Don't stop me now: A qualitative study of how Brazilian dancers and staff perceive injury and its prevention.

OBJECTIVE: To investigate how Brazilian dancers and dance staff perceive and deal with injury and its prevention in professional and non-professional contexts. DESIGN: Qualitative study. SETTING: Semi-structured interviews conducted using an online platform. PARTICIPANTS: Thirteen participants (8 women, 5 men) from four different dance styles (classical ballet, jazz, contemporary and urban): 6 dancers, 6 staff and 1 classified as both. MAIN OUTCOME MEASURES: Interviews were recorded, transcribed and analyzed based on Grounded Theory principles using comparative data analysis. RESULTS: The main themes and findings were: 1) Injury definition: Injury was defined and classified based on pain, structural damage and consequent limitations and restrictions. 2) Dealing with injury: Dancers' fear of having to stop dancing justifies different behaviours facing injury. 3) Injury factors: Overload and many personal and environmental factors were perceived as related to injury. 4) Injury prevention: it is linked with physical preparation and additional measures and influenced by communication, trust, experience, time, access to preventive programs, dancers' personalities and environmental factors. Responsibility for injury prevention should be shared by all stakeholders. CONCLUSIONS: To improve injury prevention, we need to acknowledge the dancers' drive to keep dancing, consider the multiple factors that influence their behaviours, and develop education and self-efficacy to help them make better decisions to reduce the risk of injury.

Training Load, Pain Intensity, and Functioning Can Explain Injuries in Dancers: A Classification and Regression Tree (CART) Analysis.

OBJECTIVE: To identify the biopsychosocial factors that explain injuries in dancers through use of a Classification and Regression Tree (CART) analysis. METHODS: Cross-sectional study performed with dancers over 18 years of age from dance schools in Brazil. Sociodemographic factors, pain intensity (numerical pain rating scale, NPRS), anxiety (Beck anxiety inventory, BAI), and functioning (WHO Disability Assessment Schedule 2.0, WHODAS) were assessed. We used a classification and regression tree (CART) analysis considering the occurrence of injury as a dependent variable, and the independent variables included age, training load, BAI, pain level, and WHODAS 2.0 score, adjusted for body mass index. RESULTS: The sample included 61 dancers (ballet, jazz, contemporary, tap, and urban dance), and they were mainly women (72.1%) with a mean age of 25.6 (± 5.79) years. Thirty-three percent presented dance-related musculoskeletal injuries in the last 12 months. The CART analysis showed that training load was the main associated factor, explaining 52.4% of injuries in dancers with a workload > 11.5 hrs/wk (p=0.05). When NPRS > 6.5 is added to the high load of training, these two variables explain 100% of the cases of injury (p=0.02). Training load < 11.5 hrs/wk and WHODAS 2.0 score < 68.0 were associated factors for no injury in dancers (80%; p=0.03). CONCLUSIONS: Our results demonstrated that training load, functioning, and pain intensity were factors associated with injury in dancers, and we established cutoff points. The inclusion of functioning in the algorithm suggests the influence of structure, function, activity, and social participation on injury in dancers and strengthens the patient-centered care.

The Relationship between Vitamin D Levels, Injury and Muscle Function in Adolescent Dancers.

Vitamin D has been shown to benefit a diverse range of health functions including muscle function. The aim of the present study was to identify serum 25(OH)D3 levels in a sample of adolescent dancers and compare them to muscle function and injury incidence. We incorporated a cross-sectional design to study 49 pre-professional male and female dancers (17±4.44 yrs, 52.1±6.72 kg, 1.63±0.07 m) in full-time training in Bazil. Serum 25[OH]D3 was analyzed by Enzyme-linked Immunosorbent Assay; quadriceps and hamstring peak torque and muscle fatigue were measured by isokinetic dynamometer at 60 and 300° s-1. Injury type and location in the previous 6-months were determined by self-report questionnaire. Participants were categorized into 2 groups: normal or insufficient/deficient (>or<30 ng/ml 25[OH]D3). Results indicated the normal serum 25[OH]D3 group had significantly lower fatigue rates than the insufficient/deficient group (p<0.05) but not for the other muscle function parameters. Fifty-seven percent of participants reported at least 1 injury. The most common were sprains (33%) and tendinopathies (19%). Injured dancers had significantly lower peak torque at 60°/s. The link between serum 25[OH]D3 and reduced muscle fatigue resistance has not been shown before, though the underlying mechanisms aren't apparent and the link between muscular strength and injury has been previously evidenced.

Associated factors and profile of injuries in professional ballroom dancers in Brazil: a cross-sectional study

Abstract Aims: Ballroom dance consists of a modality characterized by fast and dynamic movements performed in pairs, aiming at technical and artistic excellence. Objective: To analyze the prevalence, characteristics, and factors associated with injuries in professional ballroom dancers, considering possible differences between sexes. Method: 320 professional dancers of both sexes with a mean age of 31.48±8.63 years, who were in professional companies and/or dance schools from five regions of Brazil. The measurement was performed through an online self-administered questionnaire about general information and injuries. Results: A high frequency of musculoskeletal injuries (80.0%) was observed, especially osteoarticular ones (52.4%). In women, the lower limbs were the anatomical location most reported (31.1%) and the knee in male dancers (28.7%). Overweight men, with more than 11 years of dance practice, who danced in companies and also performed other physical activities, were more likely to have injuries. However, women were less likely to have injuries when they were overweight and more likely when they practiced other dance modalities besides ballroom dancing. Conclusions: Approximately 64.1% of ballroom dancers suffered an injury throughout their professional careers. For men, being overweight as well as the search for complementary activities to the physical training routine for both sexes, seem to influence the occurrence of injuries. Identification of the factors associated with injuries in ballroom dancers contributes both to preventive actions and to rehabilitation processes, favoring a healthy and safe career for professionals involved in this practice.

[The experience of pain among classical dance ballerinas: meanings derived from a qualitative study]. / A experiência da dor em bailarinas clássicas: significados emergentes num estudo qualitativo.

This article presents the results of a study focused on the meaning that pain assumes in the discourse of a group of classical dance ballerinas. To achieve this, we accessed their experiences and perceptions through a semi-structured interview, to better understand the pain that is an integral part of their routines before, during and after a performance. This study is based on the discourses which emerged from a group of ten ballerinas with six or more years of training, and the method chosen to tap into the underlying meanings was Grounded Analysis or Sustained Data Analysis. The analysis of the discourses collected revealed that pursuing a dancing career involves obstacles that increase the demands felt by the ballerinas, in parallel with their desire to remain in the world of performance. Thus, it is the excessive practicing and repetitive movements which give rise to pain and injuries, which are concealed and denied so as not to impede the focus of attaining perfection. In general, the results obtained emphasize the passion for dance that involves pain as an ally to this career and force the ballerinas to varied confrontation strategies. In tandem, pain is linked to fear of injury, to the end of a career as a ballerina and the relinquishment of a dream.

Este artigo apresenta os resultados de um estudo centrado no significado que a dor assume no discurso de um grupo de bailarinas de dança clássica. Para tal acedemos às suas experiências e vivências através de uma entrevista semiestruturada de forma a entender a dor que faz parte suas rotinas antes, durante e após estarem a dançar. O estudo sustenta-se nos discursos que emergiram num grupo de dez bailarinas, com mais de seis anos de formação, e o método para aceder aos significados providenciados pelas suas vozes foi a "Grounded Analysis" ou Análise Sustentada nos Dados. A análise dos discursos recolhidos revelou que o evoluir no percurso da dança implica dificuldades que aumentam as exigências experienciadas pelas bailarinas, paralelamente ao desejo de querer permanecer no mundo do espetáculo. Assim são os treinos excessivos e os movimentos repetitivos que fazem surgir a dor e as lesões, que são ocultadas, negadas, de modo a poder continuar no foco de querer alcançar a perfeição. Em geral, os resultados obtidos salientam a paixão pela dança que configura a dor como aliada desta prática, e obriga as bailarinas a várias estratégias de confronto. Paralelamente, a dor liga-se ao medo da lesão, ao fim do percurso como bailarina e ao abdicar de um sonho.

A experiência da dor em bailarinas clássicas: significados emergentes num estudo qualitativo / The experience of pain among classical dance ballerinas: meanings derived from a qualitative study

Resumo Este artigo apresenta os resultados de um estudo centrado no significado que a dor assume no discurso de um grupo de bailarinas de dança clássica. Para tal acedemos às suas experiências e vivências através de uma entrevista semiestruturada de forma a entender a dor que faz parte suas rotinas antes, durante e após estarem a dançar. O estudo sustenta-se nos discursos que emergiram num grupo de dez bailarinas, com mais de seis anos de formação, e o método para aceder aos significados providenciados pelas suas vozes foi a "Grounded Analysis" ou Análise Sustentada nos Dados. A análise dos discursos recolhidos revelou que o evoluir no percurso da dança implica dificuldades que aumentam as exigências experienciadas pelas bailarinas, paralelamente ao desejo de querer permanecer no mundo do espetáculo. Assim são os treinos excessivos e os movimentos repetitivos que fazem surgir a dor e as lesões, que são ocultadas, negadas, de modo a poder continuar no foco de querer alcançar a perfeição. Em geral, os resultados obtidos salientam a paixão pela dança que configura a dor como aliada desta prática, e obriga as bailarinas a várias estratégias de confronto. Paralelamente, a dor liga-se ao medo da lesão, ao fim do percurso como bailarina e ao abdicar de um sonho.

Abstract This article presents the results of a study focused on the meaning that pain assumes in the discourse of a group of classical dance ballerinas. To achieve this, we accessed their experiences and perceptions through a semi-structured interview, to better understand the pain that is an integral part of their routines before, during and after a performance. This study is based on the discourses which emerged from a group of ten ballerinas with six or more years of training, and the method chosen to tap into the underlying meanings was Grounded Analysis or Sustained Data Analysis. The analysis of the discourses collected revealed that pursuing a dancing career involves obstacles that increase the demands felt by the ballerinas, in parallel with their desire to remain in the world of performance. Thus, it is the excessive practicing and repetitive movements which give rise to pain and injuries, which are concealed and denied so as not to impede the focus of attaining perfection. In general, the results obtained emphasize the passion for dance that involves pain as an ally to this career and force the ballerinas to varied confrontation strategies. In tandem, pain is linked to fear of injury, to the end of a career as a ballerina and the relinquishment of a dream.

Epidemiology of athletic injuries in classic ballet practitioners / Epidemiologia de lesiones musculoesqueleticas en practicantes de balé clásico / Epidemiologia de lesões musculoesqueléticas em praticantes de ballet clássico

Specific overloads of ballet practice may represent risk factors for injuries. The objective of this study was to analyze the epidemiology of typical injuries of ballet, including factors associated with history of injury in ballet practitioners. Studied subjects integrated 124 dancers, of both genders, from nine ballet schools from Campo Grande, Mato Grosso do Sul State, Brazil. To obtain information about injuries, we used a morbidity survey. Participants were divided into two groups: G1 (with injuries) and G2 (without injuries). In relation to prevalence of injuries, 89 cases were registered, and 61 dancers (49%) reported damages incidence, with record of 1.48 cases per practitioner. Moreover, the G2 presented higher body weight (G1: 51±8 versus G2: 55±10 kg) and training time (G1: 4.0±2.0 versus G2: 5.0±4.1 years). With respect to injury type, joints (32%) and muscle affections (25%) were the main occurrences in the lower limbs (85%) due to specific exercises (30%). Weekly exposure time was the most important mechanism to injury installation. The more important causal circumstance to injury occurrence was constituted by specific training (49%) and choreographic performance (41%). In conclusion, evidences have showed that joint injuries in lower limbs are the main classical ballet injuries in ballet practitioners, and weekly exposure time is the most important factor associated with injuries in classical ballet.

Demandas específicas de la práctica de balé pueden representar factores de riesgo para lesiones musculoesqueleticas. Eso estudio tuvo como objetivo analizar la epidemiologia de lesiones típicas del balé, con factores asociados a la historia de lesión en bailarines. Hubo la integración de 124 participantes de los dos géneros, procedentes de nueve escuelas de balé de Campo Grande, Mato Grosso do Sul, Brasil. Se utilizó una averiguación de morbidad referida para registrar las lesiones. Los participantes fueron distribuidos en dos grupos: G1, sin lesión, y G2, con lesión. Con relación a la presencia de lesión, se registraron 89 casos, y 61 bailarines (un 49%) reportaron lesiones con registro de 1,48 casos por practicante. El G2 presentó mayor masa corporal (G1: 51±8 versus G2: 55±10 kg) y tiempo de entrenamiento (G1: 4,0±2,0 versus G2: 5,0±4,1 años). Hubo predominancia de lesiones articulares (32%) y musculares (25%) en las extremidades inferiores (85%) originarias de ejercicios específicos (30%). El mayor tiempo semanal de práctica se configuró como el principal factor de riesgo para lesión. La circunstancia que más causó lesiones fue el entrenamiento específico (49%), seguido por el ensayo de coreografía (41%). Se concluso que las lesiones articulares en extremidades inferiores son las principales lesiones del balé clásico, y el tiempo semanal de exposición se constituye el principal factor asociado a las lesiones en el balé clásico.

Demandas específicas da prática de ballet podem representar fatores de risco para lesões musculoesqueléticas. Este estudo teve por objetivo analisar a epidemiologia das lesões típicas do ballet, com fatores associados ao histórico de lesão em bailarinos. A casuística integrou 124 participantes de ambos os sexos, procedentes de nove escolas e companhias de ballet de Campo Grande, no Mato Grosso do Sul. Para registro de lesões, utilizou-se um inquérito de morbidade referida. Os participantes foram distribuídos em dois grupos: G1, sem lesão, e G2, com lesão. Em relação à presença de lesão, foram registrados 89 casos, sendo que 61 bailarinos (49%) relataram terem se lesionado, com registro de 1,48 casos por praticante. O G2 apresentou maior massa corporal (G1: 51±8 versus G2: 55±10 kg) e tempo de treinamento (G1: 4,0±2,0 versus G2: 5,0±4,1 anos). Houve predomínio de lesões articulares (32%) e musculares (25%) nos membros inferiores (85%), decorrentes de exercícios específicos (30%). O maior tempo semanal de prática configurou o principal fator de risco para lesão. A circunstância que mais provocou lesões foi o treino específico (49%), seguido pelo ensaio de coreografia (41%). Conclui-se que as lesões articulares em membros inferiores são as principais lesões do ballet clássico, e o tempo semanal de exposição constitui o principal fator associado a lesões no ballet clássico.

Factors that influence in the turnout in ballet dancers with knee pain / Factores que influyen en el turnout em bailarinas com dolor em lãs rodillas / Fatores que influenciam no turnout em bailarinas clássicas com dor nos joelhos

The turnout, primary gesture in classical ballet, refers the 180º of the feet. The lateral rotation provides the greatest amount of degrees necessary to perform the position perfectly. If performed improperly, it can generate problems, specialy in the knees, causing pain. The aim of this study was to evaluate the factors that influence the implementation of turnout in adolescents ballet dancers with knee pain and to compare them to the dancers without pain. Twenty three (23) ballet dancers with knee pain and 26 ballet dancers without pain were evaluated for range of motion of external rotation of the hip, muscle strength, femoral neck anteversion and static and dynamic turnout. The angles were measured with a manual goniometer, and the strength of the abductor muscle groups, external rotators and hip extensors with isometric dynamometer. The analysis was performed using ANOVA and Mann-Whitney. Range of motion of external rotation of the hip, femoral neck anteversion and muscle strength were similar between groups. The dynamic turnout was lower in ballet dancers with knee pain (p=0.02) and ballerinas with angular deficits above 10% over the static group had lower turnout under the bilateral extensor muscle group (p=0.04 and 0.03, right left) and right abductor (p=0.03). Although anatomical factors can influence the lateral rotation of the turnout, the angle decreased dynamic turnout was related to the group of dancers with pain. This suggests that training based on proximal awareness of movement can prevent and minimize burdens on the knees of classical dancers teens.

El turnout, principal gesto del ballet clásico, se refiere a la posición de 180º entre los pies. La rotación lateral de la cadera proporciona una mayor cantidad de grados necesarios para realizar la posición perfectamente. Si se realiza de forma inadecuada, puede generar compensaciones, preferentemente en las rodillas, generando dolor. El objetivo de este estudio fue evaluar los factores que influyen en la ejecución del turnout en bailarinas clásicas adolescentes con dolor en las rodillas y comparar las bailarinas y sin dolor. Se evaluaron a 23 bailarinas con dolor y 26 bailarinas sin dolor en cuanto al rango de movimiento de rotación lateral de la cadera, la fuerza muscular, a la anteversión del cuello femoral y al turnout estático y dinámico. Los ángulos fueron medidos con un goniómetro manual, y la fuerza de los grupos musculares abductores, rotadores externos y extensores de la cadera con dinamómetro isométrico. El análisis se realizó por medio del ANOVA y Mann-Whitney. El rango de movimiento, la anteversión del cuello femoral y la fuerza del músculo fueron similares entre los grupos. El turnout dinámico fue menor en el grupo de bailarinas con dolor (p=0,02), y las bailarinas con déficits angulares superiores a 10% en relación al turnout estático presentaron menor fuerza del grupo muscular de los extensores bilaterales (p=0,04 y 0,03, derecha e izquierda) y abiductores derecho (p=0,03). Aunque los factores anatómicos pueden influir en la rotación lateral del turnout, la disminución del ángulo del turnout dinámico se relacionó con el grupo de bailarinas con dolor. Tal hecho sugiere que el entrenamiento basado en la conciencia proximal del movimiento puede prevenir y minimizar las sobrecargas en las rodillas de bailarinas clásicas adolescentes.

O turnout, gesto principal do balé clássico, refere-se à posição de 180º entre os pés. A rotação lateral do quadril fornece a maior quantidade de graus necessários para realizar a posição com perfeição. Se executada de forma inadequada, pode gerar compensações, preferencialmente nos joelhos, ocasionando dor. O objetivo deste estudo foi avaliar fatores que influenciam na execução do turnout em bailarinas clássicas adolescentes com dor nos joelhos e comparar a bailarinas sem dor. Foram avaliadas 23 bailarinas com dor e 26 bailarinas sem dor quanto à amplitude de movimento de rotação lateral do quadril, força muscular, à anteversão do colo femoral e ao turnout estático e dinâmico. Os ângulos foram mensurados com goniômetro manual, e a força dos grupos musculares abdutores, rotadores laterais e extensores do quadril com dinamômetro isométrico. A análise foi feita por meio do ANOVA e Mann-Whitney. A amplitude de movimento, a anteversão do colo femoral e a força muscular foram semelhantes entre os grupos. O turnout dinâmico foi menor no grupo de bailarinas com dor (p=0,02), e bailarinas com déficits angulares acima 10% em relação ao turnout estático apresentaram menor força do grupo muscular dos extensores bilateral (p=0,04 e 0,03, direita e esquerda) e abdutores direito (p=0,03). Embora fatores anatômicos possam influenciar na rotação lateral do turnout, a diminuição angular do turnout dinâmico esteve mais relacionada ao grupo de bailarinas com dor. Tal fato sugere que o treinamento baseado na conscientização proximal do movimento pode prevenir e minimizar as sobrecargas nos joelhos de bailarinas clássicas adolescentes.

Zapateado technique as an injury risk in Mexican folkloric and Spanish dance: an analysis of execution, ground reaction force, and muscle strength.

Zapateado is a repetitive percussive footwork in dance. This percussive movement, and the differences in technique, may be risk factors for injury. A survey on zapateado dance students found a rate of 1.5 injuries/1,000 exposures. Knee injuries are more frequent than in Spanish dancers than folkloric dancers. The aim of this research was to study the relationship between technique and ground reaction force between zapateado on Spanish and Mexican folkloric dancers. Ten female dance students (age 22.4 ± 4 yrs), six Spanish dancers and four Mexican folkloric dancers, were considered. Each student performed zapateado with a flat foot, wearing high-heeled shoes during 5 seconds on a force platform. Videotapes were taken on a lateral plane, and knee and hip angles in each movement phase were measured with Dartfish software. Additionally, knee and ankle flexor and extensor strength was measured with a dynamometer. Ground reaction forces were lower for Spanish dancers than Mexican folkloric dancers. Spanish dancers had less knee flexion when the foot contacted to the ground than did Mexican folkloric dancers. On Spanish dancers, the working leg had more motion in relation to hip and knee angles than was seen in folkloric dancers. The ankle extensors were stronger on folkloric dancers, and there were no differences for the other muscle groups. Knee flexion at foot contact and muscle strength imbalance could be risk factors for injuries. It is suggested that the technique in Spanish dance in Mexico be reviewed, although more studies are required to define more risk factors.

Lesiones en bailarines de ballet / Lésions chez les danseurs de ballet / Injuries in ballet dancers

El ballet es un deporte que se está practicando frecuentemente. Los bailarines están expuestos y tienen factores predisponentes para lesiones deportivas. Por tal razón se hizo una revisión de la literatura para mostrar un enfoque general de los factores de riesgo, la incidencia de lesiones y su distribución en los bailarines de ballet. Existen varios factores de riesgo para lesiones como el arco de movimiento, anomalías anatómicas, técnica de baile, disciplina de baile, estabilidad postural. Anualmente se lesionan alrededor de 50 po ciento de los bailarines y la mayoría son adolescentes. Las lesiones más frecuentes son por sobreuso y ocurren principalmente en los miembros inferiores. Se concluye que necesitan una atención especial como grupo ocupacional, más información sobre los factores de riesgo y las posibilidades de diseñar programas de prevención(AU)

Ballet is a sport that is being practiced frequently. Dancers are exposed to sport injuries and have predisposing factors for them. For that reason, we made a literature review to show a general approach of risk factors, incidence of injuries and their distribution in ballet dancers. There are several risk factors for injuries such as arch movement, anatomic anomalies, dancing techniques, dancing discipline and postural stability. About the 50 percent of dancers present injuries each year and the majority of them are adolescents. The most frequent ones occur as a result of overuse and are mainly located in the lower extremities. We conclude that they need a special attention as occupational group, more information about risk factors and that there should be more possibilities to design prevention programs on this respect(AU)

Le ballet est des nos jours une pratique habituelle. Les danseurs sont exposés à des lésions dites du sport. C'est pourquoi, on a fait une révision de la littérature afin de montrer une approche générale aux facteurs de risque, à l'incidence des lésions et à leur localisation. Ils existent plusieurs facteurs de risque tels que les anomalies anatomiques, la technique de la danse, la discipline de la danse, la stabilité posturale. Chaque année, 50 pourcent des danseurs se lèsent, et la plupart sont des adolescents. Les lésions les plus fréquemment trouvées sont dues au surentraînement, et se localisent au niveau des membres inférieurs. On conclu que comme groupe occupationnel ils ont besoin d'un soin spécialisé, de plus d'information sur les facteurs de risque, et de la possibilité de participer à la conception des programmes de prévention(AU)

Investigation of risk factors and characteristics of dance injuries.

OBJECTIVE: The aim of the present study was to identify risk factors for the occurrence of sport injuries in dancers related to anthropometric variables, training, and specific dance characteristics. DESIGN: One-year, retrospective, cross-sectional study. SETTING: 26th Dance Festival of Joinville (Brazil), 2008. PARTICIPANTS: Five hundred dancers (409 women and 91 men) with a mean age of 18.26 ± 4.55 years. ASSESSMENT OF RISK FACTORS: Dancers participating in the 26th Dance Festival of Joinville (Brazil) were interviewed using the Reported Condition Inquiry, which was previously validated and modified for dance. This questionnaire contains questions addressing the anthropometric data of the volunteers and characteristics of injuries that occurred in the past 12 months. MAIN OUTCOME MEASURES: The data were collected through interviews addressing the occurrence of injuries and respective characteristics. Injury was considered any pain or musculoskeletal condition resulting from training and competition sufficient to alter the normal training routine in terms of form, duration, intensity, or frequency. RESULTS: A total of 377 injuries (75.40%) of the interviewees reported injuries in the past 12 months. The most affected anatomic segments were the ankle/foot (92 injuries; 28.75%) and thigh/leg (88 injuries; 27.50%) in classical ballet, the thigh/leg (43 injuries; 27.92%) in jazz/contemporary dance, and the knee (22 injuries; 43.14%) in tap/folk dance. The most reported causal mechanisms were dynamic overload and excessive use. CONCLUSIONS: Age and body weight were associated with injury in jazz/contemporary dance. Height was associated with injury in classical ballet and tap/folk dance. Duration of practice was associated with injury in classical ballet and jazz/contemporary dance.

Injuries in students of three different dance techniques.

As with any athlete, the dancer has a high risk for injury. Most studies carried out relate to classical and modern dance; however, there is a lack of reports on injuries involving other dance techniques. This study is an attempt to determine the differences in the incidence, the exposure-related rates, and the kind of injuries in three different dance techniques. A prospective study about dance injuries was carried out between 2004 and 2007 on students of modern, Mexican folkloric, and Spanish dance at the Escuela Nacional de Danza. A total of 1,168 injuries were registered in 444 students; the injury rate was 4 injuries/student for modern dance and 2 injuries/student for Mexican folkloric and Spanish dance. The rate per training hours was 4 for modern, 1.8 for Mexican folkloric, and 1.5 injuries/1,000 hr of training for Spanish dance. The lower extremity is the most frequent structure injured (70.47%), and overuse injuries comprised 29% of the total. The most frequent injuries were strain, sprain, back pain, and patellofemoral pain. This study has a consistent medical diagnosis of the injuries and is the first attempt in Mexico to compare the incidence of injuries in different dance techniques. To decrease the frequency of student injury, it is important to incorporate prevention programs into dance program curricula. More studies are necessary to define causes and mechanisms of injury, as well as an analysis of training methodology, to decrease the incidence of the muscle imbalances resulting in injury.

Bailarinos profissionais e saúde: uma revisão da literatura / Professional dancers and health: a literature review

O bailarino é um artista com demandas físicas comparáveis às de um atleta de alta performance e a um profissional de dedicação integral, com um longo período de formação. A saúde do bailarino apresenta especificidades, ainda pouco investigadas. As lesões musculoesqueléticas são o maior enfoque da literatura, em virtude das altas incidências. Muitos são os fatores de risco de lesão descritos entre bailarinos. Citam-se idade, gênero, tempo de prática, índice de massa corpórea, treino suplementar, fatores ambientais e biomecânicos. Mais recentemente, foram descritos fatores psicológicos. O tratamento das lesões muitas vezes é postergado em virtude dos compromissos profissionais e do medo do afastamento. Há evidências de que as estratégias de tratamento e prevenção podem diminuir a incidência de futuras lesões. A literatura é recente e heterogênea, o que limita conclusões mais consistentes. Nota-se que fatores relativos à dinâmica e ao processo de trabalho ou a aspectos organizacionais são raramente pesquisados. Uma nova forma de aproximação é necessária para melhor compreensão do processo saúde/doença do bailarino profissional.

The dancer is an artist with high physical demands who can be compared with an athlete of a high performance and a professional of integral devotion, with a long period of formation. Dancer’s health has specific features that are still little investigated so far. Musculoskeletal injuries are the most frequent focus of the studies, due to their high incidence. There are many risk factors described in dancers, like: individual’s characteristics as age, gender and time of practice, body mass index (BMI), supplementary training, environmental factors, biomechanical factors, and more recently, psychological factors have been more focused in the studies. Also, the treatment of injuries is usually delayed because of professional commitments, aggravated by the fear of missing show sessions. Preliminary evidences suggest that appropriate strategies of treatment and prevention could avoid the development of further injuries. The literature on this issue is young and very heterogeneous, limiting more consistent conclusions. It is also observed that factors related to work process and dynamics, as well as work organization, are poorly approached, so far. So, new approaches are required in order to improve the understanding on the health disease process in professional dancers.

Sintomatologia dolorosa e fatores associados em bailarinos profissionais / Painful symptoms and associated factors in professional dancers

A sintomatologia dolorosa no esporte e na dança tem sido objeto de crescentes pesquisas nos últimos anos. Assim como os profissionais do esporte, os bailarinos profissionais apresentam dores e limiar de tolerância à dor elevados. É comum encontrarmos bailarinos com diversas lesões decorrentes do esforço excessivo. O objetivo do estudo foi investigar a prevalência e fatores associados à sintomatologia dolorosa em bailarinos profissionais. Foi realizado um estudo analítico de corte transversal em 141 bailarinos profissionais atuantes nas principais capitais do Nordeste brasileiro. Para avaliação da sintomatologia dolorosa foram utilizadas versões validadas para o português do Protocolo de McGill e do Inventário para Dor de Wisconsin. Para análise estatística dos resultados realizou-se uma análise descritiva, seguida dos testes t de Student e de correlação de Pearson, considerando-se um valor de p < 0,05. Observaram-se níveis elevados de tolerância à dor em 70,2 por cento dos sujeitos, em que a intensidade variou de moderada a intensa. A dor na região lombar esteve presente em 85,8 por cento dos entrevistados. Foram verificadas correlações positivas entre o grau de intensidade de dor com atividades da vida diária, sono, humor e relacionamento pessoal. O presente estudo constatou elevada prevalência de dor em bailarinos profissionais atuantes das principais capitais do Nordeste. A região mais acometida foi a lombar, observando grande interferência da sintomatologia dolorosa em diversas atividades da vida pessoal e laboral desse contingente.

Painful symptoms in sports and dancing have been object of increasing research over the last years. Professional dancers as well as sports professionals present high pain and tolerance thresholds, being common to find dancers with several injuries derived from excessive effort. The aim of this study was to investigate the prevalence and factors associated with painful symptoms in professional dancers. An analytical study of transversal cut was conducted in 141 professional dancers performing in the main capitals of the Brazilian northeast. For evaluation of the painful symptoms, versions validated for Portuguese of the McGill Protocol and the Pain Inventory of Wisconsin were used. For the statistical analysis of results, a descriptive analysis followed by the t-Student and Pearson correlation tests was used, being considered a value of p < 0.05. High levels of pain tolerance were observed in 70.2 percent of the subjects, where the intensity varied from moderate to severe. Pain in the lumbar region was present in 85.8 percent of the interviewees. Positive correlations were observed between the degree of pain intensity with daily life activities, sleep, mood and personal relationship. The present study found high prevalence of pain in professional dancers performing in the main northeastern capitals, where the region most recurrent was the lumbar, observing great interference of painful symptoms in several activities of personal life as well as work of this population.

Agravos músculo-esqueléticos em bailarinas clássicas, não clássicas e praticantes de educação física / Musculoskeletal injuries in classical and non-classical ballerinas, and people who practice physical education: a comparative study

A literatura especializada descreve grande número de agravos que são típicos das praticantes de dança compredominância das lesões nos membros inferiores. No entanto, em nosso meio, pouco se conhece sobre oimpacto da exposição das bailarinas a esses processos mórbidos. O objetivo da presente investigaçãobuscou observar a ocorrência de Agravos Músculos-Esqueléticos (AME) em praticantes de balé e embailarinas sem formação clássica, comparando-as com escolares participantes apenas de aulas de EducaçãoFísica. Para tanto, realizou-se um estudo na cidade de Bauru - SP com 83 jovens de 12 a 17 anos dispostas emtrês grupos, a saber: i) bailarinas clássicas (27); ii) praticantes de dança sem formação clássica (19) e iii)alunas que participavam apenas de aulas escolares de Educação Física (37). A investigação ocorreu noperíodo de 225 dias, sendo que, por quinzena, cada participante foi entrevistada e as informações registradasem formulário específico. Os números médios de dias com AME nos grupos considerados foram de 42,16+59,09nas escolares, 181,80+118,65 para as bailarinas clássicas e 36,32+ 61,71 para às não-clássicas. Entre asbailarinas clássicas, 24 (89%) relataram agravos, as quais passaram, em média, 81% dos dias do período deacompanhamento com manifestações dolorosas. As bailarinas clássicas e não clássicas apresentarammovimentos de flexão como a causa situacional que mais resulta em AME. Entre as escolares os movimentosde força muscular são responsáveis por grande parte dos AME. Entre os grupos a região corporal que maisse destaca com relação a presença de AME é o joelho, com predominância de intensidade moderada. Oelevado número de dias que as bailarinas clássicas referiram queixas de dor pode estar relacionado commovimentos repetitivos resultantes de microtraumas na ultra estrutura de músculos, tendões e ligamentosque indicam o caráter crônico dos agravos.

The technical literature describes a large number of disorders typical of people who practice dance withpredominance of lower extremities injuries. Nevertheless, there is a little knowledge about the impact of theexposure of ballerinas to these morbid processes. The aim of this investigation was to observe the occurrenceof musculoskeletal injuries in ballet dancers and ballerinas with no classical formation comparing them toschool dancers, which only practice it in their physical education classes. To accomplish that, a study wascarried out in Bauru, São Paulo, Brazil, with 83 youths aging from 12 to 17 years old and divided into threegroups as follow: i) classic ballerinas (27); ii) dancers without classical formation (19) and iii) students thatparticipate in regular P.E classes (37). The evaluation was accomplished in 225 days. Each participant wasinterviewed in an interval of fifteen days and an appropriated formulary was filled to register the information.The average of days with musculoskeletal injuries in the considered groups was 42.16 + 59.09 into studentsgroup, 181.80 + 118.65 to classical ballerinas group, and 36.32 + 61.71 to non-classical ballerinas group. Amongclassical ballerinas 24 (89%) presented injuries and spend approximately 81% of the attendance days with painfulmanifestation. The classical and non-classical ballerinas presented movements with flexion as the situationalcause, which mostly results in MSI. Among the schoolgirls the movement of muscular strength is responsible formost part of MSI. Among these groups the body region where the MSI is easily recognized, with predominanceand in moderate intensity, is the knee. The high number of days in which the classical ballerinas mentioned to befeeling pain can be related to the repetitive movements resulting from micro traumas in the ultra structure of themuscles, tendons, and ligaments that indicate the chronic aspect of the injuries.