Supporting Artistic Athletes with Selina Shah, MD

[00:11] Jennifer Milner: Welcome back to Bendy Bodies with the Hypermobility MD, where we explore the intersection of health and hypermobility, focusing on dancers and other aesthetic athletes. This is co-host Jennifer Milner, here with the founder of the Bendy Bodies Podcast, Dr. Linda Bluestein.

[00:27] Dr. Linda Bluestein: Our goal is to bring you state-of-the-art information to help you live your best life. Please remember to always consult with your own healthcare team before making any changes to your routine.

[00:37] Jennifer Milner: Our guest today is Dr. Selina Shah, dance company physician for numerous ballet companies and team physician for U.S. Figure Skating, USA Artistic Swimming, and USA Weightlifting. Dr. Shah, hello and welcome to Bendy Bodies.

[01:03] Selina Shah, MD: Thank you. It's great to be here. And I really appreciate the honor of being here with you guys.

[01:09] Jennifer Milner: Well, before we get started, could you tell us a little bit about yourself and your background?

[01:15] Selina Shah, MD: Sure. So I am a sports medicine physician practicing here in Walnut Creek, California, which for those of you that don't know is part of the greater San Francisco Bay Area. I'm in private practice, and the reason I went into sports medicine is really my own personal background in terms of athletic endeavors. I actually started off as a competitive gymnast — artistic gymnast — and fell in love with rhythmic gymnastics when I saw it on the Olympics for the first time. I thought, okay, that's perfect because I really didn't want to do all of the flips and all the scary stuff in terms of gymnastics. I went into competitive rhythmic gymnastics. And then after that, I was in a little small town, so unfortunately the program fell through, and I got into dance. I've been dancing ever since — danced all the way through medical school, residency, fellowship — and have never stopped actually. So I still dance, which is really exciting.
[02:16] I've done ballet and pointe and jazz and hip hop and modern, and was in a professional Bollywood company in LA, as well as a professional salsa dance group, through residency. Really fun.

[02:30] Jennifer Milner: That's great. And just a reminder to everybody as they're listening that there's no time that you have to stop dancing, right? It's something that you can keep doing throughout your life. I still love to take class. Dr. Bluestein still loves to move. It's great to keep doing what you love and not feel like there has to be more to the story than that. You can be a successful and amazing doctor and also still enjoy your salsa dancing.
[02:58] So as a dancer and an athlete yourself, you work extensively with elite performers across several different fields. Why would hypermobility be helpful to some of these competitors?

[03:12] Selina Shah, MD: If you look across all the aesthetic activities — such as professional ballet, professional modern, even ballroom, professional competitive dance — and then you look at your aesthetic sports like artistic gymnastics, rhythmic gymnastics, figure skating, artistic swimming, which was formerly called synchronized swimming, to name a few — all of them require such beautiful extension. For somebody that's hypermobile, that comes mostly naturally to them. Usually it's in the joints that we want them to be hypermobile in, from an aesthetic perspective — from the audience's view, the judge's view, the artistic director's view, whatever the case may be.
[03:56] The nice beautiful long legs, the ability to split, the ability to have that back extension, beautiful arms in terms of positioning — those usually come naturally to somebody that's hypermobile. And those of you listening probably don't realize it sometimes, but some people have to work so hard for that compared to someone who's got it naturally.

[04:25] Dr. Linda Bluestein: Sure. That makes sense. We also know that hypermobility can be problematic for performing artists and athletes. What aspects of hypermobility make them more prone to injury?

[04:39] Selina Shah, MD: I think the problem starts with understanding what it means — why is someone more flexible than somebody else, and what is flexibility versus hypermobility? That's really a spectrum. If we think back to a little bit of the basics, hypermobility mostly has to do with how flexible your collagen is. And collagen is found throughout our body in so many different tissues. But in particular, when it comes to our joints, it's the capsule that covers the joints plus our ligaments. Ligaments connect bone to bone — they're part of our support structures for the joints. And then if you look at tendons as well — tendons connect muscle to bone — those also have collagen.
[05:26] So if your collagen is looser, meaning it's more elastic and stretchy, then that's someone who is born that way — that's what hypermobility is. And remember, all of those same structures — the capsule, the ligaments, the tendons — are also there to support your joints. So if they're looser and stretchier, then sometimes it's actually harder to control those joints. That's where the difficulty arises in terms of needing to balance that, and strength becomes more of an issue for people that are hypermobile and is actually harder to attain than for someone who doesn't have that elasticity. That's where issues can arise in terms of increasing the risk for injury and even difficulty in holding certain positions.

[06:17] Dr. Linda Bluestein: And I bet a lot of our listeners will be able to relate to — at least we get these comments a lot — "I have so much difficulty building strength. Other people seem to be able to put on muscle or maintain proper joint alignment more easily than I can." Can you elaborate a little bit as to why that's the case for people that are hypermobile? What are some of the reasons why they might have more difficulty building strength?

[06:53] Selina Shah, MD: It comes back again to that same concept of the collagen being looser and more elastic. And remember, you can't strengthen ligaments, you cannot strengthen the capsule. Those are the deep structures that are really close to the joint. Then comes your layer of the muscle tendons, and you can strengthen muscle for the most part. But remember that muscle is also built of that tissue that tends to be a little stretchier and elastic. Trying to get that strong compared to someone who doesn't have that looseness is difficult. That's really the issue — the inherent structure of somebody who has hypermobility.
[07:37] It's not impossible, it's certainly possible, and it really has to be done in the right way. I think the first step is really having that awareness — am I hypermobile or not? Understanding that first is helpful, because it helps alert everybody around you, especially coaches who are training you, so they can give a little extra attention to strengthening the muscles that are closest to the joints — the smaller muscles — and working outward to the bigger muscles. There are many different avenues to do that.
[08:10] A lot of times coaches have great conditioning programs that all athletes and performing artists go through. Sometimes it's helpful to get some additional help. Pilates is a great way to do that, for example. And a common misperception is that people who are hypermobile often keep stretching a lot. It's okay, of course, to stretch to maintain what you have for your performance or competitive needs. But we don't want to keep self-perpetuating that problem, because then it actually makes it harder to get the stability and strength that you also need to support that flexibility.

[08:55] Dr. Linda Bluestein: Yeah, I think that's one of the really tricky points because it probably depends on whether you're a very serious pre-professional, a casual dancer, a professional dancer, or one of these athletes. Balancing that stretching versus strengthening and knowing how much to push into the stretching — we actually also just recently chatted with Jennifer about stretching and overstretching, which is obviously an important topic.
[09:26] So in terms of training for hypermobile performing artists, you mentioned some of the things that might be different — it might be even more important for them to work with someone like Jennifer, who is a Pilates instructor. Are there any other training suggestions you would give to hypermobile performing artists? And perhaps it would be different depending on the level they're at and/or their age, because that's going to obviously make a huge difference.

[09:56] Selina Shah, MD: I think first is always having that conversation with your artistic director, coach, or ballet instructor — coaches for all the different athletes. Most of the time the coaches are aware. They've been training you, so they know that you're more hypermobile, and a lot of times their strength training already incorporates some of that. But it doesn't hurt to have a conversation to say, "Hey, what do you think I should work on?"
[10:31] In athletics, strength and conditioning is often built in. When it comes to dance, it's not always — I know some studios do have strength and conditioning classes or Pilates classes, but not all studios have that avenue available. One thought is to talk to your teachers: "Do you know anyone locally that does strength and conditioning for dancers?" A lot of times it is someone who does Pilates. Many Pilates instructors, at least in our area, were former dancers in some capacity. That's a really nice resource to have.
[11:11] Another thought would be a trainer — there are trainers out there who understand performing artists, dance, and different aesthetic athletic endeavors. A lot of times they're going to work with you on bodyweight-type strengthening and not the heavy weightlifting that you might picture. Because all of these aesthetic sports and performing artists don't want to bulk up, and that's often the fear people have: "I don't want to do any strengthening because I don't want to build up big bulky muscles." But for the most part, you're not going to. It actually takes quite a lot to build up big bulky muscles, and people that are hypermobile struggle with that anyway. So the chances of that happening are extremely low, especially if done guided with bodyweight-type work. And you can get really nice long lean muscle that supports your joints that way.

[12:16] Jennifer Milner: One of the common threads I'm hearing from you throughout all of this is that idea of getting one-on-one feedback. You talk a lot about going to your dance teacher, going to your coach, and saying, "Hey, what do I need to work on?" or "Do you have suggestions?" or finding a trainer — getting that individual attention, which I think is so key.
[12:36] I personally don't love to teach group classes because it's so hard to address the hypermobile body and the hypomobile body and the person who has scoliosis all at once. Hypermobile people are one of the groups that kind of get lost in those group classes because they can make the pretty pictures, but they're probably using the wrong muscles and they're hanging on their tendons. So I appreciate that you're saying to get that one-on-one attention — get in front of someone who is going to say, "Do this, not that," or "Do that, but do it this way," or "With this intention." Getting that individual feedback can be expensive, but it doesn't have to be every week. Even getting it occasionally is going to help so much as you're trying to train as a hypermobile athlete.
[13:37] When we look at injuries, I know we're talking about a wide group of people again because you treat swimmers and gymnasts and weightlifters and dancers, but are there certain types of injuries that you see that are more common for hypermobile artists and athletes?

[13:54] Selina Shah, MD: I would say it's really sport specific — that's probably the best way to put it — because it depends on what that specific athletic or dance endeavor is using. Usually it's going to be a repetitive use issue, and that's where we're going to see problems.
[14:19] For example, in artistic swimming, they're eggbeatering, so their hips are constantly being rotated. We'll see a lot of hip issues there, and shoulder issues too because of what they're doing in the water. Whereas in dance, we'll see issues with ankles — especially in pointe dancers — knees, and hips. Even the low back or the entire back, because with hypermobility, sometimes people are flexible at certain levels more than others. When they're doing maneuvers that require back extension — whether in gymnastics, figure skating, or dance — they don't realize they're overusing a certain part of their back and not really the whole back, and certain parts are stronger than others. That's where we start to see a lot of issues with back problems. So it really depends on the sport and activity.

[15:25] Dr. Linda Bluestein: Which brings me to a common theme that we keep coming back to: it's never too soon to start working with somebody. If you wait until you're really having a problem, the best time to start working on that was probably a year ago or more. It's a good idea to be proactive. Would you agree with that?

[15:53] Selina Shah, MD: I definitely would agree with that. Like I was saying, in other sports, strength and conditioning is often already built into part of their training, where I think it's really lacking in a lot of dance — not all, but many. If that could be identified early on — a lot of times a dancer doesn't even realize they're hypermobile, they don't realize how easily something comes to them — they may not realize it until they get older and notice that maybe their friend struggles a little more with a certain thing than they do.
[16:34] I think it's helpful if teachers were aware and could point it out to dancers, suggesting at a younger age to start working on some strengthening — starting with planks for the core, for example, at a young age. But as we all know, planks are difficult even for a well-trained person. To have someone that young do one correctly really requires supervision, so at that age it needs to be done in a class-type setting rather than going home and doing planks incorrectly on their own.
[17:16] So I think at a young age it really requires supervised training. But yes, I agree — starting early, if people realize this person has some extra hypermobility, that would be the ideal setting. That comes down to education and awareness, and those are things we try to work on in our different organizations. Once someone's a bit older, at the pre-professional or elite level, they can obviously work on conditioning on their own as well.

[17:49] Dr. Linda Bluestein: In terms of rhythmic gymnasts specifically, we recently spoke with Vita Bachmann, who is a former Ukrainian rhythmic gymnast and now a coach, and we also talked with Jennifer about overstretching. So it's great to also chat with you, because the three of you are each seeing a slightly different piece of that picture. I feel like if you look in the literature, there's dance medicine research, obviously, but less than in sports medicine. And if you take the subset of rhythmic gymnastics, there's even less. That's a group who's really pushing into their flexibility and joint mobility at such a young age, when knowledge of the risk-benefit balance may be limited. Do you have any specific training tips for that group, given that you did rhythmic gymnastics yourself and have worked extensively with gymnasts?

[18:56] Selina Shah, MD: It's a tough one. The sport requires it — a 180-degree split counts for zero points. They have to have an oversplit to actually get points. Some of it is inherent in the sport. How we do that safely, I think, is really the key. That's where the strength work is helpful — not only the stretching, but also working on strength to balance that and supporting all of those muscles being stretched to that extreme end range.
And then there are spectrums, right? There's the athlete who's doing rhythmic gymnastics just for fun and never has any aspiration to go to the Olympics or join a company like Cirque du Soleil, versus someone who does have those aspirations. That's also a mindset decision: am I going to push my body to those extremes, or am I just happy enjoying this sport and doing what I can?
[20:18] Usually it's the hypermobile person that ends up selecting into that higher-level, Olympic-level competitiveness, because it's very hard for someone who's not hypermobile to attain that flexibility. Not impossible — they work on it at a young age — but it is harder. The balance is that someone who does attain that flexibility without being inherently hypermobile usually has a better chance with strengthening. So there's this idea of: maybe I'm not hypermobile, but I'm going to work hard on stretching, and I have a little advantage on the strength work, so hopefully the two balance each other out.

[21:57] Dr. Linda Bluestein: That's a good point. You mentioned overuse injuries, and that in artistic swimmers those overuse injuries are more likely in their shoulders and hips because of the types of movements they're doing. I think a really common misconception that I would love to hear you talk about is tendinopathy. What is it? We know it's more common in people who are hypermobile, whether they're an athlete or not. But I think there's a lot of confusion — "I've had tendinitis for the past 10 years." So could you talk about what tendinopathy is, what some of the options for treating it are, and what it looks like in different groups?

[22:48] Selina Shah, MD: Let's talk about tendinopathy. Coming back to the anatomy: tendons connect bone to muscle. They're a thick, ropey structure. Tendinopathy is really just a broad term meaning a problem with the tendon.
[23:08] Tendons have some blood supply depending on the tendon — and that's what's interesting, because different tendons in our body are very different. For example, the Achilles tendon is unique in that the blood supply is in the sheath that surrounds the tendon. It's a very different tendon compared to something like a tendon in your elbow. The way these tendons get injured can be a little bit different as well.
[23:37] There's tendinitis — if you go back to Latin, "-itis" means inflammation. To truly have tendinitis, there has to be inflammation. Unfortunately, that term gets thrown around a lot very incorrectly, even among the medical community. If everyone can just understand that "-itis" means inflammation — to truly have tendinitis, you have to have inflammation, and inflammation really should be a short-lived, few-week issue. If pain in a tendon is going beyond that, there's some question as to whether it truly is tendinitis, or whether there's some other actual problem going on — either it's not really that tendon but some other structure in that joint, or there is what we call tendinosis, which is actually degeneration of the tendon.
Tendinosis usually starts a little later in life — we see it in older teenagers and those in their 20s, but usually a little more in people who are older than that. Degeneration means a breakdown of that same collagen we were talking about, and that can be difficult to treat depending on how severe the pathology is and what is involved.

[25:11] Dr. Linda Bluestein: Tendons in general don't have great blood flow, at least relative to other tissues, so they can be really stubborn problems. Do you do some more advanced types of procedures if people have tendinosis and are really struggling?

[25:31] Selina Shah, MD: Yes. What I was alluding to is that you have to have a decent blood supply to get inflammation. If tendons don't have great blood supply — which we've talked about — then a lot of times they're not truly getting inflamed. It's more along the realm of tendinosis or some degeneration. When you get those tendons that already have some damage in terms of degeneration and then you injure them — a strain, which is either an overstretch or a partial tear or a complete tear — those are very difficult to heal because there's already some underlying damage, and they lack that blood supply to really heal themselves well.
[26:10] Not impossible — there's some good research showing that with enough time, pathology can reverse, which is great about the human body, especially the younger you are. That requires adequate, appropriate rest and then an appropriate buildup. But in terms of treating tendinosis when someone comes in with pain we diagnose as such, the first step is to figure out where they are in training and whether we can modify that training to not load that specific tendon. Most of the time you don't have to pull someone out of something completely — we can work around it and let them still train in other areas that don't overuse that specific tendon.
[26:59] Then we like to get physical therapy involved to help with the right appropriate exercises, taking a stepwise approach of building upon exercises as the person is ideally getting better. If they don't get better — if they're stuck, not improving, or plateaued, or need to return to activity a little faster — there are some great procedures out there with research showing benefit, depending on the tendon.
There's platelet-rich plasma, for example, that's commonly done throughout the world. You have to be really careful about reading the actual research studies and understanding the methods to interpret them appropriately. Some research studies have come out recently saying platelet-rich plasma doesn't work in certain situations, but when you actually read the methods, they used what's called a low-concentrate platelet-rich plasma — not really a good concentration. You can't say it didn't work because they didn't use an appropriate amount.
Platelet-rich plasma works by concentrating platelets, which have growth factors, with the idea that they can help promote pain relief and functional improvement. They can, in some research studies. We were hoping we could reverse arthritis with this 20 years ago when we started using it, but we're not seeing that happening. We are, however, finding really good application in treating people's pain and improving function in tendons. It involves drawing blood, spinning it down in a centrifuge, concentrating the platelets — ideally to at least a fivefold concentration — and injecting that into the damaged areas of the tendon. This should be done ideally using guidance — ultrasound, for example, which I have in my office and many physicians who do this procedure also use. You're looking visually at the actual tendon and injecting the platelet concentrate into it to promote pain relief and functional improvement.
[29:05] It does require a period of rest and physical therapy, and it can take a few months before seeing full results — sometimes less, sometimes longer. Nothing in medicine is 100%, so does this work for everybody? No, but it does work for a lot of people when done in the appropriate setting. It can have over a 75% success rate if done appropriately.
[29:34] There's also something called ultrasound-guided percutaneous tenotomy — a big mouthful of words. There are a couple of different devices out there. One uses a blunt probe the size of a needle that produces a high-volume, high-frequency water jet that can go in and break up some of the damaged tissue. Another uses high-frequency ultrasound to go in and break up and remove some of that damaged tissue. It's a little like mimicking surgery but not really full-on surgery. Again, done with real-time ultrasound visualization, the probes are the size of a needle, inserted after local anesthesia, and essentially clean up the tendon pathology. Similar recovery timeline — several weeks to a few months — working closely with a physical therapist. But it's another great option.
[30:43] What's really nice is that we have these two fantastic options, and we really try to avoid cortisone in tendons. Several research studies have shown how cortisone can damage tendon tissue. For someone at a high level using their tendons all the time, we really want to avoid cortisone unless there's an emergency need — an upcoming performance, the Olympics — where you just have to have that relief and can't work through it. In that case it can be reserved for those situations, and I would definitely recommend trying to get it done ultrasound-guided if possible to make sure the right tissue is being injected. But really, try to avoid cortisone if you can. The last resort is surgery. Most people luckily don't need surgery with these other options these days, but it's always in the toolbox if needed.

[31:36] Dr. Linda Bluestein: I'm so glad you raised the question about cortisone, because I feel like especially when people have weak connective tissue to start with — I have patients who are still being offered that as an option — and the data doesn't show that a year later, two years later, they're any better off than the people who took the more conservative approach.

[31:57] Selina Shah, MD: Yep.

[32:04] Jennifer Milner: Tendinopathies, at least in my practice and among the people I see, seem to be more prevalent in the hypermobile population. So it's really great that you've laid out some concrete things they can talk through with their own physicians as they try to solve their own tendinopathy issues.
[32:25] We've talked about the importance of having one-on-one care with a strength and conditioning coach, making sure the coach or dance teacher or whoever is in charge understands that they have hypermobility, knowing that sooner is better than later if an issue comes up, and what they can bring up to discuss with their physician if they are trying to treat some of these issues.
[32:49] For the hypermobile artists and athletes who are moving into a new situation, though, we'd love to hear a little advice from you. I know you've been the team physician for numerous sports teams as well as a company physician for several ballet companies, and you've treated performers from major Broadway shows, Cirque du Soleil, and the San Francisco Opera. How would you advise a hypermobile athlete to get the specialized training or attention or maintenance that they need when they're working with a team physician — someone they're stepping into a new arena with compared to who they originally worked with as a soloist?

[33:30] Selina Shah, MD: I think the biggest key, if you were to summarize everything, is communication — that's been a theme throughout this conversation. At those high levels, there is a lot of healthcare support staff. If you're new to the company, or the team physician is new, having an opportunity to meet that team physician one-on-one is great. Ideally, that team physician is helping coordinate all aspects of care — introducing you to the other ancillary services available, such as physical therapy, an athletic trainer, massage, and Pilates, depending on the company or athletic situation.
[34:20] Having that conversation with all of those different avenues, setting up appointments, letting them assess and figure out where the problem areas are — where the weaknesses and strengths are — and what needs to be done to balance out the body, no pun intended. Being proactive about that and taking advantage of it is really valuable, because at that level you're so lucky to have all of that available. When you first start training, not all of that is available. So use it, keep everyone in communication and working together, and you can really optimize your treatment, your care, and your body to minimize injury.

[35:29] Jennifer Milner: And that's something that is hard for artists and athletes to learn — to have that communication. A lot of times we have the relationship where our coach, trainer, or teacher is someone in a position of authority over us, and it's hard to develop the habit of approaching them. It's a learned skill for artists and athletes, but especially for artists. It's important to learn that you do have to be able to advocate for yourself. It's okay to go to a coach and say, "Hey, I have this specific issue — just wanted to let you know." They will appreciate that, and they'll be able to, like you said, point you in the direction of services that are probably already there but that you may not know how to access.
[36:21] Have you seen any trends? You've been looking at so many different fields as a physician — do you see people leaning more toward pushing into those extreme ranges of hypermobility, or do you see people starting to pull back from it? Or is it really sport specific?

[36:43] Selina Shah, MD: I think it's hard to know without a true research study, but I would say I think it's a process of natural selection, like it is for any athlete. Generally, the ones who make it to the elite level have either been able to attain that flexibility or they're naturally hypermobile and were able to strengthen enough to maintain that flexibility alongside whatever training they've had access to. Many athletes move all over the country — and sometimes the world — to find the right training environment because that's their passion. But I think natural selection is the main driver at the elite level.

[37:37] Jennifer Milner: That's fair. Is there any research that you would love to see on hypermobility and the artistic athlete?

[37:46] Selina Shah, MD: Well, like Linda alluded to earlier, there really isn't that much research out there in general for these sports. And then if you take the niche of hypermobility, it's even less. So the field is wide open for anyone who wants to take it on.
There are just so many ideas that came up during this conversation. What if you take someone young who's found to be hypermobile and you start strengthening them early, compared to someone who doesn't have that opportunity — are there fewer injuries in the one that strengthened versus the one that didn't? That would be interesting to see. It'd also be interesting to see if this natural selection really holds true — how many hypermobile athletes can't make it because they can't build enough strength, versus how many were able to strengthen and make it? And was it the resources available to them that made that difference, or was it something else?
And for those who do start strengthening, if you compare someone who has Pilates and similar resources available to them versus someone who doesn't — are there really fewer injuries? We think there are, based on what we see, but is it true? You really don't know until you do that research study.
[39:10] What is the healing time difference for someone who's hypermobile versus someone who's not? Generally, what we see is that hypermobile people unfortunately do take longer to heal and require a slower, more gradual approach with physical therapy. You can't throw everything at them the way you can with someone who's not hypermobile. It would be great to see a research study confirm that. And along the spectrum of hypermobility — from the extreme contortionist to someone who's just barely hypermobile — what's the difference in ranges of injuries and longevity as an athlete? The field is wide open.

[40:05] Jennifer Milner: Hint, hint to all the researchers out there who are listening, right?

[40:08] Dr. Linda Bluestein: Exactly.

[40:09] Selina Shah, MD: Those of you that have time, resources, and IRBs that could take this on.

[40:13] Dr. Linda Bluestein: Yes. They need a thesis for their PhD program.

[40:13] Selina Shah, MD: Right.

[40:20] Jennifer Milner: Well, is there anything you wanted to make sure we covered that we haven't yet brought up?

[40:26] Selina Shah, MD: I think this is a fantastic topic, and you could take it in so many directions. I think it'll be fun to see what feedback and questions you get, because that would probably spark something. There may be people who want to talk more about treatment of tendinopathy — that's a whole series in and of itself. But I think this is a fantastic start. Thank you so much for this opportunity.

[40:50] Jennifer Milner: Well, thank you. You're absolutely right — each episode sparks more questions that our listeners send to us, and then we find someone to talk about those questions, and that sparks more questions. It's an excuse for us to go down our own rabbit holes.

[41:08] Selina Shah, MD: Pretty much.

[41:08] Dr. Linda Bluestein: Pretty much. Yeah, that's exactly how we get the ideas for our episodes — based on questions that we get and conversations like this where we say, "Oh boy, we better learn more about some specific topics." So we really appreciate you sharing your knowledge with us.

[41:29] Jennifer Milner: Yes, thank you. And where can people find you? How can they get in touch with you?

[41:39] Selina Shah, MD: I do have a website — that's probably the easiest way. It's selinashah.com. So S-E-L-I-N-A-S-H-A-H.com. I'm located in Walnut Creek, California. My specialty niches are taking care of dancers, performing artists, and aesthetic athletes, but I love to see everyone of all ages and abilities.

[42:09] Jennifer Milner: Excellent. We will have your contact information in the show notes so people can click on that link to find you easily.
[42:15] Well, you have been listening to Bendy Bodies with the Hypermobility MD. Today we've been speaking with Dr. Selina Shah, dance company physician for a multitude of ballet companies and team physician for U.S. Figure Skating, USA Artistic Swimming, and USA Weightlifting. Dr. Shah, thank you so much for sharing your expertise with us today. We really enjoyed having you.

[42:33] Selina Shah, MD: Thank you.

[42:39] Dr. Linda Bluestein: Yeah, thank you so much.

[42:39] Jennifer Milner: Thank you. And we'll say goodbye to our listeners. Bye.

[42:39] Dr. Linda Bluestein: Okay, bye-bye. Thank you for joining us for this episode of Bendy Bodies with the Hypermobility MD, where we explore the intersection of health and hypermobility for dancers and other aesthetic athletes. If you found this information valuable, please share it with a colleague or friend and leave us a review on your favorite podcast player. Remember to subscribe so you won't miss future episodes.
[43:09] If you want to follow us on Instagram, it's @bendy_bodies, and our website is www.bendybodies.org. If you want to follow Bendy Bodies founder and co-host Dr. Bluestein on Instagram, it's @hypermobilitymd, all one word, and her website is www.hypermobilitymd.com. If you want to follow co-host Jennifer Milner on Instagram, it's @jennifer.milner, M-I-L-N-E-R, and her website is www.jennifer-milner.com.
[43:46] Thank you for helping us spread the word about hypermobility and associated conditions. We want to hear from you. Please email us at [email protected] to share feedback. The thoughts and opinions expressed on this podcast are solely of the co-hosts and their guests. They do not necessarily represent the views and opinions of any organization. The thoughts and opinions do not constitute medical advice and should not be used in any legal capacity whatsoever. This information is not intended to diagnose, treat, cure, or prevent any disease, as this information is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Please refer to your local qualified health practitioner for all medical concerns. We'll catch you next time on the Bendy Bodies Podcast.