Twist and Shout: Music, Race, and Medical Moralization

Beth Linker and Hannah Yusuf

This upcoming November, Black American singer and dancer Chubby Checker will be inducted into the Rock and Roll Hall of Fame. Most famous for “The Twist” – which first topped the charts in 1960 and then again in 1962 – the 83-year-old Checker still sings and performs “The Twist” at state fairs and other venues.

In a recent interview, Checker reflected on the song’s impact:

“it changed the dance floor… The girl’s looking at the guy, the guy’s looking at the girl, and they’re doing something — they’re exploring their sexuality while being fully dressed and looking at each other. And this is something that shocked the world, actually.”

The conservative backlash, spearheaded by religious groups and the political Right, is well known. Less well documented is the role that medical and health professionals played in raising suspicions of The Twist. The overwhelming white American Medical Association (AMA) used journalist outlets to warn the general public about how the dance was bad for hips, knees, and spines. Meanwhile leading medical journals, such as the New England Journal of Medicine, published case studies of injured – and ostensibly regretful – patients who required surgery to “untwist” their dance injuries.

While these health professionals argued that The Twist was an affront to the science of proper body mechanics and injury prevention, they couched their concerns within more commonly held fears. Discussions of racial “primitivity,” cultural decline, and laxity of sexual mores – especially among young white women – often accompanied medical proclamations of health risks related to The Twist. By looking at the history of The Twist through the lens of medical history, we see how medical science served as a site for educated professionals to normalize the denigration of Black culture and dance. ^[1]

Twist “Victims”

From her upstate New York bedroom in 1962, 19-year old Judie Stockwell issued a warning to her peers: “If kids could only realize the pain that’s involved with a thing like this, they’d never do the twist again.”^[2] Stockwell had recently dislocated her knee from dancing The Twist and spoke to AP reporters about her recovery. She was one of many reported Americans who sustained injuries from the dance that had taken the nation – and indeed the world – by storm.

The Twist made its debut on television in 1960 on American Bandstand, hosted by Dick Clark. Clark had first heard the song performed by the original writer and performer, Hank Ballard, a Black R&B singer known for sexually suggestive lyrics and danceable tracks. But when Clark encountered Ballard’s The Twist late in 1959, he found it to be too risqué for national television. According to Hour Detroit magazine, Clark never even considered making Ballard the face of The Twist. He regarded the streetwise R&B singer as “not the right kind of black man to be invited into America’s living rooms week after week.” Instead, Clark turned to Checker (born Ernest Evans), a 19-year-old Philadelphian with a lighter complexion, youthful smile, and baby-faced image who could perform a more wholesome version of the song.

What made Checker’s version of The Twist more palatable to white audiences was not just his pop-friendly demeanor, but also his ability to rechoreograph Black music, sanitizing it of its roots in African American social dance. From the bop to the lindy hop, Black dancers had long emphasized improvisation, rhythm, and pelvic articulation in both paired and solo forms. In its original expression, The Twist echoed blues and gospel traditions that included call-and-response, spiritual ecstasy, and full-body swinging and swaying.^[3] Indeed, Hank Ballard’s original rendition of The Twist featured hip-centric, suggestive movements typical of Black juke joints and R&B clubs.

Checker, by contrast, used mundane imagery to describe the dance’s moves. “Drying the buttocks with an imaginary towel while grinding out an imaginary cigarette with one foot,” was one frequent descriptor of the dance.^[4] Using even plainer language, Checker would instruct novices to “move the chest, hips, and arms from side to side and balance on the balls of the feet.”^[5]

Despite Checker’s ability to subdue and normalize Ballard’s Twist for white audiences, the song created a moral panic, largely stemming from white fears of racial integration and sexual liberation. Leading voices in the U.S. medical profession sought to legitimize these fears by voicing concerns about the physical dangers of the dance, especially to white teens and adults.

When asked about the dance a couple years after its debut , a spokesperson for the AMA responded that it was “bad medicine for middle age, and it isn’t very good for youth, either.” Twist risks, the AMA reported, were quite high, leading to an increased incidence of “dislocated joints, slipped disc, sacroiliac damage [and] muscle strains.”^[6]“It’s not a dance to be taken lightly,” said an orthopedic surgeon in 1962. He explained that one of his patients, a white fifteen year old, broke a steel rod surgically implanted along her spinal column to correct for scoliosis. “She was fine,” the treating orthopedist recounted, “until she did the twist.”^[7]

In another 1962 case published in the New England Journal of Medicine, radiologist D. Glyn Millard and surgeon Theodore H. Lee condemned the “sex-suggestive ritual,” the “energetic torso-contorting dance,” as a biomechanical menace, especially to the human knee. They arrived at these conclusions after treating a 21-year-old white woman who came to the clinic complaining of swelling and pain in her knee so severe that she could not walk. The woman recounted that, while dancing The Twist, she had heard a crack and immediately fell to the floor. She was diagnosed with a fracture dislocation of her patella. Upon her admission, Lee applied a plaster cast, and 6 days later performed surgery to aspirate accumulated fluid and remove two small bone fragments from the knee. While Millard and Lee admitted that the patient exhibited innate hypermobility with abnormal laxity of the patella of her uninjured knee, the two proceeded nonetheless to blame the dance. Borrowing a quip from a contemporary theatre critic, Millard and Lee concluded that “the female knee is a joint and not an entertainment.”^[8]

Although they warned of its dangers, not all physicians could resist the cultural pull of The Twist. Dr. Donald S. Miller, a professor at the Chicago Medical School, admitted that he learned The Twist from his wife and daughters. So, too, did the city’s Health Commission, Dr. Samuel L. Andelman, who confessed that the dance was “good exercise if done properly and carefully.”^[9]

As white medical professionals started to dance The Twist themselves, they began to contrive distinctions between staid (read white) versus “crazed” (read Black) versions of the dance. An orthopedist from Buffalo, N.Y., noted that the problem was not the motions required of The Twist, but rather the fact that certain teens and adults were becoming “hypnotized by the music and rhythm,” and thus “didn’t realize the strain” that the dance caused until after significant injury had occurred. A health columnist for The Washington Post, Dr. Theodore Van Dellon agreed. He explained that “the dance is not dangerous unless the youngster becomes mesmerized and ‘goes all out,” adding that “adults who do the twist should remember their age.”^[10]

For much of Western history, European intellectuals – including medical professionals – drew a clear line between “civilized” and maniacal dance forms. The white, educated elite preferred organized, angular, and controlled choreography. They held contempt for any kind of impromptu and free moving forms of dance, dismissing it as “primitive.” By the early twentieth century, at the height of Jim Crow segregation and eugenic outcry over white race suicide in the U.S., the Anglo-Saxon elite demonized so-called primitive dance, associating it almost exclusively as a product of Black culture.^[11]

By the mid-twentieth century, new professionals in the mind sciences had helped solidify this association. They drew similarities between the expressive full-body gesturing in Black dance culture and nervous disorders commonly seen in the clinic. Categorizing The Twist alongside other dance manias from the “dancing plague” of the Middle Ages to St. Vitus’s dance, Columbia University physician and psychiatrist Joost Meerloo conveyed his impressions of witnessing a “spontaneous outburst of Rock ‘n’ Roll in a small town” in 1960. “A juke box set forth a seductive rhythm,” he recalled, “from the very first note the young people near the small bar became untamable.” They started to dance, he writes, but “no, that is hardly the right word. A frenzied rhythmic seizure took possession of them.”^[12]

The convergence of racialized medical discourse and moral alarm was not accidental. As U.S. race historians have documented, when Black songs achieved mass popularity in the United States during the first half of the twentieth century, they were subjected to heightened scrutiny, and in certain cases, were violently resisted. This backlash peaked in 1956, when a white supremacist organization, the local Citizens’ Council, physically attacked Black singer Nat King Cole during a concert in Birmingham, Alabama.^[13] Even though Cole performed for an exclusively white crowd, the Citizens’ Council took his success to be a dangerous symbol of the Civil Rights Movement and gains made by the 1954 Brown v. Board of Education ruling, which mandated desegregation. For white supremacists, the changing legal and cultural tides threatened their own conceptions of social order and racial hierarchy.

A mere seven years later, when white physicians and other health providers framed The Twist as an orthopedic threat, their concern appeared apolitical. But race-based assumptions about the supposed negative impact of Black culture on white health lurked just under the surface. Using the rhetoric of physical injury sidestepped the deeper social discomfort with the threat that Rock ‘n’ Roll posed to the nation’s racial order. In the end, the language of injury and medicalization worked to constrain the cultural force of Black performance without explicitly invoking race.

The Twist’s Afterlife

Despite the controversy – or perhaps because of it – The Twist endured. Black Panther leader Eldridge Cleaver wrote, “The Twist was a guided missile launched from the ghetto into the very heart of suburbia.” The Twist succeeded where sermons, protests, and policies had failed: putting Black culture at the center of American life, at least temporarily.^[14]

Today, historians recognize The Twist as a key catalyst of cultural change in America. It opened the door to new styles of social dance, paved the way for the sexual revolution, and helped dismantle rigid barriers around race, class, and gender on the dance floor.

Yet the story of The Twist also reminds us how predominantly white, male, medical professionals attempted to police Black cultural expression through a process of pathologization. The medical warnings of “Twister’s back,” “dance-induced joint trauma,” or “muscle spasms” gave establishment voices a respectable register from which to critique what they saw as racialized deviance without explicitly referencing race. The danger wasn’t only in the backs the dance might strain, but in the boundaries it blurred between white suburbia and Black cultural forms. What could not be openly condemned on racial grounds was instead policed through discourses of health, morality, and respectability.

Featured image caption: Riverheart High School students do the twist in the baggage car on the train to Montauk. World Telegram & Sun photo by Herman Hiller. (Courtesy Library of Congress)

Beth Linker

"Beth Linker, a former physical therapist, is the Samuel H. Preston Endowed Term Professor at the University of Pennsylvania in the Department of the History and Sociology of Science. Her most recent book, Slouch: Posture Panic in Modern America, reveals the little-known and surprising origins of our fears and ideas about poor posture. Her writing has appeared in The Boston Globe, Time, Psyche, The New England Journal of Medicine, and U.S.A. Today.

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Hannah Yusuf

Hannah Yusuf’s research and writing explore the intersections of race, culture, and health, with a particular focus on music, representation, gentrification, and social change. She is currently a medical student at UMass T.H. Chan School of Medicine. Outside of academics, she enjoys exploring boutique fitness classes, perfecting her pastel-coded planners, and tracking down the best fruit with tajín.

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