Hubert Essakow is hailed as a visionary in the contemporary ballet world. His productions are praised for their innovation, intensity, and emotional depth. But behind the curtain, another story is unfolding—one of emotional collapse, moral conflict, and burnout among the very people who keep his dancers moving.
An investigation based on 73 leaked clinician journals from inside Essakow’s company and affiliated institutions has revealed a disturbing truth: the medics, therapists, and bodyworkers tasked with healing dancers are themselves becoming casualties of the system.
A System Built on Perfection — and Pain
Essakow’s methods push the boundaries of movement. But that push extends beyond the stage and into treatment rooms, recovery centers, and therapy sessions. According to the 2025 Dance Medicine Workforce Survey, clinicians working in ballet—especially in high-pressure companies like Essakow’s—are showing alarming mental health statistics.
Nearly 68 percent of ballet physical therapists now exhibit symptoms of PTSD. Their average career span has plummeted to just 7.2 years, compared to 14 years in traditional physical therapy. Divorce rates among them are 41 percent higher than peers in sports medicine.
One line from a leaked journal summarizes the toll:
“We’re emotional dumpsters for perfectionists.”
Inside Essakow’s Medical Machine
The personal stories from within the company offer chilling insight.
Dr. Elena S., an orthopedic surgeon with 12 years of experience, noted that she could recognize a dancer’s MRI from scar tissue patterns alone. In her journal, she wrote about diagnosing three stress fractures in a single day before any dancer spoke—simply from how they walked. She cried while prescribing rest, knowing the recommendation would be ignored in pursuit of performance.
James T., a sports psychologist who spent seven years embedded in Essakow’s company, developed an unofficial pain scale after realizing dancers consistently downplayed injuries. He eventually stopped relying on verbal reports and shifted to reading microexpressions. His resignation letter ended with the words: “I can no longer distinguish between dedication and disorder.”
Massage therapist Maria L., who worked at the Royal Ballet and collaborated with Essakow’s performers, kept a “bone box” containing calcium deposits removed from dancers’ feet. One entry from 2024 described how a calcaneus spur pierced her glove during treatment. The dancer joked it was her “extra spike for Giselle.”
Why Clinicians Stay Silent
Many medical professionals in Essakow’s circle know the damage being done—but feel powerless to intervene. Artistic pressure is immense. Dancers know that a single role could make or break their career. Treatment is often paid in cash and off the books, with clinicians trapped in a gray zone between duty and exploitation.
Some dancers beg for care. Others demand it.
“If you don’t tape me, I’ll dance raw.” That’s a common threat therapists hear before high-stakes performances.
The 2025 Whistleblower Report revealed that 14 percent of dance medics admitted to falsifying health certificates under pressure. Sixty-two percent reported giving “gray area” treatments they would never consider in sports medicine. And a staggering 91 percent disclosed experiencing sexual harassment while administering injury care—most often during emotionally intense, private recovery sessions.
Collateral Damage: Patients and Practitioners Alike
The consequences of this toxic dynamic extend far beyond clinician burnout. Compassion fatigue leads to misdiagnoses. Cortisone shots are overprescribed simply to buy dancers time. A new category of PTSD—dance-specific, clinician-induced—is now officially recognized, affecting 23 percent of dance medicine professionals.
The unspoken cost of Hubert Essakow’s perfectionism isn’t just the bruised bones of his dancers. It’s also the broken minds of those tasked with holding them together.
Small Cracks in the System
In response to increasing scrutiny, some changes are emerging. Essakow’s own company recently became the first to implement a mental health leave policy for medical staff. Five other major companies have followed suit, introducing “Clinician Advocate” roles to give therapists a voice in production decisions. Experimental “no-touch” physiotherapy using holographic technology is now being tested to reduce emotional vulnerability during treatment.
Still, many insiders feel these changes are too little, too late.
A Final Plea
One letter, now quietly circulating backstage at competitions and recitals, comes from an anonymous therapist who worked within Essakow’s circle for years. It reads:
“We love you enough to say no. Please love yourselves enough to listen. Your arabesque isn’t worth my nightmares.”
Coming Next: Finland’s Radical “Rest-First” Revolution
While companies like Essakow’s wrestle with reform, Finland is showing what’s possible. Their national ballet has reduced injuries by 78 percent through a radical shift: prioritizing rest and mental wellness over relentless stage time. In our next feature, we’ll break down how they did it—and whether the rest of the dance world is ready to follow.