In this episode, Circus Medicine Specialist, Emily Scherb, talks about all things rehabilitation of the circus athlete.

Today, Emily talks about recreational circus, how physical therapy comes into play, common circus injuries, and the things physical therapists should be aware of. How is “circus” defined?

Hear about important lingo, one of Emily’s favourite circus stories, and get some valuable advice, all on today’s episode of The Healthy, Wealthy & Smart Podcast.


Key Takeaways

•       “Circus is everything that can happen in a performance environment that would be defined as ‘circus.’”

•       “Ask questions. It’s okay to not know. With these artists, they’re expecting you to not know.”

•       “Figuring out the demands of the sport can be really challenging if you don’t speak the language.”

•       “Every circus artist has a video of them training on their phone.”

•       “Use the knowledge you have, and then seek more information.”

•       “Circus really is for everyone.”

•       “Be brave enough and take the time to listen more. It really does take bravery to admit you don’t know everything.

More about Emily Scherb

Emily Scherb Dr. Emily Scherb is a physical therapist specializing in circus and performing arts medicine. Through her 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. Her bestselling book Applied Anatomy of Aerial Arts was published in 2018.

Suggested Keywords

Circus, Physiotherapy, Medicine, Artists, Safety, Injuries, Lingo, Performance, Healthy, Wealthy, Smart, Healthcare, Training, Fitness,



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Read the Full Transcript Here:

Hi, Emily. Welcome to the podcast. I’m happy to have you here.

Speaker 2 (00:06):

Hi, thank you so much for having me. It’s really exciting to get, to spend some time talking about circus with you.

Speaker 1 (00:11):

Yes, and I’m excited because as we were talking before we went on the air it was, it sort of changed my outlook on what circus is and what circus quote unquote performers are. So we’re going to get into all of that, which I think the audience will really love. But before we do that, can you talk a little bit about your journey into this niche, into working with circus performers or circus athletes?

Speaker 2 (00:40):

Absolutely. I started off as a kid who loved gymnastics love to flip and fly and just be in my body and move through space. And I stumbled on circus as a hobby at a summer camp when I was a kid. So I started doing circus and I was really young and realized that I loved to perform way more than I love to compete. So the competition aspect Gnostics was fun for me, but I really just liked being out there in front of the judges and smiling and doing my thing. And I realized I could do that with circus. And it was a really collaborative collaborative environment and very challenging and very similar ways. And so I started circus as a kid went through high school, continuing to expand my knowledge about spickets and my own body. When I could, there was not a lot of resources for learning circus at the time.

Speaker 2 (01:27):

And after high school, I moved out to the West coast and joined some aerial dance companies to continue to pursue professionally knowing I’d go back to school eventually. And I did. So I went, I went to undergrad every summer, either working at a summer camp teaching circus, cause that was a popular place for circus schools to be, or wherever I could get a job teaching circus doing circus during the summers after college, once again, much, much to my parents’ chagrin. I took more time off to go back and do more circus. And I moved to New York to your neck of the woods, spent some time there working with a dance company called strep and with trapeze school, New York while I was there and teaching circus, doing circus and professionally using my body through space as a performing artist before going back to grad school. And then even in grad school, I may have taken residencies and done my clinical rotations where there were circus schools. So captain was part of my life for sure.

Speaker 1 (02:29):

That’s amazing. And now before we go on, can you define what circus is? So you’re teaching circus and people think, wait, circus is, I thought circus was a show or an event. So I’m a little confused. So can you define what that is?

Speaker 2 (02:47):

Really great question. When I say circus, it’s also going to be slightly different than when someone else says circus circus is everything that can happen in a performance environment that would be defined as circus, which is debatable even in the circus community. So circus is acrobatics. It’s aerial artists, it’s juggling, it’s clowning, it’s acting, it’s dancing, it’s communicating through movement, it’s performing arts and what qualifies a circus is kind of the definition of the individual company members that are involved in the, in the creation. When I say I’m teaching circus for me, I’m primarily teaching aerial arts, I’m teaching flying trapeze or I’m teaching aerial silks. It’s like that fabric that hangs down or I’m teaching a static trapeze or rope or web there’s lots of different apparatus and lots of different challenges for the body. I just prefer my challenges to be off the ground and in the air. So when I say teaching circus, I personally mean Ariel. Generally I have taught tumbling as well. But circus is a huge, huge arena for challenges to the body and performance challenges in space.

Speaker 1 (04:09):

Awesome. And now when, when we’re talking circus and when people think of circus, they might think of Ringling brothers, Cirque de Solei, these, you know, grand extravagant performance artists. But I know what you want to talk about is the growth of what we would call recreational circus, recreational circus athletes, let’s say. So I want you to talk a little bit more about that. I’m just going to throw the mic over to you to let the listeners know what the heck is that and where does a physical therapist come into play?

Speaker 2 (04:47):

Absolutely. so circus in the U S has grown exponentially in the last 15 or so years. We went from having maybe 10 schools for all levels. But like I said, I started a summer camp. That was an opportunity. A couple of the universities around the country have had circus schools. So like Florida state university has one. There’s some youth circuses in, in like circus Ventas in Minneapolis, Minnesota when actually youth circus out here in Washington where I am, those have been around for a really long time, but then there’s this phenomena of circus rapid rapid growth in this last 10 years. We’ve gone from those 10 or so schools to having over 800 schools in the U S that I know about, and that’s counting circus schools. That’s not including aerial yoga. And that’s not including pole-dancing studios that might have an apparatus or gymnastics gym that might have an apparatus or two in their space.

Speaker 2 (05:46):

So circus has not only grown for recreational use of it’s not only grown for recreational artists across the country to, to try to do after work or on the weekends. It’s also growing in these other niches and, and kind of just keeps expanding. So there’s things that we can all do after work or on the weekends to keep our bodies healthy. This can be our, you know, our soccer game instead of soccer game, I’m going to go take a class and I’m going to stay fit and stay strong and build my community through the circus world. The other thing that’s really happening in, in an interesting way in circus is the development of what’s called social circus, which is using social using, just using,

Speaker 3 (06:35):

There we go

Speaker 2 (06:38):

Social circus, which is using circus to do outreach and community building through specific groups often involving a social worker or using trainings that have a lot of which have been developed by search delay through a program, they call sick demo to do outreach in schools and in different settings that make people grow and increase physical literacy to also increase health literacy. There’s a urban youth circus in St. Louis called circus harmony. That’s been around for decades. I should know when, but it’s been around for decades and they have youth classes and they also have these youth performers performing every weekend at a, at a museum. And they perform every weekend. They have the social responsibility of showing up, getting their work done. They, they really have that community building element. There’s also been studies all over the world, but the one I’m thinking of in Canada in the fiscal education system that uses circus is as PE class to have an equal growth of both boys and girls.

Speaker 2 (07:47):

And they find that that does not have a gender differentiation. Everyone has an increase in physical literacy in those, in those groups. So it’s a great way of reaching out that way. Here in Seattle, we have a women’s group, a women’s circus group. That’s run by a social worker here which is a really great resource for, for these women. We also have a boys and girls club group that comes in and we have on the other side of things on the more medical side of things, we have circus it’s been adopted for anyone to participate. There are juggling tools that don’t actually involve throwing and catching. They involve rolling in gliding so that they can be a little more accessible. We can take our aerial apparatuses and lower them down to the ground. So we can use it like the aerial silks, more like a sling or a hammock where you can tie the bottom together.

Speaker 2 (08:36):

And you can use that for compression. You don’t need to have quite as much balance or grip strength. So we’ve been able to do work with kids with cerebral palsy and had great work with them on the trampoline, kind of getting some, some input with them there and then taking them to the air and they get to do things that are cooler than their friends. They have to go back into and tell stories. And on the other side of that, we have adults with Parkinson’s and we have a Parkinson circus group and using the novel learning novel movement, learning of circus with Parkinson’s to make improvements and give them more comfort moving in their bodies as well. So circus has just really expanded into the recreational world and into every aspect of movement, which has been incredible boon to, to see, and, and to be on the sideline of, as a physical therapist, my personal interests tend to be more on the orthopedic side, but if there’s someone out there who really loves working with pediatrics, and you want to get involved with circus, how cool, you know, someone, someone comes in your door and they have difficulty with dorsiflexion, but what if the goal is to hook their foot on something instead of just trying to make their ankle move, you know, and it gives different goals and different levels of excitement for all sorts of artists of all ages and abilities.

Speaker 1 (09:53):

I mean, this is so much more than I was thinking. I was literally thinking that what you do within circus medicine is just working with like Cirque de Solei or professional. Like I had no idea, the large umbrella that is sort of circus and that is circus performing and yeah, so much more fun,

Speaker 2 (10:19):

So fun and so cool. And it’s incredible because all these schools have popped up that most of us can within a couple mile radius find a circus school to take a class in on the weekends if we want, or are likely to, as healthcare practitioners have a client will walk in the door, who’s taken a class and wants to get back to doing it as their physical activity.

Speaker 1 (10:39):

Okay. Well, let, now let’s talk about that. So, because let’s say you’re a physical therapist and maybe this is not your specialty, but like you said, if there’s this huge rise in recreational circus, we may be seeing people who are coming in for an injury that maybe they got well doing circus. So let’s talk about what are some, and if there are common injuries that one may see understanding to all the listeners understanding, like we said, this is a huge umbrella, so we’re not going to go over every single injury, but let’s talk about some common ones that maybe the everyday PT might see from one of their recreational circus athletes.

Speaker 2 (11:23):

Probably the most common one that I see in my practice is chronic overuse of the shoulder. And when I say overuse, I mean under preparedness for the activity that they’re undertaking and that’s because most of us live our day-to-day life, especially right now in front of our computers, typing away with their arms in front of us and reaching out to our laptops. And then when we go into the circus world and we’re all of a sudden asked to bring our arms all the way up, overhead stabilize our entire body weight, without relationship to the ground, or only in relationship to the ground, if our legs are over our heads and we’re in a handstand, our shoulders just aren’t necessarily prepared for that level of load. And so there’s definitely a pattern of different shoulder problems that crop up. So there’s, there’s a lot of chronic shoulder pain.

Speaker 2 (12:13):

And some of my job is also go into the circus schools and educate these artists that, that chronic shoulder pain is not normal and that they can get rid of it. So that’s also a huge, huge thing is there’s a, a saying in circus that is pretty pervasive, which is circus hurts and circus does hurt in that you’re pushing your body in new ways. You may be having pressure against an apparatus. Maybe you get a bruise and that’s okay, but circus shouldn’t hurt like an injury hurt like deepen the joint hurts. So that’s one of those things I try to get out there and, and explain to people there’s of course, more acute injuries both of the shoulder and the rest of the body, but that, that’s one of the biggest ones, especially in my aerialists and a little bit in my hand balancers.

Speaker 2 (13:01):

And even my recreational contortionists, that is a thing we have recreational contortionists now, which is incredible. The other really big injury is hamstring strains, proximal, hamstring strains are a huge one. I can. Same thing. Yeah. So we’re getting to end range possibly with dynamic motion. So maybe if there are tumbling and working in the ground and they go to do a Cartwheel for the first time as an adult, or the first time in a very long time as an adult, and you’re kicking your leg approaching end range rapidly without necessarily the preparation, strength and control at that end range. So that’s, that’s another one that’s really common. And then, Oh, go ahead. Oh, say one of the, the third, probably most common injuries are ankle sprains, either from landings or falling off mats. So often protective equipment can also be in an interesting challenge as well.

Speaker 1 (13:55):

Oh yeah. That makes a lot of sense. I was a gymnast for many years when I was younger and I always had an ankle sprain. So I would feel like I remember being on crutches at least once a year, once every other year from an ankle sprain. So I can definitely see that now let’s say you’re a physical therapist like me or others who do not don’t have like this vast knowledge on circus and what is involved. And someone’s coming in to see me with chronic shoulder pain. I don’t expect you to go through a whole eval here, but what are some things, maybe some questions we want to ask some things that we should be aware of and then maybe even some resources you can send us to, to look at, Hey, what are these people doing?

Speaker 2 (14:45):

Yeah. So great question, because I think it really will be a challenge that we will face soon. I hoping circus keeps growing beyond the pandemic. And as, as circus schools keep keep expanding. And I hope that you will get to see eventually a circus status walk into your clinic. So the first thing is, ask questions, ask questions, ask a lot of questions. It is okay to not know with these artists, they’re expecting you to not know. They, they probably learned relatively recently, all the things that they’re learning about circus. So ask questions, ask them what their discipline or their apparatus is. Ask them if they’re an aerialist or a ground Acrobat. Are they doing handstands on the ground? Are they doing handstands on another person holding them up? Are they hanging from a bar or a horizontal apparatus grabbing kind of like with normal shoulder flection or are they holding a vertical apparatus?

Speaker 2 (15:43):

Like those aerial silks where they might be grabbing one hand up stacked on top of each other. Let’s just give you, gives you an idea of what kind of shoulder range of motion they’re going to need. And what they need to do with their body is also asking what level they are. Because as recreational circus grows, circus artists people are defining themselves as circus artists in different ways. So the recreational artists may still say, I’m a circus artist. And so might your professional. And so really diving down, what does their training look like and who are they? And then specifically to the shoulder, I just want to reassure everyone that circuit shoulders aren’t that different. They are just functioning at, at end range. So you just need to make sure that all the things you normally look at are working and are working at and range. So if they need to get into field reflection, making sure those last 10 to 15 degrees, if their mechanics look perfect and I do a lot off the ground sorry, I do a lot on the ground without them being in the air. And you can learn a lot just by watching their movement through everyday activities. Even if they’re not having pain with those, they may only have pain with their circus activity, but there’s still things you can see with your professional life that really can be helpful.

Speaker 1 (16:57):

Awesome. And then obviously when you ask those questions, you look at that end range being so important, and then you get into the treatment. And again, this is where, you know, as a physical therapist, you’re looking at, what are the demands of the sport? What does this person have to do? And how can you create a plan around that? Is that about right?

Speaker 2 (17:17):

Yeah. And so figuring out the demand to the sport can be really challenging if you don’t speak the language or you don’t know what the apparatus, the discipline is that they’re doing. And here’s the cool thing. Every single circus artist has a video of them training on their phone.

Speaker 1 (17:31):

Oh, that’s so smart. Of course. Right?

Speaker 2 (17:33):

So everyone’s like setting their phone up in the corner and watching themselves trained. If they have a move that’s painful, they usually have a video of that too. If you didn’t ask them in advance to take one, if you have that opportunity, that’s fantastic. And if not, just ask them, Hey, you have a video of you doing that and you can get a general idea of what they’re doing. If you, and, and that’s interacting with your patient as well, in a way that’s kind of building that trust trust with them, that that level of interest, if you have advanced knowledge and you kind of know what’s going on, Google it, it’s amazing. There’s so many beautiful performers out there and you can Google almost any apparatus and see how they interact and what they need to do. Again, it’s going to depend on their level, but it gives you an idea or even better. If you do have access to a circus school, taking a class, if you have the have the ability to do it, or just go out and observe and see kind of what’s going on with their bodies it can be really fun and educational and the, both the students and the coaches usually love it. They love knowing that healthcare providers are interested and want to get involved with their bodies and help them perform better.

Speaker 1 (18:41):

Awesome. That’s all great tips and great advice because I just don’t want PTs to walk away from our conversation and be like, well, that was really cool, but what am I supposed to do? Well now, you know what to do.

Speaker 2 (18:53):

Absolutely. Yeah, yeah. There’s plenty of resources out there. There’s not plenty of resources out there. There are, there are resources out there to seek knowledge in how to work specifically with circus artists, but there’s so much you can do with the knowledge that you already have. And that’s the real key is use the knowledge you have and then seek more information. The artists are great resource themselves, and they really want to get the most out of the treatment and that interaction. I have learned so much from my artists. I give them an exercise, they come back making it three times more relevant, and I’ve taught me so much over the years, which is just absolutely incredible.

Speaker 1 (19:35):

Yeah. That’s pretty amazing. And is there like lingo or jargon that if you’re going to be working with this population that you should really know,

Speaker 2 (19:46):

There is some lingo, some jargon I can happily get you a link to a vocabulary list that I have. And I’ll, I’ll get that over to you. So that there’s a little bit of a little bit of lingo that, that helps. There’s some things that just having a few words mean so much to these artists to just feel welcome. So taking the time to look over and things like that is great. Some of the lingo you should know is Ariel is anything off the ground. A bass or a Porter is a person who throws someone else or move somebody off. And they place them in space, either from the ground or from hanging the flyer is the person who’s being manipulated. Right. And then some other things that are really helpful, kind of coming from the domestics world, the idea of opening or closing a joint is kind of a similar to flection or extension opening in the shoulder cases.

Speaker 2 (20:47):

And closing would be extension hips. Closing the joint would be fluxion opening extension. So like when they’re artists are saying things like that inversions are hand balancers are doing inversions when they are turning upside down. Our air lists are inverting when they turn upside down as well, but they’re hanging from their hands. So that’s another really common place that there’s pain is as we’re changing through all those planes of motion. That’s another really helpful term to note as well. And then that, that vocab sheet just has some of the common ones on it. Of course the circus being so broad, it doesn’t cover everything, but it gives it a good starting point, at least a starting point for us.

Speaker 1 (21:29):

Yeah, absolutely. And, and I’ll have that in the show notes at on the website under this episode so that people can, can click and download that. And, you know, as you’re saying all of this, gosh, it does sound a lot like the competitive cheerleaders, the flyers, the base. So, you know, learning about the rehab, learning about rehab within the circus space can really translate out to a lot of other areas of, of athletics, I suppose,

Speaker 2 (22:03):

And the other way around. So if you are working with St gymnast or park core artists or climbers or cheerleaders there’s, there’s so much inter relatedness of the movement, other, so there’s so many connections in, in how there’s so many connections and how these artists move to other things, because circus is so broad, it comes from a tumbling background, it comes from a climbing background. It comes from all these things that have been pulled into what is now currently circus either in a contemporary or a more traditional sense.

Speaker 1 (22:38):

Yes, yes. I think that’s great. And, and for me, this cleared up a whole heck of a lot because I had no, I mean, I had an idea of maybe what a physical therapist can do, but boy, it’s so much more, it’s just so much more, so it was great. So much more than I thought. Like, I, would’ve never thought of working with children’s cerebral palsy or adults with Parkinson’s or the recreational, the growth of recreational circus didn’t even come into my head and I’m in New York city. I see that trapeze on the Hudson, you know, like I know it exists and I know it’s not professionals using it. Know, we all saw that sex in the city episode when Sarah Jessica Parker was flying on that trap piece. Right.

Speaker 2 (23:27):

Absolutely. I was happy to be involved with that school at the time. And it was a blast to be there.

Speaker 1 (23:33):

Yeah. Oh, I bet it was. Yeah, I bet. So I, so when people, when therapists say, Oh, I’ll probably never see anyone that works in the circus, ah, you don’t have to be a professional. So you might,

Speaker 2 (23:48):

I don’t have to be a professional and those recreational artists need help. And if I have a moment to tell a story, I would love to, one of my favorite stories is I had the pleasure of talking to someone, not a patient actually. She’s 72 year old woman. And she was telling me her story, which is she went golfing and she hurt her shoulder, playing golf for club into the ground, hurt her shoulder. And she was fine doing everything she does except for pole dancing because she was also a recreational pole dancer. And so she went to go see her doctor. And she said, doctor, my shoulder hurts my pole dance, but I’m fine. Otherwise I heard it playing golf. And he said, well, you shouldn’t pull down. That’s dangerous stick to golf. And it’s like, it’s just so interesting. Our preconceived notions of what our normal activities for our body. She’s 72, she’s spinning in space. She’s holding her body weight up. She’s doing proprioceptive training, strength, training full body movement, mobility work. How much better could it be than that? And, but golf is the normal activity. So the more we normalize recreational circus and make it more part of our practice, the more helpful we can be to keep our patients healthy and active in doing the things they love.

Speaker 1 (25:01):

Amazing. And now I have to tell you, after watching the super bowl halftime show, not this year, but last year with Jayla and Shakira, I was like, okay, I think I, I need to do some pole dancing here because, Oh my gosh, like J lo is out of this world, you know,

Speaker 2 (25:20):

It’s an amazing fitness tool. It really is. Yeah. It’s on so many aspects.

Speaker 1 (25:25):

Yeah. Oh, and I never thought of that as being in circus again, under that circus umbrella, but of course it is. It’s just your apparatus is the pole versus the silks.

Speaker 2 (25:35):

Exactly. Exactly. And again, it’ll depend on the person and how they want to define circus because it keeps changing. But there are many circuses now that do include pole and there’s even something called swinging pole or hanging pole that moves in space instead of just staying.

Speaker 1 (25:50):

Oh my gosh. No, thank you. Oh my gosh. That’s crazy. Well, is there anything, do we gloss over things? Is there anything that we didn’t hit that you’re like, Ooh, I really want the listeners to take home this.

Speaker 2 (26:06):

I just really want the listeners to understand that circus really is for everyone that you can go take a class right now and that you might have a client in your waiting room at any moment that has at least some experience with it. And being able to speak that language or having a little understanding of what they do can really go a long way.

Speaker 1 (26:23):

Excellent. I love it. Now, where can people find you? Where what’s your website? Where are you on social media? If they have questions, they just want to say, wow, this was awesome. Where can they find you?

Speaker 2 (26:34):

They can find me on social media at the circus doc on Instagram, on Facebook, on Twitter. I’m on most of the things I was going to say, all the things that I’m on Tik TOK yet. But I am out there on at the circus doc and my website is the circus And through there you can find the courses I teach and lots of information lists of physical therapists that like to work with circus artists and other resources to help improve your knowledge about circus bodies.

Speaker 1 (27:04):

Amazing. Well, thank you so much. And before we sign off, I have one last question and that’s knowing where you are now in your life and your career. What advice would you give to your younger self let’s say right out of, right out of PT school?

Speaker 2 (27:18):

I think the biggest thing is taking the time to you. The biggest thing is to be brave enough to take the time to listen more. I think it really does take bravery to admit you don’t know everything and to do more listening and do more and better question asking both of my patients and of mentors and of just the resources around me. I think in the last couple of years, I’ve just done such a better job of connecting with humans like yourself and, and taking the time to ask questions because you just never know what you’re going to learn and where you can help each other on this great journey that we’re not in competition and having the bravery to collaborate.

Speaker 1 (27:58):

Amazing. What great advice, Emily, thank you so much for coming on. This was great. I’m like so excited because I feel I learned now and like, I was like, I want to go take a class. So next time I’m in New York, we’ll go together. Perfect deal. I will hold you to that. Thank you so much for coming on.

Speaker 2 (28:15):

Thank you so much, guys. This was a bunch of fun,

Speaker 1 (28:17):

Everyone. Thanks so much for listening. Have a great week and stay healthy, wealthy and smart.


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©2019 Karen Litzy Physical Therapy PLLC.
©2019 Karen Litzy Physical Therapy PLLC.