Some unsung stars of the American Repertory Theaterโs recent production of dance thriller โBlack Swanโ were the backstage team of physical therapists led by Melissa Buffer.

The show was โa very intense production due to all the dancingโ and because it had 24 actors, said Buffer, 43, and the founder of Cambridgeโs Artistic Athlete Health Collective.
Melanie Moore, who played the demanding lead role, โreceived services outside the typical need,โ said Buffer, who often brings in a massage therapist, and will consult with acupuncture, dry needling and chiropractic practitioners. โBlack Swanโ included a whole mental health team as well.
Buffer oversees physical therapy for the American Repertory Theater (A.R.T), as well as other local theater companies, and works with individual dancers, theater performers and circus artists.
Buffer started dancing as a child and discovered dance medicine while in college at Northeastern University. She then pursued a degree in physical therapy in graduate school, during which she did a clinical affiliation with a physical therapy office, Performing Arts Physical Therapy, located in New Yorkโs theater district. Every afternoon they went to the theater to spend a couple of hours getting performers ready for their show. On days with matinees, she was there between shows, too. Her later training included cases with the late Lyle Micheli, a pioneer in the field of dance medicine, and with the Boston Childrenโs Hospital dance medicine team.
The focus of her work is prevention; โvery few dance-related injuries are acute,โ said Buffer. Before a show opens, she and her team evaluate everyone in a company. They look at the requirements for each track, or role, and make suggestions for how performers might prepare for the show. They might also suggest modifications. For example, they might suggest a wider toe box in footwear or make recommendations for how long certain shoes are worn. All such modifications are made in consultation with the director and the choreographer.
Injuries can still happen. Carmen Rizzo, a long-time client who recently had solo shows at Cambridgeโs The Dance Complex, as well as a show at the Foundry, earlier this year woke up with a painfully swollen ankle the day before a show opened. Unable to walk properly, she warned the director that an understudy might need to step into her role. Then she reached out to Buffer. โShe was able to pop it [her ankle] back into place and I had no further problems. Itโs so much quicker and easier to see someone who actually knows whatโs going on,โ Rizzo said, referring to Bufferโs understanding of the challenges faced by dancers.

Claire Lane of Detritus Dance, currently an artist-in-residence at Mount Auburn Cemetery, is another long-time client of Bufferโs. After Buffer recently observed a rehearsal of a show Lane was preparing for, she provided a warm-up plan that included breathing techniques to employ the full power of the diaphragm to support movement and stamina and exercises for the feet.
Dancers are not the only performers who benefit from Bufferโs services and insights. For actors in non-musicals, Buffer will suggest adjustments to how people sit to balance the stress on their backs. Buffer says that one of the most challenging shows from a physical therapy standpoint was A.R.T.โs 2022 production โLife of Pi.โ It had life-sized puppets and a raked stage, one that is slanted for greater visibility but presents a physical challenge for actors. Actors Equity, the union representing actors, requires that performers working on such a stage receive a rake orientation, another service Buffer provides. Emma Watt, associate producer at the A.R.T, said that for performers, the functioning of their bodies is critical to their work. โItโs a clichรฉ to say that their bodies are their instruments,โ Watt says, โbut itโs true.โ
Before each performance of โLife of Pi,โ Buffer held a puppetry call to mock through the movements. โI would remind people to lift with their shoulders, try to grip it like this instead of this.โ The puppetry in โLife of Piโ required many repetitive movements to replicate animal behaviors. Watt described the close collaboration between Buffer and Jill Johnson, the movement advisor for that production. Buffer and Johnson worked together to create warm-up routines and an icing protocol to protect the health of the performers.
In their most recent contract negotiation, Actors Equity stipulated that any actor or company member in any Equity production has the right to request physical therapy at any point in the production. Buffer hopes more companies will see PT training and injury prevention as part of a showโs infrastructure, just like costuming, lighting, staging, and dramaturgy. She also encourages musicians and the crew for the back of the house โ the people who build sets, string lights, and manage the stage during the performance โ to avail themselves of physical therapy.
Bufferโs work with local performers extends beyond her services to A.R.T. โThe mission behind my health collective is to bring what has been available to a very few elite institutions to regular performing artists,โ Buffer explained. Because dancers are often underpaid and overworked, they donโt always have access to the health care support they need. Lane appreciates Bufferโs efforts to provide lower-cost services through programs like her Resilience and Recovery classes, which offer small-group physical therapy sessions. Buffer, she said, โis trying to bridge the gap, meet artists where they are at whatever stage they are at, to make sure services are accessible and affordable.โ


