The Performing Arts: America’s Most Dangerous Profession You’ve Never Heard Of

Most people think construction workers or pro athletes have the riskiest jobs—but the data tells a different story. Workers in the performing arts face some of the highest non-fatal injury rates in the U.S., exceeding even many spectator-sports occupations.

For artistic athletes and theatre production teams alike, this is a wake-up call.

The Hidden Hazards of the Stage

When an audience sees a flawless performance, they rarely glimpse the underlying physical and occupational demands. Behind the curtain lie multiple hazards:

• Unguarded edges, raked floors & tricky lighting
  Some theatre productions use raked stages (sloped surfaces) to improve sight-lines—but that increases the risk of falls, hip and/or knee strain, and balance issues.

Add variable lighting, haze/fog, and tight backstage wings, and you’ve got a complex terrain.

• Moving scenery, heavy rigging & quick-change chaos
  Fly systems, heavy set pieces, hydraulics, trap doors: a mistaken move or mis-cue and the consequences can be serious.

Quick-change areas often mean cramped corridors, high stress, and limited recovery time.

• Repetitive strain from choreography, instruments or technical work
  Whether you’re a performer in a dance-heavy show or a crew member handling dozens of quick set changes, repeated motion and long periods in static positions can lead to overuse and fatigue over time.

• Exposure to hazardous materials
  The backstage world might not look like a typical industrial site, yet it’s full of potential irritants — from fog and haze fluids to paints, adhesives, and costume treatments that can affect skin and breathing quality over time.

• Recent example: The contract recently ratified by Equity gives a tangible signal of change in this space. (See section 3.)

These hazards directly impact the performers on stage — the artists whose precision, stamina, and expression rely on finely tuned physical health. When the environment itself becomes unsafe, it’s not just art at risk — it’s the artist.

Why This Matters

Framing the performing arts as a workplace is crucial:

• The Occupational Safety and Health Administration (OSHA) began requiring injury/illness reporting in 2015, helping reveal the real scope of risk in creative industries.

• New national data underscores the magnitude of the issue. According to the 2025 NORC Artist Labor Survey (reported by NPR):

• Over 50% of performing artists have sustained a work-related injury or illness.

• Nearly 70% lack consistent access to employer-provided health benefits.

• Dancers, theatre performers, and movement artists reported the highest levels of physical strain and financial precarity.

• These findings highlight that performer health challenges aren’t isolated—they’re systemic.

• Many artistic athletes work as self-employed contractors, freelancers, or students—outside of the traditional employment infrastructure. Roughly 40% of U.S. adults engage in creative work at some level, yet many lack access to structured safety and health resources.

The entrenched “the show must go on” culture often means pain is ignored, micro-injuries accumulate, and burnout becomes normalized.

For dancers, actors, and creative movers, this is a call to shift the culture. Prioritizing recovery, mobility, and long-term care isn’t selfish — it’s how we build a performing arts community that can thrive, not just survive.

A Milestone for Performing-Arts Occupational Health

For the first time, Broadway performers have formal contract protections around rest and recovery. The new agreement between Actors’ Equity and The Broadway League limits how many days in a row actors can work and guarantees access to on-site physical therapy when requested — signaling that performer wellbeing is now a contractual right, not a perk.

“For years, our members have pushed to make health and safety part of every conversation,” said Equity Executive Director Al Vincent Jr. “This contract moves us closer to that reality.” NYC Labor Council+5AEA Public Site+5Playbill+5

A Turning Point for Performer Health

• The maximum consecutive workdays for actors and stage managers has been reduced to 12 (down from 16). Producers may schedule longer runs only up to four times a year—and then must provide a paid performance off or paid personal day. Playbill+1
  

• Any actor covered by Equity can now request on-site physical therapy, even if the production did not previously provide it. BroadwayWorld
  

• The deal was reached after intense negotiations and a strike-aversion effort—underscoring that health, safety and workload matters were central, not peripheral. NY1+1
  

Why this matters for you (and for theatres everywhere):

It signals a shift in the industry—from viewing performers purely as “talent” to recognizing them as workers in a high-risk environment who deserve structural support. 

It gives leverage to theatres, companies and performing artists to advocate for onsite PT, smart scheduling, recovery timeframe, and proactive safety programs.

If the highest-visibility theatres in the country are embedding these protections, then every production—whether large or small, commercial or community-based—should be thinking along those lines.

In fact, some already are. Here in the Boston area, the American Repertory Theater has long made performer health part of its operational culture, providing on-site physical therapy as a standard of care. It’s an approach deeply aligned with AAHC’s mission: treating artistic performance as both art and athleticism, and building systems that keep artists healthy enough to sustain their craft.

Bringing an Occupational Health Lens

When we say “occupational health” we’re not talking about optional add-ons—we’re talking about standard of care for artists and crews.

• Artists, dancers, actors, stage managers, technicians—these are workers, performing in dynamic environments with physical, cognitive and emotional load.
  

• Partnering with occupational-health specialists (physical therapists, movement scientists, ergonomists) shifts the mindset from “wait until someone’s hurt” to “prevent, condition, support.”
  

• This aligns performing-arts medicine with public-health and workforce-safety standards (rather than treating arts work as an exception).
  

For artistic athletes: think of warm-up, mobility, recovery, baseline screenings as professional tools—as integral as rehearsal and performance.

For theatres: thinking of PT, conditioning and recovery services as part of your production budget, schedule planning and crew-care strategy will set you apart—and safeguard your production’s longevity.

The AAHC Framework

At AAHC we’ve developed a model built for both sides of the spectrum: artistic athletes who know they need the support and theatres ready to integrate it.

• Hazard Mapping & Safety Walkthroughs – We audit rehearsal studios, storage/wing/trap zones and performance venues.
  

• Performer & Crew Screenings – Role-specific baseline assessments for actors, dancers, and tech crew.
  

• Prevention & Conditioning Programs – Customized warm-ups, mobility & recovery tracks, periodised loading for cast & crew.
  

• Onsite PT & Rapid Response – Onsite physical therapy support during rehearsals and/or production runs—so when a strain or fatigue signal appears, you catch it fast.
  

• Education & Ongoing Resources – Workshops for cast, crew and stage management teams on movement literacy, ergonomic awareness, self-care culture.
  

For artistic athletes: you gain access to tools and programming that support peak performance and sustainable health.

For theatres and production teams: you gain a framework to integrate health and safety culture into your operations—reducing risk, improving morale, enhancing performance reliability.

Why Invest?

This is not just an overhead line item — it’s strategic.

• Fewer injuries → fewer claims. When your cast and crew are supported and conditioned, you reduce unplanned downtime and associated costs.
  

• Reduced absenteeism, overtime and production delays. One strain or injury can ripple across lighting, sound, cast coverage, understudies—impacting scheduling and budget.
  

• Improved morale and retention. When artists and crews feel seen and supported, they stay longer, recover better, and bring their best to each show.
  

• Competitive advantage in recruiting top talent. Your production becomes known not just for the art, but for the care you give to your people.
  

• Eligible for grants and sponsor partnerships. Increasingly, funders ask about workplace safety, wellness supports, crew-health—and you’ll be ahead of the curve.
  

• Better performance outcomes. Healthy, well-recovered artists and crews transition faster, maintain energy late in runs, and deliver consistently.
  

For artistic athletes: you’re investing in your career longevity.

For theatres: you’re investing in the stability, resilience and reputation of your production ecosystem.

Closing & CTA

The performing arts can only thrive when the people creating them do.

Theaters may check their rigging and exits—but true safety means protecting the artists who bring each story to life.

At AAHC, we believe performer health is production health. Our work exists to make recovery, conditioning, and safety part of the creative process itself—so that artistry and wellbeing rise together.

The show will go on. Let’s make sure the people behind it do too.

Transforming the Stage: Highlights from Melissa Buffer’s Interview with Dr. Alyssa Arms

At the Artistic Athlete Health Collective, we're always on the lookout for conversations that shape the future of artist wellness. Melissa Buffer, MSPT, CNPT, recently joined Dr. Alyssa Arms, PT, DPT, OCS, on Dance Med Spotlight to discuss advancing the standard of health management for performing artists. From pioneering early intervention to promoting holistic and collaborative care, Melissa’s approach is reshaping how we view and support artist health.

---

Melissa’s Journey to Championing Artist Health

Melissa’s path began as a dancer herself, which influenced her transition into performing arts physical therapy. “I’ve been a dancer my whole life,” she shared, explaining how her immersion in dance from an early age laid the groundwork for her deep understanding of the physical and emotional needs of performers. This journey fueled her drive to not only provide traditional care but also integrate a sports medicine model tailored for artists—a model that prioritizes proactive health management.

Redefining Performance Health with Early Intervention

One of the standout themes Melissa highlighted was the importance of getting ahead of injuries before they start. She described the common backstage practice: “Most productions offer 20-minute PT slots—quick fixes that don't address the root cause.” Instead, Melissa advocates for being present early in rehearsal processes, assessing risk factors like repetitive movements and costume limitations, and working directly with performers to implement injury reduction strategies.

By collaborating closely with choreographers and directors, Melissa’s team identifies adjustments that can reduce wear and tear on the body. She proudly noted, “In our last production, we made small changes to choreography and saw just one injury throughout the entire run. That’s what proactive care can achieve.”

Collaborative Care as a Game-Changer

Melissa’s mission goes beyond individual treatments. She shared, “We need to think of artist care as a community effort. It’s about assembling a network of experts—PTs, massage therapists, acupuncturists, nutritionists—who work together to ensure that every performer has tailored support.” This multi-pronged approach, embedded in her collective’s services, has changed the landscape of artist care, emphasizing that true support is holistic.

“We need to think of artist care as a community effort. It’s about assembling a network of experts—PTs, massage therapists, acupuncturists, nutritionists—who work together to ensure that every performer has tailored support.”

— Melissa Buffer, AAHC Founder

The Role of Self-Advocacy in Artist Health

A significant takeaway from the discussion was Melissa’s belief in empowering performers to voice their health concerns: “Artists know their bodies better than anyone else. Speaking up when something feels off is crucial, and clinicians need to be safe havens for those conversations.” She highlighted the necessity of breaking the silence around injuries and discomfort, noting that open communication can lead to better care and long-term health.

Building Mentorship and a Future-Ready Community

Melissa’s impact doesn’t stop at direct care. Through her mentorship program, she’s nurturing a new generation of clinicians with the skills to support performing artists effectively. “When I started, I didn’t have a guide. Now, seeing mentees step into their own practices and tailor their care to this community has been incredibly rewarding,” she reflected.

Empowering Change in Performing Arts

Melissa’s advocacy extends to encouraging systemic change. She’s passionate about collaborating with companies to build emergency plans, educate artists on their rights, and create pathways for seamless access to healthcare resources. “We need to support our performers as athletes—they train and endure the same physical rigors,” she emphasized.

---

Melissa’s interview offers a compelling look at how artist care can be more than reactive—it can be preventive, collaborative, and deeply empathetic. Her work is not just about keeping performers on stage; it’s about fostering an environment where they can thrive.

The conversation with Dr. Arms makes it clear: it’s time to rethink how we care for artists.

Watch the full interview here to explore Melissa’s innovative approach and learn how we can collectively champion a culture of well-being in the performing arts.

The 10 Biggest Wellness Challenges in the Performing Arts

Why Performing Artists Need Better Health and Wellness Support — And How Consulting Can Help

Moving Forward: Wellness as a Priority

The challenges facing the performing arts in terms of health and wellness are many, but they are also solvable. By addressing the root causes of these problems—whether through better access to care, preventive strategies, or improved collaboration between healthcare and the arts—organizations can create a healthier, more sustainable future for performers.

The performing arts industry has a responsibility to prioritize the health of its artists. By making wellness a standard practice, not an afterthought, we can ensure performers have long, successful careers doing what they love.

Unlocking Performance Potential: The Power of Midday Movement for Artistic Athletes

In the demanding world of artistic athletics, finding ways to enhance performance and maintain overall well-being is crucial. One often overlooked strategy is incorporating midday movement into daily routines. This blog explores the benefits of midday movement specifically for artistic athletes and how it can energize their bodies and minds, prevent injury and enhance performance in the short and long-term.

I. Midday Movement: Energize and Enhance Performance

Midday movement offers a range of advantages that can have a profound impact on the lives of artistic athletes. According to a study by Koutedakis, engaging in physical activity during the middle of the day stimulates blood flow, oxygenates the brain, and releases endorphins, leading to increased energy, productivity, and enhanced focus throughout the day.

Improved Focus and Mental Clarity:

Taking a break from one’s sport to engage in movement helps clear the mind, reduce mental fatigue, and enhance cognitive function. According to research by Andrews University, incorporating midday movement into daily routines can improve mental clarity and provide a fresh perspective, allowing athletes to return to their creative and physical endeavors with renewed focus.

Enhanced Physical Performance and Stamina:

Regular midday movement routines contribute to increased physical performance and stamina. By maintaining an active lifestyle throughout the day, artistic athletes can improve their endurance, coordination, and overall physical abilities. This translates into enhanced performance during practices and performances.

II. The Summer Season: A Time for Rest & Renewal

Artistic athletes often find themselves caught in a perpetual cycle of training and performances, leaving little time for rest. However, the summer season presents a unique opportunity for rejuvenation and personal growth. According to Koutedakis (2005), temporarily stepping away from their primary discipline during the summer allows artistic athletes to give their bodies and minds a chance to recover, reducing the risk of burnout and overuse injuries.

Allowing Time for Mental and Physical Recovery:

Replacing one dance class a week with a strength and conditioning class over the summer allows artistic athletes to recharge mentally and physically. It also provides an opportunity to explore other interests, engage in self-care practices, and reconnect with their passions outside the realm of their primary discipline.

Embracing New Experiences and Sources of Inspiration:

The summer break offers the perfect time for artistic athletes to embrace new experiences and seek inspiration from different sources. Exploring other art forms, engaging in outdoor activities, or attending workshops in related fields can spark fresh ideas and revitalize creativity, contributing to personal growth.

III. The Role of Strength and Conditioning for Dancers

Strength and conditioning training play a vital role in the development and longevity of dancers. According to a study published in the Journal of Dance Medicine & Science, incorporating strength and conditioning into an artistic athlete's routine provides several benefits:

Building a Strong Foundation for Technical Skills:

Strength and conditioning training help build a solid foundation for technical dance skills. By targeting specific muscle groups, dancers can improve their overall strength, control, and technique, enabling them to execute movements with precision and athleticism

Enhancing Overall Flexibility, Endurance, and Controlled Mobility:

Through targeted exercises, dancers can improve their flexibility, endurance, and controlled mobility. This increased physical capacity enables them to perform challenging movements with ease and reduces the risk of injuries caused by inadequate capacity.

Improving Balance, Stability, and Body Control:

Strength and conditioning exercises focus on developing stability , strength, and control, which are essential for dancers. Enhanced proprioception and core strength contribute to better stability during complex dance sequences and lifts, reducing the risk of strain and injuries.

Injury Prevention and Rehabilitation:

By strengthening muscles and improving controlled mobility, strength and conditioning training help prevent injuries common to dancers. Additionally, these exercises can aid in the rehabilitation process, allowing the athletes to recover faster from existing injuries and imbalances.

IV. Designing a Summer Strength and Conditioning Program

To make the most of the summer season, artistic athletes would benefit from a customized strength and conditioning program. Here are some key considerations for developing a program tailored to individual needs and goals:

A. Tailoring Training to Individual Needs and Goals:

Each athlete has unique requirements and goals. By tailoring the strength and conditioning program to these individual needs, athletes can optimize their training and achieve desired outcomes.

B. Differentiating Between Cross Training and Conditioning:

Artistic athletes should understand the distinction between cross-training and conditioning. Conditioning involves incorporating activities similar to dance or performing arts to improve access to specific requirements for their discipline. Cross-training, on the other hand, involves incorporating movement not specific to the sport, adding diversity in movement patterns, recruitment, and motor plans. Both cross-training and conditioning are integral parts of an active injury prevention plan.

C. Balancing Rest and Active Recovery within the Program:

While strength and conditioning training are essential, it's crucial to strike a balance between training and rest. Incorporating active recovery periods and ensuring sufficient rest helps prevent overtraining and promotes optimal physical and mental recovery.

Midday movement offers a range of benefits that artistic athletes should embrace to enhance their performance and overall well-being.

By prioritizing rest and incorporating strength and conditioning training, athletes can achieve long-term success

and improve their overall performance.

Join the Artistic Athlete Health Collective for midday movement classes for artists at the Foundry this summer, and take a step towards optimizing your artistic athleticism. Embrace the power of midday movement and unlock your full potential!

References:

Smith, J. E., Owen, D., & Finch, C. F. (2005). Stress management and injury prevention. Journal of Applied Sport Psychology, 17(4), 232-247.

Andrews University. (n.d.). [PDF] Retrieved from https://digitalcommons.andrews.edu/cgi/viewcontent.cgi?article=1053&context=pubs

Journal of Dance Medicine & Science. (2005). The effect of a combined cross-training program on anaerobic power in artistic gymnastics. Journal of Dance Medicine & Science, 9(1), 23-27. [Link: https://www.ingentaconnect.com/content/jmrp/jdms/2005/00000009/00000001/art00006?crawler=true]

AAHC: A Conversation with The Founder, Melissa Buffer

This month, we conducted an interview with the Artistic Athlete Health Collective Founder, Melissa Buffer. The marketing team, along with Libby Bullinger, a Boston-based choreographer, dance educator and AAHC team member, asked Melissa about the inspiration behind The Collective, what impact she hopes it has on the Boston performing arts community and what she envisions for the future of The Collective. You can watch the interview here or read about it below.

🎥 AAHC: A Conversation with The Founder, Melissa Buffer 🎥

The Artistic Athlete Health Collective is a group of interdisciplinary health professionals in the performing arts medicine world with the uniform goal of bringing prevention and wellness directly to where artistic athletes train and perform.

When Melissa was asked to provide the inspiration behind the collective, she said “well, it was sort of like the perfect storm, frankly. The inspiration came after many, many years of working in a clinic, one-on-one with clients, dancers, circus artists and actors and also spending many hours over my long career working backstage in pretty much every theater in Boston. It has become more and more clear to me that artistic athletes need preventative and wellness services in a far more robust and regular way…and that is just now how it is viewed in the performing arts and my mission with this collective is to change that.”

How is The Collective already benefiting the community?

Libby Bullinger, whose personal priority is to promote health and wellness in the dance world and advocate for preventive methods before injuries occur, tackled this question. She shared that “as an artistic athlete, myself, our bodies are our livelihoods. So the culture of performance arts often emphasizes a no pain, no gain mentality that makes it really difficult for us to seek out medical attention. Dancers usually wait to address physical pain until it’s far too late in the process, which is why the proper care and injury prevention that The Collective is advocating for is really important.”

She went further to point out that when you increase access to preventive services like the ones offered by The Collective, artistic athletes are able to focus on what’s really important: making and sharing their art. And it’s what every artistic athlete should have the access and opportunity to do.

“The whole no pain, no gain culture that is ubiquitous in the performing arts, we all know, especially those of us on the healthcare side of it, that culture needs to change” - Melissa Buffer, AAHC Founder

Melissa continued to stress that the mission of the collective is to shift this culture and prioritize proper care and injury prevention and, at the end of the day, prioritize the performers. The United States healthcare system is reactive and focuses on injury care rather than injury prevention and for artistic athletes in particular, that can be devastating. Melissa wants to change all of that through her work with The Collective.

How is The Collective going to accomplish this culture shift?

For Melissa, the answer to this question is quite simple: go to where the artists are. 

It’s important for clinicians to understand the actual environment and what goes into prevention and wellness. So she broke down the steps involved. She shared that “we’re doing this by providing onsite services, which include physical therapy - literally right on site, we bring the table there - weekly recovery classes, specific recovery classes for post performance, pre-performance, training, warm up and cool down consultations, mental health and mindset motivation for the artists, nutrition consultants, we literally have a huge array of clinicians that are experts in exactly the needs that these artistic athletes have.”

Through this array of clinicians and on-site preventive care, The Collective is filling a void that has existed in the community for far too long. Melissa plans to fill that void by coming on site, meeting the artists where they are, and doing the things they need to as health professionals to provide preventive care to artistic athletes throughout the community.

How does this benefit the dance studios and theater companies?

All of The Collective’s services have been designed and curated with the artistic athletes front of mind. But that doesn’t mean they don’t exponentially benefit these companies and theaters as well. 

As Melissa explained, “Providing these sorts of services helps companies and theaters continue to attract all of the top talent and provide the optimal work environment for their artistic athletes. The research is out there. These services will help studios and companies decrease their claims, costs and time loss and improve the overall well-being of the artists throughout the process. It’s a win-win for everybody.”

“These services will help studios and companies decrease their claims, costs and time loss and improve the overall well-being of the artists throughout the process. It’s a win-win for everybody.” - Melissa Buffer

Libby echoed Melissa’s sentiment by pointing out that “company wellness should be a top priority. And The Collective really helps companies accomplish this easily by conducting a thorough and individualized needs assessment and, from there, coordinating all the logistics so that studios can easily provide these services for their artists.”

She goes one step further and stresses what’s absolutely key for companies to recognize, “if the artistic athletes aren’t functioning at their best, at their highest capacity, then the art is going to suffer. So if companies want to be serious about advancing their product, the art they’re producing, they absolutely have to ensure that their artists’ needs are being met. And that means investing in wellness programs and prioritizing company wellness as a core value, not as an afterthought.”

“If the artistic athletes aren’t functioning at their best, at their highest capacity, then the art is going to suffer.” - Libby Bullinger

What does the future of The Collective look like?

Naturally, it was hard to produce a concise answer to this question because Melissa has many goals for the future of The Collective.

She shared with us that, first and foremost, she’s excited about The Collective’s Mentorship Program. The goal of this program is to increase the number of trained, interdisciplinary health professionals in the performing arts medicine world so that, as The Collective grows, they can continue to serve more and more artistic athletes throughout the community.

The first three months of the program is all about learning the didactic information, the lectures, in-person sessions, labs, etc. and the second three months, it’s all about application. Each mentee designs and implements a wellness program for an actual arts entity. The Mentorship Program, at present, has three mentees, one of whom is developing a Pilates based program for hypermobile bodies and artists. Another is putting together a workshop for health considerations and injury prevention for crew and tech. And the third is creating a health, wellness, strength and conditioning program for collegiate dancers.

These mentor created workshops and programs will be free and open to the public in order to give back to the community.

Melissa also shared that she envisions a future brick and mortar space for The Collective, “dedicated to the health and wellness of the artists of this community, a place where artists can come and train independently, take workshops, or receive care.”

As for Melissa and what The Collective means for her, she shared that “One of the best surprises of this collective so far has been how my job has shifted. I’ve been a physical therapist for 17 years now and I'm still very much a physical therapist. But to be able to utilize my skill sets as a PT, but also as an artist and dancer myself, in this new way. As a mentor, I cannot explain how good these new hats feel on my head and how excited I am to continue to wear these hats as we continue to grow The Collective.”

While we may have sat down with the Founder to learn her specific role in The Collective and its impact on the community, it is not lost on Melissa that it takes a village to make this sort of cultural change happen. The Artistic Athlete Health Collective is always looking for folks that are interested and, as Melissa said, “a rising tide lifts all ships. So the more, the merrier.”

If you’re interested in learning more about The Collective, please reach out. You can also watch the full interview here.