What You Should Know About Dance Injuries

By Lisa M. Schoene, DPM, ATC

   In recent years, dance medicine has become increasingly separate from the traditional sports medicine culture. As dance injuries are being evaluated and studied from many different medical perspectives, it is becoming more apparent that there is a serious need for dance medicine specialists to educate not only the dancers but the dance company managers and teachers.

   Awareness of injuries among dancers and their need for proper treatment and rehabilitation has become more accepted by the dance community. Prompt evaluation and treatment can facilitate long lasting benefits for dancers, and reduce the risk of damaging or career threatening injuries. Early intervention and treatment can save money, time and potential long-term disability. Intervening with young dancers can set a positive tone for future injury prevention and knowledge.

   Dancers, like professional athletes, operate in a very competitive environment. Given this competitive culture, paranoia can set in for dancers. When they suffer injuries, they may seek medical care outside of the company’s medical staff and pay out of pocket in order to conceal an injury. Dancers realize that their contract may be scrutinized for past injury history and may ultimately lead to dismissal. It is understandable why this occurs as the average age for a dancer to retire may be in the mid- to late 20s, which is similar to the average retirement age of professional football players.

   Fortunately, these attitudes towards medical care for the dancer are changing, due to intervention by doctors, physical therapists and company managers. Accordingly, this helps promote longer, healthier careers.

What About The Etiology Of Overuse Injuries?

   There are two types of injury mechanisms: overuse and traumatic. Dance injuries typically fall into the overuse category. Given the numerous repetitive movements in dance, there is a higher incidence of overuse injuries, which usually occur during class or rehearsals as opposed to happening during performance. Approximately 50 percent of overuse dance injuries are foot and ankle injuries. Injuries of the lower extremity comprise the vast majority of all dance injuries as well. Most injuries increase seasonally as the rehearsal and performance schedules increase.

   Other contributing factors to overuse injuries include …

   Age. Often, dance students start out very young and if they are pushed along too quickly, they may not have the ability to perform at a certain level, neurologically, structurally and/or emotionally.

   Nutritional status. Unfortunately, as with other sports, aesthetics are very important and having a certain body type is expected. Young dancers may have a tendency to restrict food either by cutting calories, purging or over-exercising, which will lead to performance failure, injuries and the possibility of other developmental, mental and emotional problems.

   Strength and flexibility issues. As the dancer matures, so does the technical difficulty of the dance class. When flexibility and strength are compromised, injury can ensue. It is very common for a dancer to have left and right-sided strength disparities, which one should address immediately. Going up onto pointe before a dancer has developed proper strength may lead to injuries. Physical therapy and classes like Pilates may help the dancer to improve these areas quickly. Many dance schools offer strengthening classes that are incorporated into the weekly dance schedule.

   Biomechanical imbalances. Turnout is especially crucial among ballet dancers. It must come from the hip and not from the foot or knee. When bad turnout habits occur over a period of time, the dancer will often have problems. The soft tissues of the knee, hip, ankle and foot joints may be affected. Scoliosis may also be a detriment to a dancer as this may affect balance, aesthetics and create overuse back injuries.

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