"I heard this click: a clean sound; it was enough to make me wince, but not that alarming"
KAREN SMITH remembers distinctly hearing her neck break. She had been travelling in the front passenger seat of a car when a joy rider forced it off the dual carriageway. The vehicle veered through a crash barrier and down an embankment. When it jolted to a halt, Karen's head was wedged between the front seats.
"I heard this click: a clean sound, rather like someone cracking their knuckle joints; it was enough to make me wince, but not that alarming. I thought I must have pulled a muscle," she recalls.
"But then I went to open the door and I couldn't move. It was the strangest feeling: trying to reach out and finding that nothing was happening. I was paralysed."
Karen, a former pupil of the Royal Ballet, who had been dancing since the age of two was 31 and approaching her professional peak: That very day, she had resigned as founder member and principal dancer with the London City- Ballet after an invitation to join what is now the English National Ballet. That evening, she had led a troupe of 30 dancers in a performance of Tchaikovsky's Sleeping Beauty, bowing out as Princess Aurora to tumultuous applause at about 10.30pm. Less than two hours later, her career was at an end.
"We had been on tour and were driving from Canterbury back to London," Karen explains. "There were three other girl dancers in the car with me, who were not so seriously hurt. They didn't try to lift me out of the car, thank goodness, but lay me across the front seats until the ambulance arrived. One of the paramedics asked me to wiggle my fingers and toes. When I couldn't, I heard him say: `We must be careful with this one'."
X-rays showed that Karen had fractured her second and third cervical vertebrae and crushed the nerves in that area of her spinal cord. "I overheard doctors telling my mother that I might not walk again. She had been a nurse and knew what I was up against. But for me, ignorance was best. I didn't ask any direct questions because I was afraid of what I might be told."
Just how narrow an escape Karen had becomes evident when she tells you her neck was injured in exactly the same place as the actor Christopher, Reeve. "He broke the second and third vertebrae, too; however, whereas his spinal cord was severed - paralysing him for life - mine was severely damaged, but could be salvaged."
Today Karen's slender frame has recovered all its poise and much of its enviable agility. But it has been a slow process.
She spent two and a half months in skull traction: lying flat, with her head held rigid in a weighted metal frame so that the vertebrae could fuse back together. Much of her waking time was spent staring at the ceiling.
"My ballet training - the self-discipline and determination that it instilled in me - helped. Gradually, I started to regain movement: first in my legs, then in my arms. I would lie there telling myself: `You must lift this arm off the bed before you go to sleep'. And I would strain and strain until I did. As a dancer, you are used to breaking through pain barriers and pushing yourself to physical limits."
Within six months, Karen had made remarkable progress and was determined to re-establish herself as a principal ballerina. Unwittingly, in her eagerness to become flawlessly fit, she was embarking on a new career direction - as an alternative therapist.
Like many dancers, she had dabbled with complementary therapies from time to time to help with injuries. Her priority now was to dispense with the painkillers, sleeping tablets and laxatives that seemed the only orthodox way of treating the aftermath of her injuries. She knew where to start.
"I went to an acupuncturist, who began by treating the burning sensation in my left arm that had been caused by nerve damage. From the very first session, there was a tangible improvement. She also worked on stimulating my kidneys and other internal organs that had initially gone into shock and then become very sluggish because of the amount of time I had been immobile."
The acupuncturist recommended reflexology to help speed up Karen's recovery and restore her energy. Lower back problems triggered by the neck injury were dealt with by an osteopath.
Karen's diet also came under scrutiny. "People think' dancers eat well; in fact, we eat Mars Bars and smoke. The spasmodic working hours - rehearsing during the day and performing at night - mean there is never a good time to have a proper meal. Because I wasn't dancing, I was able to eat normally and I soon realised that the more healthily I ate, the faster my recovery."
She developed her own exercise regime, using both her ballet routines _and Pilates - work-outs centred on breathing and posture that helped tone her muscles. "I could feel myself becoming stronger and stronger, but there was always an imbalance - my left side remained weaker than my right. A dancer has to be 100 per cent balanced and I found it so frustrating that I couldn't correct myself."
Karen tried cranial-sacral therapy (gentle massage of the cranium) in an attempt to rebalance her spinal fluid, and then a neurosurgeon friend suggested a CT scan. It revealed a tiny blood clot - about the size of a drawing pin head - pressing on the nerve in her neck.
"It was too tiny and risky to operate; the advice was to live with it and hope that it might eventually disperse. And so - a year on from the accident - I finally learnt my ballet career was over. The neurologist said there was no way I would return to the standard of dancing I had had before."
"I was devastated. Ballet had been my whole purpose, my passion. Dancers don't have much of a life outside their work; to be at the top, you have to give it your all. I truly thought my world had come to an end."
Karen tried singing and acting lessons, but found that whenever she went for an audition, her confidence crashed. She fell into a deep depression and underwent some psychotherapy. "That helped, but I knew it was a question of being able to accept what had happened and get on with life. The more you dwell on the past, the more you stop yourself enjoying the present."
Having witnessed how the alternative therapies had enhanced her recover, Karen decided to become a practitioner. She learnt basic massage and went on to do courses in aromatherapy, anatomy and physiology, reflexology and nutrition. She then set up a practice in Covent Garden, London and later worked at the Chelsea Harbour Club.
"It is very difficult to sustain a relationship when you are a dancer; my personal life always came a very poor second," Karen says. "The great joy is to be with someone who shares my interests." Karen now also teaches ballet and has just taken up teaching Pilates. In the New Year, she publishes her first book, Body & Soul: AWoman's Guide to Staying Young., which incorporates much of the treatment she herself underwent. The only lasting injury from her accident is to Karen's left hand, which has lost some of its grip and flexibility. Now 46, she retains the grace and posture that are the hallmarks of an accomplished ballerina, but is no longer governed by the anxiety and intensity that were an integral part of her previous life.
"These worked very much in tandem. The acupuncturist uses needles to rebalance energy levels; the reflexologist massages pressure points on the foot. First, they tackled the nerve damage that was causing pins and needles down my left side. Then they stimulated my major organs - kidneys, liver and spleen - all of which had become very sluggish during my convalescence and were creating havoc with my digestive system."
"One of the hardest things to recover after the accident was my balance. This treatment helped rebalance my spinal fluid. Although it couldn't fully restore my balance, it certainly improved it."
"People who suffer neck problems will often find that the pain reverberates down the spine to the lower back The osteopath was able to treat my back as a whole, rather than focusing only on the area of impact."
"After three months in hospital, my weight had dropped to 5 stone (I am normally between 7½ and 8 stone). This was partly because I had not been eating well, but also because my muscles had wasted away.
"I combined simple ballet exercises with Pilates, a series of resistance techniques now being used in many ballet studios because of their toning benefits. They are gentle enough to be carried out by those who are ill - or pregnant - and have helped to strengthen my stomach and back and improve my breathing and body awareness."