ST PAUL, Minn — Cassi Nelson's childhood was spent at Circus Juventas in St. Paul. By high school, she was set on pursuing a professional career in circus performing.
"I would come [to Circus Juventas] from 2:30 to 9, and I was training here all day," Nelson said. "You’d think that doing the same thing all the time would get a little bit dull, but there’s always something new to do."
Nelson appears to have done it all. She's done handstands while balancing dozens of feet in the air, and she's flown on trapezes.
"I love being thrown," she said. "Especially nice and high up in the air."
It's clear, when you see Nelson perform, that it takes an incredible amount of strength. She says years of intense conditioning and athletic training have allowed her to build up to jaw-dropping acts.
"Even just pulling yourself onto a trapeze, that’s a full pull-up," she said. "You're able to use all of these different muscles. We are athletes."
Nelson, who now attends a school out in California to continue her professional career path in circus, says she's thankful to have spent her youth working alongside a medical team who understood the unique demands of the sport. For the past seven years, a team from HealthPartners TRIA Orthopedics has partnered with Circus Juventas to treat performers, getting to know them on an individual basis.
That partnership was especially important in 2021, when Nelson suffered an elbow injury, tearing her UCL.
"The seven, eight years I had been here, I had never been injured before," she said. "It ended up being a moment of weakness, just landing in the net wrong. Even that night, they were already so helpful."
Dr. Ashley TeKippe, the physician who works with Circus Juventas, helped Nelson get into an urgent care that night. Soon after, Nelson began months of physical therapy with physical therapist Jackie Voigt.
"I knew, from knowing her before, that this was going to be hard for her," Voigt said. "She has a career planned in this, so we knew from the get-go we needed to get her in soon, and we need to have a plan for her and be structured."
Nelson's team helped her set personal goals to keep her safe while easing her back into full movement.
"They went out of their way to make sure that I was doing what I love still, but still doing it safely," Nelson said. "People usually get surgery for this injury, but sometimes in the circus world, scars can be looked at as bad. They did full PT with me so that I’m extra strong and back into it as I can be."
Now, TRIA has formalized the program they have created over the past seven years with Circus Juventas, launching the "performing arts medicine" program. It consists of Dr. TeKippe, two athletic trainers, and two physical therapists, including Voigt. Voigt says it was a "herculean effort" to meet what they have learned is a great need.
"There are so many professional circus artists out there that don’t have medical coverage, or don’t have a medical team at all," she said. "But it’s also not uncommon for all performing artists to not seek medical care. We’ve done research, and we see their injuries are underreported in a lot of athletes that are performers."
Now, she's excited to create equity within the world of sports medicine.
"It’s really the same as a football team or basketball team, and they still need that medical care that other teams are getting," she said. "That’s kind of what we see as the gap we need to fill in our performing artist athletes."
TRIA now plans to expand the program by partnering with other performing arts organizations, such as dance and gymnastic teams. They also are hoping to treat individual athletes, including ice skaters. You can reach out to them here.
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