Injury in dancers
As usual I am always trying to find a new subject to write on, and this week, I have been inspired to write about injury in dancers due to the fact that, recently, I have had quite a lot of dancers come into clinic.
So what are the common injuries experienced by dancers then?
Well, the injuries that I have seen in clinic recently are knee injuries, Achilles issues and back problems but is this a true reflection of dancers as a whole?
As a whole this is the general view:
Minor injury in professional ballet, modern, and theatrical dancers is 74% according to Chmelar et al (1987).
Chronic injuries in professional ballet and modern dancers was 48% according to Bowling (1989).
Musculoskeletal pain that lasted for at least 1 year in Swedish professional ballet dancers was reported to be about 95% according to Ramel and Moritz (1994) and (1998).
They also found that 90% of those followed up 6 years later reported recurrent pain (Ramel and Moritz 1999).
What about the more specific injuries then?
The most common injury locations were ankle (21%), foot/toes (17%), hip/thigh (13%), and low back (12%). 48% of the injuries were sprains/strains or tendinopathies, (Solomon et al 1999).Professional dancers:
Ankle: 80% chance of injury.
Knee: 57% chance of injury.
Foot: 51% chance of injury.
Pre-professionals:
Ankle: 43% chance of injury.
Knee: 46% chance of injury.
Foot: 26% chance of injury.
College dancers:
Ankle: 36% chance of injury.
Knee: 35% chance of injury.
Foot: 40% chance of injury.
Young dance students:
Ankle: 27% chance of injury.
Knee: 23% chance of injury.
Foot: 18% chance of injury.
(McNeal et al 1990).
So this highlights as you move up the ladder your injury risk actually increases, which is clearly related to the demands on the individual but also highlights the lack of increased preventative management as the demands increase.
So why is this?
Well firstly, as a group, dancers have received very little attention in the research according to Bronner et al (2003). This means that compared to football as an example, there is no hard and fast guidelines on the best course of action to take to prevent and manage injury in dancers. Obviously money is plentiful in football, so as the demands increase, the money put into the correct strategies to prevent and manage injury increases also.
What dance form has the highest level of injuries?
Hip Hop:
Hip Hop dance has a 237% annual injury rate and from this 162% required time off. Lower extremity injuries were 52% and upper extremity injuries were 32%. Breakers had a higher injury incidence compared with Popper/Lockers, and New Schoolers (Ojofeitimi et al 2010).
So what are the common reasons that could be improved to minimise injury?
Amount (volume) of dancing:
More than 5 hours per day and having a history of amenorrhea lasting longer than 6 months increased risk of stress fracture (Kadel et al 1992).
Previous Injury:
Having had a previous injury increases injury risk according to Evans et al (1998).
Greater physical demands of choreography (intensity):
So as with high volume work the risk of injury increases with higher intensity work (Evans et al 1998).
Performing on a raked stage:
Evans et al (1998) also found higher levels of injury were reported in dancers who performed on a raked stage.
Soloists and principals:
Ramel and Moritz (1998) found that in their study soloists and principles accounted for 25% of the study population but they were 45% of the injuries in total.Stretching:
In acute injury, 88% occurred during slow, controlled stretching (Askling et al 2002).Hypermobility:
In Summary:
Clearly, more needs to be done to prevent and manage dancing related injury and just because there is a lack of research, funding and guidelines doesn't mean it can't be done. On the contrary it is definitively possible to prevent injury and manage injury better to enable the maximum potential of a dancer.
Every dancer is different so it is impossible to just say you should all do this or this and you'll be fine. So each dancer needs to be assessed to tailor a plan to help to prevent and manage injury so ultimately you can keep dancing.
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