Dance Injuries Research Articles

Dance exposure, wellbeing and injury in collegiate Irish and contemporary dancers: A prospective study

ObjectivesDance exposure and determinants of wellness in Irish dance (ID) and contemporary dance (CD) are under-investigated in pre-professional, collegiate cohorts. This study prospectively investigated these variables in ID and CD participants for one year. DesignProspective study. Setting: University-level institutes of dance, United Kingdom (UK) and Ireland. Participants: Fifty (ID = 21, CD = 29) full time students of dance at Trinity Laban Conservatoire of Music and Dance, (UK) and the University of Limerick, Ireland. Main Outcome Measures: Weekly hours of dance, general health, sleep quality, injury defined as “any pain or injury that impacted upon their ability to dance”. ResultsDance exposure varied considerably for both genres across the year. CD participants danced for more hours weekly (p < 0.001). Overall injury incidence (time-loss and non-time-loss) was 10.6 and 8.4 injuries per 1000 h dancing for ID and CD groups respectively. 70.4% of injuries were non-time-loss. Better sleep (p = 0.007) and general health (p < 0.001) scores were negatively correlated with days lost/impacted by injury. CD participants reported a significantly higher dance exposure in the week prior to a time-loss injury than during the previous four weeks (p = 0.044). ConclusionsDance exposure is erratic in these cohorts with dancers frequently performing when injured. Poor sleep, general health, and increased dance exposure may be associated with injury.

The Effect of Physical Therapist Involvement in the Diagnosis and Treatment of Youth and Adolescent Dancers' Injuries.

In studies of major dance companies that employ mostly adult dancers, measuring the effect of comprehensive medical management that includes daily on-site physical therapy has shown a decrease in the incidence of dance injuries, days missed from dance, injury-related costs, and Workers Compensation claims. As no comparable data have been collected with regard to youth and adolescent dancers, we sought to assess the effect of physical therapist involvement in the care of injuries sustained by young dancers on the incidence and amount of time missed from dancing. A cross sectional study was conducted by questionnaire of 55 students attending a US school for the arts summer dance program. Dancers ranged in age from 13 to 17 years, with a mean age of 15.0 ± 1.0. Most (87.3%) were female. Participants reported dancing a mean of 4.4 ± 2.6 hours per day prior to arrival at the program. They recorded 37 prior injuries, most of which (51.4%) were diagnosed by a physician, although a substantial proportion were diagnosed by a physical therapist (43.2%). Dancers whose injuries were diagnosed by a physician were more likely to miss dance class than those diagnosed by a physical therapist (100% vs. 50%; p = 0.014). When an injury did result in missed dance time, the median number of days missed was greater when the diagnosis was made by a physician as opposed to a physical therapist, although this finding was not statistically significant (6.0 vs. 2.5 days; p = 0.203). This supports previous literature showing a beneficial effect of health care management that involves physical therapists, especially those with expertise in dance injuries, on outcomes from dance injuries sustained by adult dancers.

Interdisciplinary Experiences in Dance and Physical Therapy Students: A Mixed-Methods Study

ABSTRACT The purpose of this interdisciplinary educational experience was to explore dynamic interaction between student dancers and graduate physical therapy students in a structured learning environment regarding prevention of dance injuries. A second aim was to determine the utility of a self-report outcome measure and the Functional Movement Screen (FMS). Dance injuries were evaluated at baseline, the end of the fall semester, and during the spring semester using the Self-Estimated Functional Inability Scale (SEFIS) and the FMS. A Pilates-based intervention was provided by an expert in dance during the fall semester; weekly interactions occurred between dance and physical therapy students with qualitative responses collected. Results showed the Pilates-based protocol was feasible for dancers’ training and resulted in no injuries. The FMS showed little change over the 12-week intervention, but the SEFIS showed improvement throughout the three timed measures. The interaction and educational component showed positive experiences between students in both disciplines.

Between-Day Reliability of Pre-Participation Screening Components in Pre-Professional Ballet and Contemporary Dancers

Critical appraisal of research investigating risk factors for musculoskeletal injury in dancers suggests high quality reliability studies are lacking. The purpose of this study was to determine between-day reliability of pre-participation screening (PPS) components in pre-professional ballet and contemporary dancers. Thirty-eight dancers (35 female, 3 male; median age; 18 years; range: 11 to 30 years) participated. Screening components (Athletic Coping Skills Inventory-28, body mass index, percent total body fat, total bone mineral density, Foot Posture Index-6, hip and ankle range of motion, three lumbopelvic control tasks, unipedal dynamic balance, and the Y-Balance Test) were conducted one week apart. Intra-class correlation coefficients (ICCs: 95% confidence intervals), standard error of measurement, minimal detectable change (MDC), Bland-Altman methods of agreement [95% limits of agreement (LOA)], Cohen's kappa coefficients, standard error, and percent agreements were calculated. Depending on the screening component, ICC estimates ranged from 0.51 to 0.98, kappa coefficients varied between -0.09 and 0.47, and percent agreement spanned 71% to 95%. Wide 95% LOA were demonstrated by Foot Posture Index-6 (right: -6.06, 7.31), passive hip external rotation (right: -9.89, 16.54), and passive supine turnout (left: -15.36, 17.58). The PPS components examined demonstrated moderate to excellent relative reliability with mean between-day differences less than MDC, or sufficient percent agreement, across all assessments. However, due to wide 95% limits of agreement, the Foot Posture Index-6 and passive hip range of motion are not recommended for screening injury risk in pre-professional dancers.

Lower leg and foot contributions to turnout in female pre-professional dancers: A 3D kinematic analysis

ABSTRACTTurnout is a central element of classical ballet which involves sustained external rotation of the lower limbs during dance movements. Lower leg and foot compensation mechanisms which are often used to increase turnout have been attributed to the high incidence of lower limb injury in dancers. Evaluation of dancers’ leg posture is needed to provide insight into the lower limb kinematic strategies used to achieve turnout. The primary purpose of this study was to use 3D kinematic analyses to determine the lower leg and foot compensations that are incorporated by female university dancers to accentuate their turnout. Active and passive external tibiofemoral rotation (TFR) was also measured. A moderate-strong negative relationship was observed between hip external rotation (HER) and foot abduction in the three first position conditions. A moderate negative relationship was found between passive TFR and foot abduction in all first position conditions. Our findings suggest dancers are more likely to pronate, than rotate the knee to compensate for limited HER. Dancers with a limited capacity to pronate may force additional rotation via the knee. Ongoing research would benefit from more in-depth analyses of the foot/ankle complex using a multi-segment foot model.

A Retrospective Assessment of Return to Function in Dance After Physical Therapy for Common Dance Injuries.

An injury that causes a dancer to take time away from training or performance can be career ending, and thus it is important for dancers to have accurate expectations when considering treatment options. Thus far, few studies have reported functional outcomes after injury in dancers, which may be different than for the general athletic population. Therefore, our study sought to determine functional outcomes in dancers after operative and non-operative treatment for common dance injuries. Our outcome measures included a subjective assessment of the degree to which a dancer had returned to his or her previous level of dance, the SF-12 survey, and the WHO functional outcome scale modified for dance. We also compared these as outcome measurement tools for return to full function in dance. Secondarily, we sought to assess factors that may have contributed to poorer functional outcomes. We reviewed the charts of 675 dancers seen at our physical therapy facilities between 2006 and 2010 and identified 416 adult dancers who had experienced a dance-related injury that we categorized as "common," based on surveys of injuries among dancers (with back injuries excluded). One hundred and sixty-four dancers completed a tele- phone survey about their recovery after injury. Descriptive statistics, correlation, and linear regression were then used to identify factors associated with poor functional outcomes. Sixty-three percent of the participants had a full return to their pre-injury level. No variables were found to be significantly correlated (p < 0.05) with poorer outcomes by linear re- gression. However, there was a trend to- ward better outcomes when dancers were younger, their injuries were not chronic, and their recovery was not limited by fear. The three measurement tools were all highly correlated with one another (p = 0.000) and found to be useful determinants of functional return to dance. Given that there were few strongly correlated outcome factors, we concluded that poorer functional outcomes in dance resulted from a combination of many factors, including those of a psychosocial nature. We believe these results can be used to better advise dancers who are considering treatment options, provide better estimates of possible limitations and time needed to return to dance, and potentially promote easier recoveries and better functional outcomes.

Association Between Previous Injury and Risk Factors for Future Injury in Preprofessional Ballet and Contemporary Dancers.

To determine the prevalence of self-reported 1-year injury history and examine its association with preparticipation evaluation components aimed at predicting future injury risk (PPE-IP) among preprofessional ballet and contemporary dancers. Cross-sectional study. Preprofessional ballet school, university contemporary dance program. Full-time preprofessional ballet and contemporary dancers. Preparticipation evaluation consisted of the Athletic Coping Skills Inventory-28, body mass index, total bone mineral density, ankle range of motion, active standing turnout, lumbopelvic control, unipedal dynamic balance, and Y-Balance test. Self-reported 1-year history of dance-related medical attention and/or time-loss injury. A total of 155 ballet [n = 90, 80 females, median age 15 years (range 11-19)] and contemporary [n = 65, 63 females, median age 20 years (range 17-30)] dancers participated. Forty-six percent (95% confidence interval (CI), 38.4-54.6) reported a 1-year injury history. Self-reported injury history was not associated with any PPE-IP, however, an influence of age and psychological coping skills on the relationship between 1-year injury history and PPE-IP was identified. Multivariable analyses revealed that prevalence of 1-year injury history did not differ by age [referent group <15 years; 15-18 years: odds ratio (OR) 0.80 (95% CI, 0.35-1.79); >18 years: OR 0.69 (95% CI, 0.30-1.56)], or level of psychological coping skills [OR 1.35 (95% CI, 0.61-2.94)]. The prevalence of self-reported 1-year injury history among preprofessional ballet and contemporary dancers is high. Although measures of PPE-IP did not differ based on injury history, it is important that age and psychological coping skills are considered in future dance injury prevention and prediction research. Level 3 evidence.

Psychological Risk Factors and Outcomes of Dance Injury: A Systematic Review.

Historically, dance medicine and science has focused on the physical aspects rather than the psychological aspects of dance injury. Psychological variables, however, have been shown to influence the occurrence of injury and post-injury outcomes. The purpose of this review was to examine the dance psychology literature and determine the specific psychological factors reported to be associated with the incidence, frequency, and outcome of dance injuries. A systematic literature search was conducted using SPORTDiscus, MEDLINE, CINAHL, and PsycINFO. All retrieved articles were screened based on criteria developed a priori, and selected articles were subsequently assessed for quality. Thirteen studies met the inclusion and quality assessment criteria. Psychological factors associated with both risk and outcome of dance injury included the following: stress, psychological distress, disordered eating, and coping. Factors associated only with risk of injury were sleep, personality, and social support. The results suggest that psychological variables can affect both the incidence and outcome of dance injury among dancers. Therefore, it is critical to gain a well-rounded, thorough understanding of all the factors, including psychological, that have a negative impact on dancers with respect to dance injury. The findings are discussed in terms of the utility of including psychological assessment and intervention, such as cognitive behavioral therapy, when implementing preventative and treatment measures in dance schools and companies.

Hip and Groin Injuries in Dancers: A Systematic Review

Context:Injury data on hip and groin injuries vary, and these injuries are often misrepresented or overlooked for more commonly seen injuries, such as those to the foot and ankle.Objective:To provide a systematic review of the injury rates of hip and groin pathology in dancers and look to establish a better understanding of the occurrence of hip and groin injuries in the dancer population.Data Sources:A literature search was performed using PubMed and CINAHL databases for articles published between 2000 and 2016.Study Selection:Inclusion criteria consisted of (1) documentation of the number of hip and/or groin injuries, (2) study population consisting of dancers whose training included some level of ballet, and (3) studies of levels 1 through 3 evidence.Study Design:Systematic review.Level of Evidence:Level 3.Data Extraction:A single reviewer identified studies that met the inclusion criteria. The number of overall injuries, hip/groin injuries, study participants, injured participants, training hours per week, mean age of study group, injury definition, injury reporting method, and study time frame were extracted.Results:Thirteen unique studies were included in the descriptive analysis. Of the 2001 dancers included in this study, 3527 musculoskeletal injuries were seen in 1553 dancers. Of these, 345 injuries were localized to the hip and groin region (overall rate, 17.2%). An incidence rate of 0.09 hip and groin injuries per 1000 dance-hours was seen in the selected cohort studies. Of 462 professional dancers, 128 hip/groin injuries were recorded, for an injury rate of 27.7%. Of the 1539 student dancers, 217 hip/groin injuries were recorded, for an injury rate of 14.1% (P < 0.01).Conclusion:Data on hip and groin injuries have many limitations. However, these injuries represent an important health issue for dancers of all skill levels, encompassing 17.2% of musculoskeletal injuries seen in dancers. An increasing rate of hip/groin injuries is seen in professional dancers compared with students.

Influence of Textured Insoles on Dynamic Postural Balance of Young Dancers.

Postural balance (PB) is a significant factor in dance performance and injury prevention. We aimed to determine whether the use of textured insoles inserted into casual walking shoes of dancers improved their dynamic PB and whether dancers with previous injury manifested different dynamic PB compared with non-injured dancers. In this crossover design study, 26 ballet dancers from the Australian Ballet School, aged 14-19 yrs, were divided into two groups matched by sex and class levels. Group 1 wore the textured insoles in their walking shoes for at least 2 hrs/day during weeks 1 to 4 of the study, and group 2 wore the textured insoles in their walking shoes during weeks 5 to 8. Reports from the school medical staff identified dancers who had previous injuries. All participants were tested pre-intervention and at 4 and 8 weeks by an accelerometer for dynamic PB (average acceleration magnitude, root mean square acceleration, range, and mean frequency) during single-leg fondu, flexing and extending of the knee. Interactions (group x time) were found in dynamic PB measured in the mediolateral direction, indicating significant differences between the groups at the three testing times. Furthermore, both previously injured and noninjured dancers manifested significant time effects from pre-intervention to 8 weeks, indicating a significant improvement in their PB after using the textured insoles. Textured insoles can improve the dynamic PB of ballet dancers and can also be useful as a routine intervention. PB was improved among both dancers with previous injury and non-injured dancers.

Prediction of Injury among Elite Dancers

Injuries in dance are commonplace and distressing in terms of human and financial impact. It is the hope of dance medicine healthcare professionals and educators to detect risk for injury prospectively, often through screening efforts. It is known that screening has been very useful for rapport building, improving health literacy and facilitating entryways to local healthcare systems. However screening, as we have been conducting it, has still not proven to be predictive of injury despite implementation of preventative interventions such as pre-season conditioning programs. PURPOSE: To test the predictive validity of four patient reported outcome measures (PRO) in addition to an array of motor control designed clinical performance-based outcome measures (CPBO) collected during preseason screening in predicting subsequent season time loss injury. METHODS: 241 elite classical dancers (21.5±5.0 years; 69 men, 172 women) who received regular onsite care consented to participate in PRO and CPBO-based preseason screenings and ongoing, healthcare practitioner documented injury surveillance. The PRO’s utilized in this study were the Discomfort Rating Scale (DRS); the World Health Organization Functional Scale (WHO); the Profile of Mood States total score (POMS) and the Eating Attitudes Test-26 (EAT). Data were analyzed with a multivariate logistic regression model for the outcome variables “injured in subsequent season” and “number of therapy visits in subsequent season”. RESULTS: All PRO variables were associated with the primary outcome variables (p=0.003, R2=0.492, R2=0.242, adjusted R2=0.205). CONCLUSION: Injury prevention screening for dancers should include PRO scores to predict those at greatest risk for time loss injury.

The Relationship Between Muscular Strength and Dance Injuries: A Systematic Review.

The physical demands placed on dancers put them at significant risk for injury, with rates similar to ones sustained by athletes in sports at the same level of performance. Muscle strength has been suggested to play a preventative role against injury in dancers. To systematically search and examine the available evidence on the protective role of muscle strength in dance injuries. Five electronic databases and two dance-specific science publications were screened up to September 2015. Study selection was based on a priori inclusion criteria on the relation between muscle strength components and injuries. Methodologic quality and level of evidence were assessed using the Downs and Black (DB) checklist and the Oxford Centre of Evidence-Based Medicine (OCEBM) 2011 model. From 186 titles found, only 8 studies met the inclusion criteria and were considered for review. Because of the significant heterogeneity of the included studies, meta-analysis was deemed inappropriate. The DB quality assessment results ranged from 18.7% to 75% (mean 42.3±16.9) and the OCEBM between 2b and 4. Some level 2b evidence from 2 studies suggested that pre-professional ballet dancers who get injured exhibit lower overall muscle strength scores on the lower extremity, and that lower extremity power gains may be associated with decreased bodily pain but not injury rate. Although there might be an association trend toward low muscle strength and dance injuries, the nature of that relation remains unclear, and presently the state of knowledge does not provide a solid basis for designing interventions for prevention.

Applying Current Concepts in Pain-Related Brain Science to Dance Rehabilitation

Dance involves exemplary sensory-motor control, which is subserved by sophisticated neural processing at the spinal cord and brain level. Such neural processing is altered in the presence of nociception and pain, and the adaptations within the central nervous system that are known to occur with persistent nociception or pain have clear implications for movement and, indeed, risk of further injury. Recent rapid advances in our understanding of the brain's representation of the body and the role of cortical representations, or "neurotags," in bodily protection and regulation have given rise to new strategies that are gaining traction in sports medicine. Those strategies are built on the principles that govern the operation of neurotags and focus on minimizing the impact of pain, injury, and immobilization on movement control and optimal performance. Here we apply empirical evidence from the chronic pain clinical neurosciences to introduce new opportunities for rehabilitation after dance injury.

Injuries Requiring Surgery in Dancers Performing High-Demand Dances

Aim:Dancers are professional athletes. Dance injuries resemble sports injuries, however, they push the limits of anatomy and physiology for rightful expression of the esthetics. In this study, we examined a group of dancers and injuries which required surgery to understand the associated factors (age, gender, dexterity, dance style) and also the time to return to their full capacity.Methods:75 members of the Fire of Anatolia professional dance group (55 ethnic folk, 12 modern ballet, 8 Caucasian folk dancers) (mean age: 26.8±5.2; 17-38 years) performers were evaluated between the dates February 2009 and February 2016. The dancers suffered 14 orthopedic injuries requiring surgery during a six-year period. Nine of surgeries (64.2%) were the result of an acute trauma requiring meniscal repair in three due to meniscus tears, ACL reconstruction in two (one of them had to also undergo primary repair of the posterolateral corner of the knee) due to ACL tear, PCL reconstruction in one due to PCL tear, open medial patellofemoral ligament repair in one due to acute patellar dislocation, percutaneous fixation of the scaphoid in one due to scaphoid fracture and an extensor tendon repair of the hand in one due to extensor tendon cut. Five of the surgeries (35.7%) were due to chronic injuries consisting of deep infrapatellar bursitis treated by open bursectomy in one, arthroscopic fat pad resection due to Hoffa’s fat pad impingement in two, and arthroscopic resection of an symptomatic medial plica in two patients.Findings:Fourteen (12 male, 2 female; mean age: 30±5.45, range: 22 to 38) dancers out of 75 members (18.7%) of this high-demand dance group suffered injuries requiring surgery. Twelve (85.8%) of these injuries were at the knee joint and two (14.2%) were in the hand. There was no statistically significant difference between the mean ages of the dancers with and without injuries (p>0.05). Males suffered an injury 8.64 times more than females according to logistic regression analysis (p=0.003).Results:Male dancers are more susceptible to injuries that require surgery when compared to female dancers. All of the operated patients continue with their careers in dancing and arthroscopic surgery does not pose a threat to the career of the dancer. Level of Evidence: Level of evidence III. Retrospective cohort study

Impact of touring, performance schedule, and definitions on 1-year injury rates in a modern dance company

ABSTRACTThere is ongoing debate about how to define injury in dance: the most encompassing one or a time-loss definition. We examined the relationship between touring, performance schedule and injury definition on injury rates in a professional modern dance company over one-year. In-house healthcare management tracked 35 dancers for work-related musculoskeletal injuries (WMSI), time-loss injuries (TLinj), complaints, and exposure. The year was divided into 6 segments to allow comparison of effects of performance, rehearsal, and touring. Injuries/segment were converted into injuries/1000-h dance exposure. We conducted negative binomial regression analysis to determine differences between segments, P ≤ 0.05. Twenty WMSI, 0.44 injuries/1000-h, were sustained over one-year. WMSI were 6 times more likely to occur in Segment-6, compared with other segments (incident rate ratio = 6.055, P = 0.031). The highest rate of TLinj and traumatic injuries also occurred in Segment-6, reflecting concentrated rehearsal, New York season and performances abroad. More overuse injuries occurred in Segment-2, an international tour, attributed to raked stages. Lack of methods to quantify performance other than injury may mask effects of touring on dancer’s well-being. Tracking complaints permits understanding of stressors to specific body regions and healthcare utilisation; however, TLinj remain the most important injuries to track because they impact other dancers and organisational costs.

Single-leg squats can predict leg alignment in dancers performing ballet movements in "turnout".

The physical assessments used in dance injury surveillance programs are often adapted from the sports and exercise domain. Bespoke physical assessments may be required for dance, particularly when ballet movements involve “turning out” or external rotation of the legs beyond that typically used in sports. This study evaluated the ability of the traditional single-leg squat to predict the leg alignment of dancers performing ballet movements with turnout. Three-dimensional kinematic data of dancers performing the single-leg squat and five ballet movements were recorded and analyzed. Reduction of the three-dimensional data into a one-dimensional variable incorporating the ankle, knee, and hip joint center positions provided the strongest predictive model between the single-leg squat and the ballet movements. The single-leg squat can predict leg alignment in dancers performing ballet movements, even in “turned out” postures. Clinicians should pay careful attention to observational positioning and rating criteria when assessing dancers performing the single-leg squat.

Trust, Satisfaction, and Confidence in Health Care Providers Among Student and Professional Dancers in France.

Patients who trust their physicians are more likely to communicate about medical problems, adhere to medical advice, and be satisfied with care. Dancers have demonstrated low utilization of physician services for both preventive care and dance injuries. The purpose of this cross-sectional study was to examine trust in physicians as a variable influencing dancers' health care-seeking behavior. The validated Trust in Physician Scale was administered to 45 professional and 34 student ballet/contemporary dancers in France (36.7% male, 63.3% female) to evaluate their trust in medical doctors (MDs) vs physical therapists (PTs). Dancers were also asked about satisfaction and confidence in medical treatment for dance injuries. Dancers indicated greater trust in PTs than MDs (70.61±10.57 vs 65.38±10.79, t=-3.499, p=0.001). Students exhibited significantly less trust in MDs than professional dancers (62.04±9.96 vs 67.65±10.42, t=-2.381, p=0.020). Trust scale scores for PTs did not differ between students and professionals (69.53±8.30 vs 71.68±12.09, t=-0.866, p=0.389). Students were less confident than professional dancers in their physician's ability to treat their most severe injury (6.7% of students vs 35.7% of professionals "very confident, " X2=9.402, p=0.052). Dancer patients exhibit lower trust in physicians compared to previously studied non-dancer populations. Our results suggest that reduced trust in physicians and factors related to professional status may influence dancers' health care-seeking behavior. Student dancers may comprise a unique subpopulation of dancers with distinctive health care needs.

Fatigue-Induced Changes in Movement Pattern and Muscle Activity During Ballet Releve on Demi-Pointe.

Fatigue in ballet dancers may lead to injury, particularly in the lower extremities. However, few studies have investigated the effects of fatigue on ballet dancers' performance and movement patterns. Thus, the current study examines the effect of fatigue on the balance, movement pattern, and muscle activities of the lower extremities in ballet dancers. Twenty healthy, female ballet dancers performed releve on demi-pointe before and after fatigue. The trajectory of the whole body movement and the muscle activities of the major lower extremity muscles were recorded continuously during task performance. The results show that fatigue increases the medial-lateral center of mass (COM) displacement and hip and trunk motion, but decreases the COM velocity and ankle motion. Moreover, fatigue reduces the activities of the hamstrings and tibialis anterior, but increases that of the soleus. Finally, greater proximal hip and trunk motions are applied to compensate for the effects of fatigue, leading to a greater COM movement. Overall, the present findings show that fatigue results in impaired movement control and may therefore increase the risk of dance injury.

Femoral Shaft Torsion in Injured and Uninjured Ballet Dancers and Its Association with Other Hip Measures: A Cross-sectional Study.

Low range femoral torsion, termed "lateral shaft torsion," has been associated with greater range of hip external rotation and turnout in dancers. It is also hypothesized that achieving greater turnout at the hip minimizes torsion at the knee, shank, ankle, and foot, and consequently reduces incidence of lower limb injuries. The primary aims of this study were to investigate: 1. differences in range of femoral shaft torsion between dancers with and without lower limb injuries; and 2. the relationship between femoral shaft torsion, hip external rotation range, and turnout. A secondary aim was to examine the relationship between femoral shaft torsion and other hip measures: hip strength, lower limb joint hypermobility, hip stability, and foot progression angle, as explanatory variables. Demographic, dance, and injury data were collected, along with physical measures of femoral shaft torsion, hip rotation range of motion, and turnout. Hip strength, control, lower limb hypermobility, and foot progression angle were also measured. Eighty female dancers, 50 with lower limb injury (20.7 ± 4.8 years of age) and 30 without lower limb injury (17.8 ± 4.1 years of age), participated in the study. There was no difference in range of femoral shaft torsion between the groups (p = 0.941). Femoral shaft torsion was weakly correlated with range of hip external rotation (r = -0.034, p = 0.384) and turnout (r = -0.066, p = 0.558). Injured dancers had a significantly longer training history than non-injured dancers (p = 0.001). It was concluded that femoral shaft torsion does not appear to be associated with the overall incidence of lower limb injury in dancers or to be a primary factor influencing extent of turnout in this population.

Awareness Of Risk Factors Leading To Ankle And Foot Injuries Among Ballet Dancers, in Mumbai, India

Background: Ballet dancers have high prevalence rate of 34-62% of ankle and foot injuries. Purpose: To primarily increase the awareness regarding the risk factors that lead to ankle and foot injuries among ballet dancers. Methods: 123 ballet dancers, aged between 18-25 years of age, with an experience in ballet for minimum one year from various dance schools and institutes of Mumbai were interviewed via validated questionnaire over a period of 5 months. Results: Majority of the ballet dancers had an experience between 4-8 years. 74% of the dancers were aware regarding ankle and foot injuries. But, 91% among them were only aware regarding ankle sprain to be the most common injury while being unaware of the other injuries. It was found that dancers did not consider factors like ‘improper partner work, tightness of muscles, unsuitable dance floor and improper footwear’ to be the risk factors for ankle and foot injury. The results showed that 82% were aware regarding physiotherapy being helpful for ballet dance injuries, yet only 35% of them had taken physiotherapy treatment after an injury with 17% of ballet dancers soldiering even after the first sign of injury. Conclusion: Majority of ballet dancers were aware regarding risk factors like: Tightness of muscles > Inadequate warm up/cool down exercises > Improper footwear > Unsuitable dance floor. While awareness regarding injuries was: Ankle sprain (91%) > Forefoot sprain and stress fracture (48% & 47%) respectively > Hallux rigidus and nail problems (46%) > Achilles and Flexor hallucis (42%).