Background
Boston Ballet, one of the premier dance companies in the United States, maintains a rigorous performance schedule that demands exceptional physical and mental preparation from its dancers. Founded in 1963, the company employs approximately 70 professional dancers across the main company, second company, and apprenticeship program who perform classical and contemporary works throughout a 40-week season.
Alex Howard, Director of Physical Therapy at Boston Ballet, brings 15 years of clinical experience to her role and is now in her fourth season with the company. Her background spans work with both junior and elite athletes, giving her perspective on various electronic medical records (EMR) systems across different sports medicine contexts. She was glad that Boston Ballet was already utilizing AthleteMonitoring, an advanced athlete management system (AMS) that was better suited to her job function than the EMR platform that some organizations use.
“When I joined the company, they had started using AthleteMonitoring just one year prior,” Howard said. “Historically, I’ve used a lot of different EMR systems, and AthleteMonitoring provides a much better way of tracking our dancers.”
Improving Injury Tracking
Traditional physical therapy documentation systems can be arduous, requiring extensive clicking through multiple screens and creating formal records for every clinical encounter. This approach becomes problematic in athletic environments where the volume of minor complaints and preventive care far exceeds formal injuries.
“With AthleteMonitoring, we’re able to keep cases and do more athletic triage than with a traditional EMR system,” Howard said. “It requires a lot less clicks too.”
“The person that brought on AthleteMonitoring created a case for every body part that a dancer complained about,” Howard said. “I knew that wasn’t sustainable for tracking injuries and so decided to change how we used the platform.”
Building a Custom Classification System
Howard restructured AthleteMonitoring by creating clear categories that reflected the nature of delivering care at a professional dance company. She established a distinction between routine clinical encounters and formal injury cases tied to workers’ compensation claims.
“I track injuries based on workers’ comp cases, which is especially useful when dancers have to modify their jobs because they got hurt,” Howard said. “AthleteMonitoring allows me to triage cases, distinguish between acute and chronic issues, and track our workers’ comp injuries.”
Reviewing longitudinal data revealed that approximately 70 percent of the physical therapy team’s clinical work fell into triage categories, with 30 percent representing injuries requiring formal tracking and rehabilitation protocols. This data helped Howard better allocate medical resources and improve care quality.
Working directly with AthleteMonitoring’s development team, Howard requested specific features to track variables that standard systems don’t typically capture.
“I wanted to track what body parts we were treating in triage because when I have an injury case, I’m labeling it as a body part and giving it a diagnosis,” Howard said. “Francois created a task area that makes it easier to do this. Now, it’s easy to see the ratio of triage cases to non-triaged injuries.”
With five physical therapists on staff, Howard wanted objective data on whether they were being utilized for their specialized clinical skills or primarily for services that could be provided by other practitioners, like massage therapists.
“Francois helped me create tasks so I could select specific modalities,” Howard said. “We wanted to know if our PTs were acting more like personal trainers or massage therapists. I initially assumed we were doing a lot of massage, but after reviewing AthleteMonitoring data, I realized that we were actually utilizing skilled clinical care. Such insights allow me to be more creative in my role.”
Enabling Objective Performance Conversations
Data visualization became particularly valuable when communicating with dancers about their physical status.
“I’m very big on objective data,” Howard said. “Dance medicine is probably 10 to 15 years behind sports science and sports medicine, but we stay on top of the latest trends and communicate these to our dancers.”
Dynamometry testing for muscle strength provided one example where visual data presentation helped dancers understand their performance status relative to company-wide norms.
“We show each dancer their performance compared to the company as a whole, and sometimes that really puts it into perspective,” Howard said.
Managing Complex Injury Patterns
One persistent challenge in dance medicine involves tracking injuries that recur over multiple seasons. Traditional documentation systems struggle to connect these episodes while maintaining accurate time-loss data.
“Patellar tendonitis is a very common injury in ballet,” Howard said. “AthleteMonitoring allows us to group issues like this, see how long dancers miss because of them, and track how training changes affect injury rates over time.”
Howard worked with the development team to create a reinjury tracking feature that maintains case continuity while accurately documenting distinct episodes of time loss or modified duty. AthleteMonitoring also provides color-coded visual indicators showing which dancers are completely out of work versus those on modified duty with specific restrictions, allowing any physical therapist to see their status at a glance.
Leveraging Mobile Accessibility
The physical demands and pace of professional dance created specific workflow challenges that desktop-based systems couldn’t accommodate. Howard needed the ability to document encounters immediately, often while moving among treatment areas and during brief windows between dancers’ treatment appointments.
“The phone app is one of the biggest AthleteMonitoring benefits,” Howard said. “I do a lot of note dictation, which you can’t really do using a computer unless you have a dedicated app. Now, I can easily dictate notes into my iPhone.”
Due to the explosive nature of training for ballet, several injuries can occur within a short time frame. This would be hard to handle with an EMR system.
“Our work is really fast paced, and AthleteMonitoring makes it easier to stay on top of everything in our clinic,” Howard said. “We see someone every 30 minutes, and two nights ago, I had three actual acute injuries happen within 20 minutes.”
Justifying Equipment Investment Through Data Analysis
The ability to extract and analyze injury data created opportunities to demonstrate the value of therapeutic interventions and justify additional equipment investments. When Boston Ballet considered acquiring radial shockwave therapy equipment for treating tendonitis, Howard used historical injury data in AthleteMonitoring to establish baseline metrics.
“We had nine cases of tendonitis last year that required modified duty, but this year, we only had one case,” Howard said. “I could show that we’d been using shockwave therapy and make the case that it’s effective for treating tendonitis. It was easy to pull this data from AthleteMonitoring.”
The annual injury reports Howard presents to artistic staff rely heavily on such data extraction and visualization, which provides leadership with clear metrics on injury patterns, time loss, and intervention effectiveness.
Supporting Comprehensive Wellness
While Howard primarily utilizes AthleteMonitoring for physical injury tracking, she also leverages it to document mental health screening. The system provides standardized validated assessment tools, like the Sport Mental Health Assessment Tool (SMHAT-1) from the International Olympic Committee (IOC), that serve as an early warning system for anxiety, depression, and other mental health issues. Athletes conveniently complete a regular survey in mere minutes.
“If you score more than a 17, that means we need to further assess your mental health,” Howard said.
Since Howard’s arrival, the percentage of company members who engage with mental health providers has increased from 10 to 15 percent to over 50 percent.
Collaborating with Responsive Development Support
Throughout her AthleteMonitoring project, Howard emphasized the value of direct access to development resources who were willing to implement her recommendations and customize the system to her exact needs.
“Francois is amazing to work with,” Howard said. “He’s almost too responsive. He really likes to stay on top of things, and it’s great. I can say, ‘I want to do this,’ and his team will make that happen for me.”
When certain features created unintended workflow complications, modifications could be requested and implemented relatively quickly.
Key Takeaways
For organizations considering athlete management systems in dance, Howard identified several critical factors that make AthleteMonitoring particularly suitable for high-volume clinical environments.
“The biggest recommendation is the communicability with Francois,” Howard said. “It’s really great to have a dedicated person to help me out. I also love how easy it is to customize AthleteMonitoring and that it’s so fast on my computer and phone. That makes it simple to stay on top of documentation.
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