Dance Injuries

What causes dance injuries?

Because of the repetitive movements that a dancer must practice and perform, most of the injuries associated with dance are due to overuse, including sprains, strains, tendon injuries, and stress fractures.

Youth involved in dance are susceptible to these injuries due to growth spurts, improper technique, or imbalance between strength and flexibility. During growth spurts the bones are growing rapidly, often faster than muscles. This results in weakness in the bones, tightening of the ligaments, and loss of muscle strength. As a result, growth spurts may be a time of increased injury, and decreased flexibility and coordination for young dancers.

Other common contributors to dance injury include:

  • The type of dance and frequency of practice
  • Number of years in training
  • Flooring (too hard, too slippery, or too much friction)
  • Footwear (needs to be appropriate to the type of dance or technique being used)
  • The dancers body alignment and adherence to proper technique (inadequate core strength, dancing “en pointe” before they are ready to safely do so)
  • Previous injuries
  • Nutritional deficiencies (Restrictive eating behavior or disordered eating often results in inadequate nutrient and caloric intake. This impacts general health, as well as performance and the strength of the muscles and bones.)
  • Inadequate rest or recovery

What are the most common dance injuries?

Injuries tend to occur in the low back, hips, and lower extremities (lower leg, ankle, foot). In youth, the most common structures to be injured are the joints, particularly the knees and ankles. With the most frequent joint injury being patellofemoral pain syndrome. Tendonitis/tendinopathy is the most frequent soft tissue injury, spondylolysis is the most common skeletal injury, and apophysitis is the most common physeal injury.

Common injuries broken down by body region:

  • Back: repetitive hyperextension may cause Spondylolysis, a type of vertebral stress fracture. If this goes untreated, the vertebrae can start to slip out of place, resulting in spondylolisthesis.
  • Knee: patellofemoral pain and jumper’s knee are often seen due to overuse and dance techniques that place the hip and foot in less anatomic positions.
  • Foot and ankle: Injuries related to repetitive movement include ankle tendinitis or sesamoiditis stress injuries in the foot. Ankle sprains are often seen in injuries related to dancing “en pointe.”

How are injuries treated?

For minor injuries or mild pain due to overuse dancers are often treated with rest, pain relievers (ibuprofen or acetaminophen), ice or heat. However, some injuries may require physical therapy, orthotics, or even surgery. It is critical that any injuries involving bleeding, severe pain, loss of sensation, or increased weakness be seen by a medical provider. A dancer should return to practice after an injury only when they have been given medical clearance by a health care provider.

How can injuries be prevented?

Injury can be minimized with proper nutrition and hydration, properly fitted clothing and shoes, appropriate warm-up and cool-down, and close adherence to correct technique. It is also important that the dancer be mindful of the limits of their body and not push themselves too fast, this includes resting during times of fatigue, and allowing for recovery during injury (Do not dance through the pain!).

Instructors and parents also play an important role in injury prevention. Parents may be the first to notice disordered eating. Instructors determine when a dancer is ready to advance to the next level and they assess for continued use of correct technique. It is critical that the dancer can communicate openly with their instructors and parents regarding any pain or injury.

By Aurora Selpides, MD, MPH and Mo Mortazavi, MD

References:

Children’s Hospital Colorado. “Dance.” Orthopedics: Sports medicine center. Children’s Hospital Colorado, 2016. <https://www.childrenscolorado.org/doctors-and-departments/departments/orthopedics/programs/sports-medicine-center/sports-injuries-we-treat/dance/> February 5, 2017.

Gottschlich LM, Young CC. Spine injuries in dancers. Curr Sports Med Rep. 2011 Jan-Feb;10(1):40-4.

Russell JA. Preventing dance injuries: current perspectives. Open Access Journal of Sports Medicine. 2013;4:199-210.

Russell JA, Solomon R. “Preventing Dance Injuries.” Stop Sports Injuries. American Orthopaedic Society for Sports Medicine, 2010. <http://www.stopsportsinjuries.org/STOP/Prevent_Injuries/Dance_Injury_Prevention.aspx> Accessed February 5, 2017.

Yin, Amy X. et al.  Pediatric Dance Injuries: A Cross-Sectional Epidemiological Study. PM&R, Volume 8, Issue 4, 348 – 355

What causes dance injuries?

Because of the repetitive movements that a dancer must practice and perform, most of the injuries associated with dance are due to overuse, including sprains, strains, tendon injuries, and stress fractures.

Youth involved in dance are susceptible to these injuries due to growth spurts, improper technique, or imbalance between strength and flexibility. During growth spurts the bones are growing rapidly, often faster than muscles. This results in weakness in the bones, tightening of the ligaments, and loss of muscle strength. As a result, growth spurts may be a time of increased injury, and decreased flexibility and coordination for young dancers.

Other common contributors to dance injury include:

  • The type of dance and frequency of practice
  • Number of years in training
  • Flooring (too hard, too slippery, or too much friction)
  • Footwear (needs to be appropriate to the type of dance or technique being used)
  • The dancers body alignment and adherence to proper technique (inadequate core strength, dancing “en pointe” before they are ready to safely do so)
  • Previous injuries
  • Nutritional deficiencies (Restrictive eating behavior or disordered eating often results in inadequate nutrient and caloric intake. This impacts general health, as well as performance and the strength of the muscles and bones.)
  • Inadequate rest or recovery

What are the most common dance injuries?

Injuries tend to occur in the low back, hips, and lower extremities (lower leg, ankle, foot). In youth, the most common structures to be injured are the joints, particularly the knees and ankles. With the most frequent joint injury being patellofemoral pain syndrome. Tendonitis/tendinopathy is the most frequent soft tissue injury, spondylolysis is the most common skeletal injury, and apophysitis is the most common physeal injury.

Common injuries broken down by body region:

  • Back: repetitive hyperextension may cause Spondylolysis, a type of vertebral stress fracture. If this goes untreated, the vertebrae can start to slip out of place, resulting in spondylolisthesis.
  • Knee: patellofemoral pain and jumper’s knee are often seen due to overuse and dance techniques that place the hip and foot in less anatomic positions.
  • Foot and ankle: Injuries related to repetitive movement include ankle tendinitis or sesamoiditis stress injuries in the foot. Ankle sprains are often seen in injuries related to dancing “en pointe.”

How are injuries treated?

For minor injuries or mild pain due to overuse dancers are often treated with rest, pain relievers (ibuprofen or acetaminophen), ice or heat. However, some injuries may require physical therapy, orthotics, or even surgery. It is critical that any injuries involving bleeding, severe pain, loss of sensation, or increased weakness be seen by a medical provider. A dancer should return to practice after an injury only when they have been given medical clearance by a health care provider.

How can injuries be prevented?

Injury can be minimized with proper nutrition and hydration, properly fitted clothing and shoes, appropriate warm-up and cool-down, and close adherence to correct technique. It is also important that the dancer be mindful of the limits of their body and not push themselves too fast, this includes resting during times of fatigue, and allowing for recovery during injury (Do not dance through the pain!).

Instructors and parents also play an important role in injury prevention. Parents may be the first to notice disordered eating. Instructors determine when a dancer is ready to advance to the next level and they assess for continued use of correct technique. It is critical that the dancer can communicate openly with their instructors and parents regarding any pain or injury.

By Aurora Selpides, MD, MPH and Mo Mortazavi, MD

References:

Children’s Hospital Colorado. “Dance.” Orthopedics: Sports medicine center. Children’s Hospital Colorado, 2016. <https://www.childrenscolorado.org/doctors-and-departments/departments/orthopedics/programs/sports-medicine-center/sports-injuries-we-treat/dance/> February 5, 2017.

Gottschlich LM, Young CC. Spine injuries in dancers. Curr Sports Med Rep. 2011 Jan-Feb;10(1):40-4.

Russell JA. Preventing dance injuries: current perspectives. Open Access Journal of Sports Medicine. 2013;4:199-210.

Russell JA, Solomon R. “Preventing Dance Injuries.” Stop Sports Injuries. American Orthopaedic Society for Sports Medicine, 2010. <http://www.stopsportsinjuries.org/STOP/Prevent_Injuries/Dance_Injury_Prevention.aspx> Accessed February 5, 2017.

Yin, Amy X. et al.  Pediatric Dance Injuries: A Cross-Sectional Epidemiological Study. PM&R, Volume 8, Issue 4, 348 – 355

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