.com, I believe your friends slash resources, but the circus doc.com and click on the resources  button. There'll be a list of at least a few circus PTs that are on there that is by far not an inclusive list, but it is a  list of people who are currently practicing and have expressed interest. Asking your community and if all else  fails, shoot me an email. I'm usually happy to help you try to find someone in your local area.  

00:48:34 

Linda Bluestein 

Fabulous. We covered a lot of great, interesting, topics. Was there anything else that we didn't talk about that  you would like to anything you want to add? And can you also, I know you just mentioned your website, but  could you, go through that one more time and make sure that people know where they can find you and learn  more about what you're doing? 

00:48:53 

Emily Scherb 

Absolutely. Well, I think the thing that I think would be really fun to add is that circus is a great thing to start  and try as an adult, for most of us because it wasn't so prevalent more than 10 or 15 years ago, we don't have  that judgment of going in and everyone else in the class may have taken ballet since they were a kid, right.  Almost everyone can be starting at the beginner level when you go into an entry-level class and it can be a lot of  fun and a great way to stay fit and stay active and work through your full range of motion. So I, I love circus. I  love circus for adults. I love circus for everybody. Great opportunities. I guess another thing to add is that there's  great opportunities to get involved in circus, no matter what your body and what your condition, you have  worked with people, circus for Parkinson's, circus with people with cerebral palsy, circus for people, with all  sorts of different ways of entering into movement.  

00:49:50 

Emily Scherb 

There's because circus is so broad, it's very adaptable and finding a community with through movement is super  fun. To answer your questions, how to find me, I am, on social media, I am at the circus doc and pretty much  everything. Twitter, Instagram, Facebook, all the places I haven't been on Tik TOK yet.  

00:50:13 

Linda Bluestein 

Let's okay. Your website is circus doc or is it just the circus stuff?  

00:50:19 

Emily Scherb 

My website is thecircusdoc.com and there, you can find resources about circus bodies. You can find information  about my book. Online courses are also there and once we all start off in the world again, and our teaching  courses live in person courses will also be listed there. If you're interested in online courses or learning more  about what I do, thecircusdoc.com.  

00:50:42 

Linda Bluestein 

Grant fabulous, well, Dr. Scherb, it has been so wonderful chatting with you today. We are so grateful for you to,  becoming on the bendy bodies podcast and sharing your knowledge with us. Absolutely. It was such a joy to  talk to you guys today. Great. And thank you so much, Jan. It was great to chat with you as always, of course, as  always loved it. If you've enjoyed this program, please like share, subscribe and leave a review. This podcast is  for informational purposes only, and is not a substitute for medical advice. Please see your own medical team  prior to making any changes to your health care bendy. Body's original music is by Andrew Savino and sound  editing is by Rhett Gilt. Thank you so much for tuning in, and we will see you next time on bendy bodies with  the hypermobility MD.