The Royal Ballet School’s Summer Performance season places extraordinary physical demands on student dancers, requiring specialised medical infrastructure that extends far beyond conventional school healthcare. During the 2025 season at Opera Holland Park, Physical Health Lead Erica Gethen Smith oversaw mobile clinical operations supporting over 200 students across multiple performance venues.
The healthcare team transforms performance sites into fully functional medical facilities. “We bring physio, Pilates, and strength and conditioning equipment to Opera Holland Park, so we can carry out assessments and treatments for injuries and rehabilitation as usual,” Gethen Smith explained.
Weather conditions during 2025 created unprecedented challenges requiring immediate protocol modifications. Extreme temperatures during the opening two days followed an already demanding hot weekend, creating conditions that threatened both student safety and performance capability.
Dr. Dan Fitzpatrick delivered specialised extreme heat illness briefings to healthcare, pastoral, and production staff before Opera Holland Park performances began. “The week before Opera Holland Park, Dr Dan Fitzpatrick provided an extreme heat illness briefing to all healthcare, pastoral and production staff to ensure we could work seamlessly to uphold student safety in the heat,” Gethen Smith noted.
Heat management demanded coordinated efforts across departments. “We discussed how we can all assist the students, from medical staff and pastoral teams to the stage management crew. Knowing what signs to look for in the students, and then the strategies we can utilise to manage that,” she explained.
Cooling protocols included ice towels, water sprayers, portable fans, and ice buckets for wrist and ankle immersion between rehearsals. Staff distributed over 400 ice pops while monitoring hydration status and encouraging regular fluid and electrolyte intake. Transportation schedules were modified to prevent overheating during venue transfers.
Temperature-related adjustments affected standard training regimens. “The heat meant it was too hot to expect students to do their usual strength and conditioning sessions; therefore, we have adapted rehab plans to reduce their overall load in the heat,” Gethen Smith observed.
Artistic and production teams collaborated with healthcare recommendations by modifying rehearsal schedules to include additional breaks. Safety concerns led officials to implement what Gethen Smith described as a “dress with no dress” policy, eliminating costumes during Tuesday’s dress rehearsal to prevent overheating.
Hydration monitoring revealed widespread underestimation of fluid requirements. “It can be easily underestimated just how much fluid and electrolytes need to be taken throughout the day to combat the heat. Some students thought they were drinking enough fluid but their symptoms said otherwise, so we have needed to monitor everyone closely.”
Multiple stressors compounded heat challenges during performance week. “A period of intense heat coupled with the adrenaline of performing and the end of term, meant it has been important to take fatigue levels into consideration as well. Dehydration can mimic or even cause muscle fatigue, so we have to ensure the students are rested and hydrated before they rehearse and perform.”
Healthcare services expanded beyond standard offerings during performance week. Sports massage therapy, typically available only at Upper School, became accessible to all students through volunteer therapists. “We have volunteer sports massage therapists offering treatments to both Upper School and White Lodge students, which was brilliant and much appreciated, especially for tired calf muscles.”
Injury prevention succeeded despite elevated risk factors. Performance week typically increases injury probability due to fatigue, adrenaline, and intensive scheduling, but 2025 recorded exceptional results during the acclaimed summer performances. “We’ve actually had no new significant injuries, which is great. There have been fatigue-related lower limb muscle tightness and cramps but no specific injuries.”
Mobile medical facilities replicated full clinical capabilities at performance venues. Healthcare tents housed massage tables, ultrasound equipment, and two doctor’s clinics capable of immediate assessment and treatment. “Having our entire team and equipment here has been essential. A few students had existing injuries coming into the week, but we’ve managed their loads carefully so no one has to drop out at the last-minute.”
Collaboration between healthcare and artistic staff intensified during performance periods through increased meeting frequency. These discussions enable medical recommendations to influence artistic decisions when student welfare requires standard procedure modifications.
Healthcare responsibilities extended beyond medical treatment into performance support functions. Gethen Smith assisted with backstage wardrobe quick changes, demonstrating the collaborative nature of performance production. “It’s a bit crazy, but it’s such a team effort. Everyone chips in.”
Student recovery trajectories provide professional satisfaction for healthcare staff. “It’s amazing to see students who had stress responses or fractures earlier in the year now back to their full range of dance activity and performing in their respective pieces. Watching their full rehab journey come to life on stage is the best part of my job,” Gethen Smith reflected.
The 2025 season introduced transparency initiatives involving donors and guests in behind-the-scenes healthcare tours. These pre-performance visits provided insights into physical and mental health provision while generating educational conversations about student welfare support systems.
“We’ve worked more closely with the development team to offer a behind-the-scenes look at what we do. Guests have had a chance to see the setup, hear about our physical and mental health provision, and ask questions. It’s sparked some really meaningful conversations,” Gethen Smith explained.
Communication protocols between medical and artistic personnel enable rapid response to emerging situations. “We have regular meetings with the artistic staff, which increase in frequency during performance season. Ahead of the hot weather we discussed how the students would be traveling to and from Holland Park and made small allowances to ensure they weren’t overheating when traveling to the venue.”
The mobile healthcare model demonstrates institutional commitment to maintaining clinical standards during high-pressure artistic periods. Medical tent facilities replicate permanent clinic capabilities, enabling immediate assessment and treatment without requiring external facility transportation.
Healthcare operations balance competing demands: maintaining training intensity necessary for performance quality while managing fatigue and injury risk, accommodating environmental challenges while preserving educational objectives, and providing clinical care while supporting artistic achievement.
Performance week medical protocols require integration across multiple institutional departments. Healthcare recommendations influence artistic scheduling, transportation planning, costume decisions, and rehearsal modifications when student safety considerations override standard procedures.
Healthcare team performance week operations illustrate broader institutional philosophies regarding student welfare at elite training establishments. Medical support enables pursuit of demanding artistic education while maintaining safety protocols necessary for sustainable career development.
The Royal Ballet School maintains these comprehensive healthcare standards while supporting young dancers pursuing professional ballet careers through competitive training programs. This commitment continues even as the institution adapts its approach to training younger students.
Gethen Smith articulated the healthcare mission during performance season: “Ultimately, it’s about giving the students the best chance to perform at their best – safely, confidently and with joy.” This philosophy guides medical operations that extend beyond traditional treatment to encompass holistic wellness support during the most physically and psychologically demanding periods of student training.
