Injury In Ballet Dancers Research Articles

Psychological Intervention Programs for Reduction of Injury in Ballet Dancers

The purpose of this study was to examine the effects of two psychological interventions designed to reduce injury among dancers by enhancing coping skills. Participants were 35 ballet dancers. They were assigned to three conditions: control (n = 12), autogenic training (n = 12), and a broad-based coping skills condition, including autogenic training, imagery, and self-talk (n = 11). The 12-week interventions were designed on the basis of results from previous studies. For the 12 weeks following the intervention, participants were asked to practice their respective interventions three times a week. During the 24-week period (12 weeks training plus 12 weeks practice), training staff at the dance academies recorded injuries on a record sheet each day. Participants wrote injury records by themselves for another 24 weeks. Multivariate analysis of variance (MANOVA) and univariate tests for each dependent variable showed that the broad-based coping skills condition enhanced coping skills, in particular, peaking under pressure, coping with adversity, having confidence and achievement motivation, and concentrating. Separate analyses of covariance (ANCOVA), one using preintervention injury frequency as the covariate and one using preintervention injury duration as the covariate, revealed that participants in the broad-based coping skills condition spent less time injured than participants in the control condition.

Pictorial review: MRI features of foot and ankle injuries in ballet dancers.

Foot and ankle pain is common in ballet dancers. Although clinical examination often points to the underlying cause, imaging is often necessary to confirm the diagnosis and thus ensure appropriate future management. Factors predisposing to the increased incidence of injuries in this population include the classical position in which ballet dancers stand, which is on the tips of the toes in the en pointe position or on the balls of the feet in the demi-pointe position. Furthermore, the repetitious nature of ballet and the long hours spent rehearsing cause over-use injuries. The causes of foot and ankle pain can be thought of in four different groups: the impingement syndromes; tendon abnormalities; osseous pathology; and ligament abnormalities. These will be discussed and illustrated.

Ballet dancer's turnout and its relationship to self-reported injury.

Retrospective cohort study. To compare the relationship between the degrees of turnout, passive hip external rotation range of motion, and self-reported history of low back and lower extremity injury in ballet dancers. Ballet dancers are encouraged to externally rotate their lower extremities (turnout) as far as possible. This may cause stress on the dancers' low back and lower extremities, putting them at risk for injury. Thirty college-level ballet dancers and instructors were evaluated. Each participant completed an injury questionnaire that placed the participant either in a group with a self-reported history of low back and lower extremity injury or in a group without a self-reported history of low back and lower extremity injury. Each dancer's first-position turnout and passive external rotation range of motion for both hips were measured. The comparison between each dancer's first-position turnout and the measured hip external rotation range of motion was called "compensated turnout." A 2-sample test was used to determine if the average compensated turnout was significantly different in the injured and noninjured groups. The mean (+/- SD) compensated turnout values for the injured and noninjured groups were 25.40 degrees (+/- 21.3 degrees) and 4.7 degrees (+/- 16.3 degrees), respectively. This difference was significant at P = 0.006. Based on a self-reported history of low back and lower extremity injuries, ballet dancers have a greater risk of injury if they reach a turnout position that is greater than their available bilateral passive hip external rotation range of motion.

Rehabilitation of Foot and Ankle Injuries in Ballet Dancers

Classical ballet is an exacting art form with roots dating to the Italian Renaissance. The physical demands of dance class, rehearsal, and performance can predispose the dancer to injury. The foot and ankle are common sites of injury. Most injuries are caused by overuse rather than acute injuries. The purpose of this clinical report is to describe the initial treatment, as well as a structured program directed to the restoration of motion, strength, endurance, and proprioception essential for the successful return to dance. Additionally, specific rehabilitation techniques will be presented to assist the physical therapist in reducing those risk factors that may predispose a dancer to future injury. J Orthop Sports Phys Ther 1990;11(8):355-361.

Prevention of hip and knee injuries in ballet dancers.

Hip problems form about 10% (7.0 to 14.2%) of most published series of ballet injuries. The abnormally large range of external rotation needed for a perfect turnout is primarily due to soft tissue adaptation, more readily achieved in the young dancer. Insufficient range of motion at the hip throws considerable stress on the other lower limb segments. The snapping hip syndrome is common (43.8% of hip problems), with about one-third associated with pain. A tight iliotibial band may contribute to this, and balanced flexibility requires special attention to abductor stretching. The external clicking hip must be distinguished from the internal clicking hip, which is associated with the joint and psoas tendon. Stress fractures of the hip are easily overlooked and, if undetected, they may progress to a complete fracture. Knee problems account for 14.0 to 20% of complaints, and over 50% of these are peri- or retropatellar problems. This includes synovial plica, medial chondromalacia, lateral patella facet syndrome, subluxing patella and the fat pad syndrome. Specific diagnosis leads to specific treatment and the best chance of cure. Mild hyperextension of the knee may be aesthetically desirable, but excessive range leads to symptoms in the posterior capsule and poor control. Young dancers with a tendency to very lax joint structures should be identified early and protected from overstretching. In the author's series, meniscal lesions did not appear to be as big a problem as reported elsewhere in the literature. Ballerinas appear to have less leg strength than other groups of athletes, having only 77% of the weight-predicted norms. The introduction of strength training for male and female dancers may reduce injuries and improve balance, but it requires an intensive educational programme to dispense with the many myths. There are several references to the development of early arthritis but, while relatively common in the foot, symptomatic arthrosis in ballet dancers' hips and knees is not more prevalent than in the general population. The young age at which serious dance training begins, the long and rigorous hours of practice, the thin ballet slipper, dancing en pointe and unusual dietary regimens may all contribute to injury patterns in varying degrees.