The Efficacy of Physical Fitness Training on Dance Injury: A Systematic Review.

Greater levels of physical fitness have been linked to improved dance performance and decreased injury incidence. The aim was to review the efficacy of physical fitness training on dance injury. The electronic databases CINAHL, Cochrane Library, PubMed, Web of Science, MEDLINE, China National Knowledge Infrastructure were used to search peer-reviewed published articles in English or Chinese. Studies were scored using Strength of the Evidence for a Conclusion and a risk bias checklist. 10 studies met the inclusion criteria from an initial 2450 publications. These studies offered physical fitness training for professional (n = 3) and pre-professional dancers (n = 7), participant sample size ranged between 5 to 62, ages from 11 to 27 years, and most participants were females. Assessment scores were classified as Fair (n = 1), Limited (n = 7), and Expert Opinion Only (n = 2) and risk of bias scores ranged from 22.7-68.2 %. After physical fitness training, 80 % of studies reported significant benefits in injury rate, the time between injuries, pain intensity, pain severity, missed dance activities and injury count. This review suggests that physical fitness training could have a beneficial effect on injury incidence in dance. The evidence is limited by the current study methodologies.

Perspectives of Ballet Dancers on Causes of Their Injuries and Implementation of Injury Preventive Measures by Ballet Teachers and Masters.

OBJECTIVES: Ballet dancers have a high injury risk. We aimed to gain insight into the causes for acute and overuse injuries in ballet dancers and the level of implementation of injury prevention by ballet teachers/masters, as perceived by dancers. METHODS: An international cross-sectional online-survey was based on the Fit-to-Dance Questionnaire and literature. Adult amateur, pre-professional, and professional ballet dancers reported the perceived causes of their injuries sustained in the previous 2 years. Multiple answers per injury were possible. Also, dancers rated the level of implementation of measures to prevent injury by their ballet teachers and ballet masters based on 21 items using a 5-point Likert scale. Causes were analyzed per-injury as well as per-dancer. RESULTS: 188 ballet ensembles and 51 dance organizations were contacted, from which 192 ballet dancers (mean age 27 ±7.8 yrs, 83% females) responded. 119 dancers (62%) reported 203 acute and 164 (85%) reported 469 overuse injuries. Fatigue was the most frequently perceived cause for acute injuries in the per-injury (n=89, 43.8%) and per-dancer analysis (n=63, 32.8%). For overuse injuries, pressure from the teacher/master was most frequently perceived as cause in the per-injury analysis (n=240, 51.2%), specifically in pre-/professional dancers (n=233, 61.3%). In the per-dancer analysis, fatigue/overtraining scored highest for overuse injuries (n=107; 55.7%). Other causes were previous/repetitive injuries (acute-per-injury 26.1%, acute-per-dancer 22.4%; overuse-per-injury 46.3%, overuse-per-dancer 53.1%) or erroneous dance technique (acute-per-injury 24.6%, acute-per-dancer 21.9%; overuse-per-injury 47.8%, overuse-per-dancer 45.3%). With regard to perceived level of implementation of injury preventive measures by ballet teachers/masters to prevent musculoskeletal injuries, 2 items received high ratings, 12 moderate ratings and 6 low ratings. CONCLUSIONS: Fatigue and pressure accounted for the majority of perceived causes for injuries. Perceived support by ballet teachers/masters regarding injury prevention was moderate to low. Future research should focus on the awareness, attitudes, and the important role of ballet teachers/masters for injury prevention in dancers.

Incidence, Prevalence, and Characteristics of Injuries in Pole Dancers: A Systematic Review.

OBJECTIVES: Pole dancing is an extreme form of performance physical activity, combining considerable feats of muscular strength, flexibility, dancing and acrobatics on a vertical metal apparatus. Despite rapid growth in the artform, many pole dancers continue to participate without fulfilling physical requirements to withstand the forces and physicality required. The aim of this systematic review was to determine the incidence, prevalence and characteristics of injuries sustained by pole dancing participants reported in published studies. METHODS: Five databases were comprehensively searched in February 2023. Authors independently screened titles and abstracts, with full copies of eligible studies reviewed using specific inclusion/exclusion criteria. Studies were included if they referenced pole dancing, were in English language and Level I-III-3 in accordance with the Australian National Health and Medical Research Council, with case reports considered if included 10 or more participants. The National Institute of Health quality assessment tool for observational cohort and cross-sectional studies was used to review the quality of reporting of selected studies. RESULTS: Eleven articles were retrieved based on searches, with five studies meeting full inclusion/exclusion criteria, published between 2020-2022. In total 787 study participants were identified, with 623 sustaining a total of 1,803 pole dancing injuries. Data from all studies in injury profiles reported 42.4% of injuries sustained to the upper limb, 44.8% lower limb, 10.5% trunk, 0.02% associated with the head and neck, and several injuries affecting multiple regions. Acute injuries comprised 51.6% of reported injuries compared to 48.4% chronic. Injury characteristics were varied due to inconsistencies in reporting across studies. CONCLUSIONS: This systematic review highlights a paucity of knowledge regarding injuries in pole dancing, perhaps expected with a relatively young sport. Improvement in reporting is required to aid in identification of injuries and opportunities for development of injury risk reduction strategies. PROSPERO Registration no. CRD42023401012.

An Achilles Tendinopathy Educational Intervention for Generalist Physicians Raises Awareness and Improves Knowledge for Treating Ballet Dancers.

BACKGROUND: Achilles tendinopathy can be a devastating condition in ballet dancers. Initial medical evaluation is frequently conducted by generalist physicians, who may lack the perspective of dance and sports medicine focused training and often prescribe complete rest for chronic overuse injuries. In order to provide targeted information about Achilles tendinopathy and the unique needs of elite athletes, such as ballet dancers, we designed an educational intervention that covers relevant anatomy, physiology, biomechanics, clinical presentation and evaluation, and recommendations for initial treatment and sub-specialty referral. The objectives of this study were to determine baseline understanding of Achilles tendinopathy by generalist physicians and to evaluate the efficacy of an educational intervention on their knowledge. METHODS: This was a prospective pre- post-test study, to measure improvement in knowledge about Achilles tendinopathy. Emergency Medicine and Primary Care physicians participated in an educational intervention with didactic and hands-on components. Data were analyzed using a two-tailed t-test. RESULTS: Twenty generalist physicians participated. There was significant improvement in their knowledge of Achilles tendinopathy for all our educational objectives (Pre-test: 59% correct answers; post-test: 79% correct answers; P < .0001; 95% CI: 6.32-10.78.). CONCLUSIONS: A brief educational intervention leads to increased knowledge of Achilles tendinopathy in generalist physicians. By increasing awareness of Achilles tendinopathy through a standard educational model, we propose that our curriculum can be portable and accessible to all health care providers who encounter dancers and other athletes with Achilles tendinopathy and may serve as a model for expanded education to generalists about other conditions commonly encountered in ballet dancers.

Prevalence and risk factors of musculoskeletal injuries in modern and contemporary dancers: a systematic review and meta-analysis.

Background: A large number of studies have found that the musculoskeletal injury of modern and contemporary dancers has a high incidence. Previous publications have indicated that there are many potential factors that are related to dancing injury; however, they have not been proven, and even some data are conflicting in different research. Results: The search yielded 18 prospective studies reporting on professional and pre-professional modern or contemporary dancers from companies and schools. The prevalence of modern and contemporary dancers was 0.82 (95% CI: 0.74~0.90). The injury proportion of trauma, overuse, ankle and foot, lower extremity, joint and ligaments, muscle and tendons, and time-loss were 0.40, 0.26, 0.49, 0.34, 0.33, and 0.29 in the total number of injuries. There was no evidence of a significant difference in sex, age, and education program. The factors of BMI and injury history achieved statistical significance, and the p-values were less than 0.01. Conclusion: Based on the results of this article, BMI and injury history may be risk factors for injury in contemporary and modern dancers. Modern and contemporary dancers have a high prevalence of musculoskeletal injuries. Lower extremity injuries are the most common in the whole body, with injuries to the foot and ankle being more frequent. The mechanism of injury is mostly overuse injury, and the injured tissues are mostly muscle tendons and joint ligaments.

Identity Reconstruction Following Injury in Dancers.

Objectives: To explore reconstructed identities of dancers who experienced an injury, using a model of identity reconstruction post-injury. Methods: An online questionnaire study with 145 dancers who had experienced a significant dance-related injury. Measures included a questionnaire measuring dancers' reconstructed identities, injury perceptions and injury centrality to self-concept. Statistical analyses included factor analysis, regression analyses and discriminant analysis. Results: Four latent variables discovered "supernormal self," "former self," "middle self," and "resentful self" reconstructed identities. Injury centrality to the self and specific injury perceptions were correlated with reconstructed identity scales in the predicted directions. Conclusions: The findings validated the existence of 4 distinct reconstructed identities associated with time distance from the injury. Classifying injured dancers according to these identities can help dance educators, practitioners and counselors detect dancers needing help and tailor counseling methods to modify the relevant injury perceptions.

One-Year Injury History and Safe Dance Practices Among Female Highland Dancers in Canada.

AIMS: Over 8,650 Highland dancers registered to compete in Royal Scottish Official Board of Highland Dancing events worldwide in 2019. While the burden of dance-related injuries is high among dancers, there are few studies examining Highland dance. The purpose of this study was to describe the prevalence of self-reported 1-year injury history and safe dance practices among female Highland dancers. METHODS: Sixty-five female Canadian Highland dancers (median age 18; range 14-47) completed an anonymous online survey at the beginning of the 2019 championship season. Demographics (i.e., age, body mass index), exposure (e.g., months/year dancing), safe dance practices (e.g., environmental, physical, psychological), and 1-year injury history (i.e., yes/no) were self-reported. Three definitions of dance-related injury were used: 1) time-loss (missed ≥1 class, practice, performance, and/or competition); 2) medical attention (requiring professional medical care); and 3) any physical complaint that affected full participation. RESULTS: Most participants were training at the elite standard/premier level (86%, 95%CI 75-93) and for ≥8 months/year (83%, 95%CI 75-93). The proportion of dancers reporting at least one physical complaint in the previous 1 year was 71% (95%CI 58-81). Sixty percent (95%CI 47-71) of dancers reported ≥1 medical attention and/or time-loss injury. All participants reported warming up regularly, with 59% (95%CI 46-70) participating in regular cool-downs. CONCLUSION: The prevalence of 1-year injury history among female Highland dancers is high. Education on the benefits of safe dance practice for Highland dancers may be useful. Prospective cohort studies are needed to understand the dynamic nature of dance injuries across a full competitive season.

"A sprained ankle is the biggest sign of mental fatigue": A qualitative study of the perceptions and experiences of mental fatigue in professional ballet.

Mental fatigue is known to influence endurance, skill, and tactical performance in sport. Research investigating the impact of mental fatigue on tasks that combine physical, cognitive, and aesthetic performance such as professional ballet does not exist. OBJECTIVE: To understand the perceptions and experiences of mental fatigue in professional ballet. DESIGN: Qualitative, focus groups and semi-structured interviews. SETTING: The Australian Ballet. PARTICIPANTS: Thirty-nine professional ballet dancers (53% of the company) and six dance staff members aged 18 years or above (53% female). MAIN OUTCOME MEASURES: N/a. RESULTS: The average focus group and interview length was 48 ± 7 min and 41 ± 8 min. Key categories were; (1) Dancers and dance staff perceive that new learning contributes to mental fatigue, (2) Dancers perceive changes to their mood and perception of effort when they are mentally fatigued, and (3) Dancers and dance staff perceive that mental fatigue negatively affects their physical and cognitive performance and, increases their risk of injury. CONCLUSION: This is the first study where participants associated mental fatigue with injury risk and provides a springboard to measure the impact of mental fatigue on learning, injury, and performance in professional ballet.

Perspectives and Experiences of Dance-Related Injuries: A Qualitative Survey of Adolescent Pre-Professional Ballet Dancers in Australia.

Objective: To explore perspectives and experiences of adolescent ballet dancers in Australia in relation to dance-related injuries and their impact, injury risk factors, prevention, and treatment. Design: Adolescent ballet dancers aged from 12 to 19 years in Australia were invited to participate in an online qualitative survey. Methods: Responses to open-ended questions were analyzed thematically using grounded theory while quantitative information was summarized with descriptive statistics and triangulated with qualitative data. Results: Nineteen adolescent dancers reported experiencing pain and multiple injuries but hiding or ignoring injuries due to fear. Dancers recognized the significant physical and psycho-social impact of dance-related injuries on themselves and others. Several risks and injury prevention strategies were identified by dancers. Dancers perceived that treatments were not always informed or effective. Conclusion: Findings suggest that adolescent ballet dancers experience multiple dance-related injuries but require support to disclose injuries, participate in injury prevention, and access treatment. Health professionals may improve quality of care by increasing their understanding of ballet and providing specific management advice. Dance teachers may benefit from further education to support their students. Clinical trials are required to confirm or negate the validity of proposed injury risks and the effectiveness of injury prevention strategies and treatments.

Ground reaction force as a factor responsible for the topography of injuries in professional dance. An analysis of three dance styles: classical dance, modern dance, and folk dance.

OBJECTIVE: The study aimed to identify the effects of ground reaction forces (GRF) recorded during landing in typical elements of three dance styles, including classical, modern, and folk dance, on injuries` topography. METHODS: The research involved a survey and measurements of GRF generated during landing after the jump. The survey involved a group of 90 professional dancers. In the questionnaire, the dancers marked areas of the human body that were affected at least once by injuries. Biomechanical tests of the GRF recording were conducted on a group of 15 professional dancers. The analysis focused on the following parameters: a maximum value of the vertical variable of the GRF relative to body weight (maxGRFz), the time between the moment from first foot contact with the ground to the moment of reaching the maxGRFz (tmaxGRFz), and the loading rate of the GRF relative to body weight (LRGRFz). RESULTS: Regardless of dance style and sex, the lower spine, knee joints, ankle joints and feet were the areas most affected by injuries among professional dancers. The level of maxGRFz, tmaxGRFz and LRGRFz during typical jumps in classical, modern, and folk dance was statistically significantly different (P<0.01*). The highest mean maxGRFz values were recorded for jumps performed by classical dancers. Furthermore, the sum of injury-affected areas differed significantly across various dance styles and was connected with the impact forces transferred by the dancer's musculoskeletal system. CONCLUSION: The level of GRF is one of the decisive factors affecting the topography of professional dance injuries.

Balletic bodies under lockdown: The consequences of a pandemic for highly disciplined habitus.

Like other elite athletes, ballet dancers are highly dedicated to the pursuit of their vocation. They work to perfect their bodies, their movements and their expression of the art form. The lockdowns that occurred during the COVID-19 pandemic represented a significant interruption to the extraordinary but everyday lives of ballet dancers, creating unique environments where exploration of the embodied habitus of ballet can be further investigated. The impacts of lockdown upon dancers were explored via a series of interviews with 12 professional dancers from Germany. Framed by previous research, theorising the balletic body from a Bourdieusian perspective, interview data were analysed using Interpretative Phenomenological Analysis. Our research highlights the way in which COVID-19 lockdowns and associated restrictions disrupt the habitus of dancers and results in a form of suffering that is comparable to injury or chronic illness. Our research suggests that individuals respond to the 'structural injuries' of lockdown measures in a manner comparable to the way they respond to physiological injury. Thus, dancers sought to repair or re-establish the social structures they ordinarily inhabit whilst the inevitable limitations of such efforts engendered occasions for reflexive thinking about their role, careers and identity as dancers.

Impact of Attentional Focus on Dance Performance: A Critically Appraised Topic.

CLINICAL SCENARIO: Dancing is a demanding esthetic activity with dancers having an 85% annual injury incident rate when performing complex dance motor skills. Teachers and clinicians use a combination of external and internal attentional cues when teaching dancers motor skills and when working on rehabilitation programs with injured dancers, respectively. External attentional focus (ie, focusing on movement outcome) reportedly results in superior performance than internal attentional focus (ie, focus on body movements). Interestingly, dancers reportedly often adopt an internal focus when dancing. Still, limited literature exists examining the effects of attentional focus on dancers' performance. CLINICAL QUESTION: How does attentional focus (external or internal) impact performance in dancers? SUMMARY OF KEY FINDINGS: Four original quasi-experimental studies met inclusion criteria. In the current examination, we found mixed results about the impact of attentional focus in dancers. Specifically, using an external attentional focus resulted in better performance in 2 studies, but these findings were limited to lesser experienced dancers. Experienced dancers did not have any physical performance differences when using external or internal focus. Internal focus also did not negatively affect dancers' performance in 2 studies. Some authors noted positive motivational effects (eg, increased perceived competence) when dancers used external focus. CLINICAL BOTTOM LINE: Low-quality evidence exists supporting the notion that in less experienced dance students, external focus improves performance. In experienced dancers, the type of attentional focus did not impact performance. External focus provides positive mental effects. Thus, clinicians working with dancers can integrate individualized feedback according to dancer level, with a preference toward external focus due to positive mental effects, to design optimal training and rehabilitation programs. STRENGTH OF RECOMMENDATION: Grade B evidence exists supporting the notion that an external attentional focus improves performance in less experienced dance students and also has positive mental effects. Internal attentional focus does not impede experienced dancers' performance.

Acute Musculoskeletal Complaints Vary According to the Perceived Stress Among Hungarian Professional Dancers.

Introduction: Studies showed that professional dance is often associated with a high degree of acute musculoskeletal injuries. These injuries' etiology predominantly describes their biomechanical or other extrinsic factors, but there is a limited number of scientific reports dealing with the perceived stress or mental health status concerning the physical complaints especially, among Hungarian professional dancers. Materials and Methods: In this study, we used validated questionnaires (RESTQ, SEFIP, Mental Health Test) filled out by Hungarian professional female dancers (N = 168) via an online platform anonymously and analyzed statistically. Results: Our findings showed a significantly positive relationship between musculoskeletal complaints and perceived stress, an elevated level of general stress, and a higher level of resilience in this population compared to the general population. Conclusion: Dancers demonstrate a heightened perception of stress; however, they exhibit elevated scores on resilience assessments, indicative of heightened functionality in their daily lives. Stress, per se, may not be directly regarded as a causative factor for acute musculoskeletal conditions, but it could potentially influence the severity of pain sensations and subjective pain levels in the context of existing injuries. Additional investigations are warranted to elucidate the precise mechanisms by which stress exacerbates the pain experience among dancers.

Injury incidence and severity in Chinese pre-professional dancers: A prospective weekly monitoring survey.

OBJECTIVES: To determine dance injury incidence and severity in full-time Chinese pre-professional dancers. STUDY DESIGN: Prospective weekly online monitoring survey. METHODS: Respondents were asked to record all dance-injury incidences between September 2020 and July 2021 using a remote weekly self-report injury monitoring tool. An inclusive definition of injury was used in this study to record all injuries, even if they didn't cause a cessation of training. Data were excluded if respondents completed <90 % of the survey period and had over 3 consecutive weeks of missing data. RESULTS: 450 individuals from 11 different schools were included in the analyses. A total of 1157 injuries were reported over a 30-week academic year. Injury prevalence was 64.9 % and injury incidence was 5.51 injuries per 1000 h. Forty-eight percent of the injuries were minor severity and 41 % were of moderate severity, and the main injury sites were knees (0.89/1000 h), lower back (0.80/1000 h), feet (0.58/1000 h) and groin (0.56/1000 h). Female dancers reported significantly higher injury prevalence and injury incidence, and higher rates of moderate to severe injuries than males. The university group reported higher injury incidence than the adolescent group (p < 0.05), whereas the latter reported higher rates of moderate to severe injuries than the former (p < 0.001). CONCLUSIONS: The injury incidence found in this study (5.1 injuries/1000 h) is higher than most previous sets of data. Female dancers are at a higher risk of injury and reported higher levels of injury severity than male dancers, especially for the female adolescent group.

Epidemiology and management of ankle sprain injuries over seven seasons in an elite professional ballet company.

OBJECTIVES: To investigate the epidemiology and management of ankle ligament sprains over seven seasons in a professional ballet company. DESIGN: Descriptive epidemiology study. METHODS: Medical attention injury, time-loss injury, and exposure data pertaining to 140 professional ballet dancers were prospectively recorded by Chartered Physiotherapists over seven seasons (2015/16-2021/22); a period including the COVID-19 global pandemic. RESULTS: Sixty-nine ankle sprains (46 time-loss) in 45 dancers (32 %) were recorded: 51 sprains were classified as grade I, 15 were classified as grade II, and three were classified as grade III; 53 sprains affected only one ligament, whilst 16 were multi-ligament sprains. For time-loss injuries, median time-loss durations varied by grading (I - 31 days, II - 54 days, and III - 147 days) and the number of ligaments affected (one - 31 days, two - 54 days, three - 134 days, four - 137 days), with time-loss ranging from 1 to 188 days. Of the 46 time-loss ankle sprains, eight were mild, nine were moderate, and 29 were severe. The incidence rate (injuries·1000 h-1) of medical attention ankle sprains was 0.073 (95 % CI: 0.046 to 0.117) in male dancers and 0.101 (95 % CI: 0.069 to 0.148) in female dancers, and the incidence of time-loss ankle sprains was 0.044 (95 % CI: 0.024 to 0.080) in male dancers and 0.064 (95 % CI: 0.040 to 0.103) in female dancers. No significant effect of sex was observed on either medical attention (p = .304) or time-loss (p = .327) ankle sprain incidence rates. Ten percent of dancers sustained multiple sprains across the seven seasons. Fifty and 39 % of ankle sprains in female and male dancers, respectively, were preceded by a history of ankle sprains. Jumping and landing (30 sprains) and non-dance movements (16 sprains) were the most common inciting movements. Bone bruising and synovitis were the most common concurrent pathologies. CONCLUSIONS: Ankle sprains placed a considerable burden on the ballet company studied. These time-loss durations specified by number and grade of ligament sprain, injury history, and secondary pathologies can guide return-to-dance rehabilitation pathways.

Prevalence of dance-related injuries and associated risk factors among children and young Chinese dance practitioners.

While Chinese dance is a popular dance genre among Chinese teenagers and adults, little is known regarding the prevalence of dance-related injuries or factors associated with such injuries among Chinese dance practitioners. The current cross-sectional study aimed to determine the prevalence of dance-related injuries and their associated risk factors among young Chinese dance practitioners in Hong Kong. Online surveys were distributed to dancers through local dance associations, while paper-based surveys were distributed to young Chinese dance performers during the 54th School Dance Festival in Hong Kong. Self-reported hours of dancing, injuries in the last 12 months, injury sites, and related factors were collected. The injury rate, 12-month prevalence of dance-related injuries were determined. Risk factors for common dance injuries were analyzed using separate multivariate regression models. A total of 175 children (aged 10-14 years) and 118 young (aged 15-24 years) Chinese dance practitioners provided their dance injury information. Young dancers had a significantly higher injury rate (6.5 injuries vs 4.6 injuries/1000 dance hours) and 12-month prevalence (52.5% vs 19.4%) than their child counterparts. The most commonly injured sites were the knee (children:7.4%; young:15.3%), lower back (children: 4.6%; young: 9.5%), and ankles (children: 5.1%; young: 16.9%). Age was a significant independent risk factor for dance-related injuries to the upper back, lower back, and pelvis/buttock (odds ratios ranging from 1.2 to 1.3/additional years). Additionally, height was a significant independent risk factor for lower limb injury (odds ratios ranging from 1.0-1.1/additional centimeter). Collectively, young Chinese dance practitioners are more vulnerable to dance-related injuries than are child dancers. Older age increases the risk of trunk injuries, whereas taller dancers are more likely to sustain lower-limb injuries. Future research should determine the mechanisms underlying dance-related injuries among these dancers.

Relationships Between Common Preseason Screening Measures and Dance-Related Injuries in Preprofessional Ballet Dancers.

OBJECTIVE: To examine modifiable and nonmodifiable factors for associations with dance-related injury among preprofessional ballet dancers over 5 academic years. DESIGN: Prospective cohort study. METHODS: Full-time preprofessional ballet dancers (n = 452; 399 female; median age [range], 15 years [11-21]) participated across 5 academic years at a vocational school. Participants completed baseline screening and online weekly injury questionnaires including dance exposure (hours/week). Zero-inflated Poisson regression models were used to examine associations between potential risk factors measured at baseline and self-reported dance-related injury. RESULTS: In count model coefficients, left one leg standing score (log coefficient estimate, -0.249 [95% CI: -0.478, -0.02]; P = .033) and right unipedal dynamic balance time (log coefficient estimate, -0.0294 [95% CI: -0.048, -0.01]; P>.001) carried a protective effect with increased years of training when adjusted for Athletic Coping Skills Inventory (ACSI) score. A significant association was found for left unipedal dynamic balance time and dance-related injury (log coefficient estimate, 0.013 [95% CI: 0.000, 0.026]; P = .045) when adjusted for years of training and ACSI score. There were no significant associations between dance-related injury and ankle and hip range of motion, active straight leg raise, or Y Balance Test measures. CONCLUSION: When adjusted for years of previous dance training and psychological coping skills, there was a significant association between limb-specific lumbopelvic control and dynamic balance tasks, as well as self-reported dance-related injury in preprofessional ballet. J Orthop Sports Phys Ther 2023;53(11):703-711. Epub 3 October 2023. doi:10.2519/jospt.2023.11835.

Musculoskeletal Injury in an Australian Professional Ballet Company, 2018-2021: 953 Medical-Attention and 706 Time-Loss Injuries Over 4 Years.

OBJECTIVES: To describe the incidence rate, frequency, severity, recurrence, and burden of musculoskeletal injury in professional ballet. STUDY DESIGN: Descriptive epidemiological (retrospective). METHODS: Professional dancers (n = 73, 40 females, 33 males) provided consent for retrospective review of musculoskeletal injury data. Medical-attention injuries were reported to and recorded by onsite physiotherapists between January 2018 and December 2021. Time-loss injuries were any injury that prevented a dancer from taking a full part in all dance-related activities for >1 day. Injuries were classified using the OSICS-10.1 system. Injury incidence rates (IIRs; injuries/1000 h), severity, recurrence, and burden were calculated. RESULTS: Nine hundred and fifty-three medical-attention injuries were recorded in 72 (98%) dancers at an IIR of 2.79/1000 h (95% confidence interval [CI], 2.62-2.98). 706 were time-loss injuries, which were reported in 70 dancers at an IIR of 2.07/1000 h (95% CI: 1.92, 2.23). Overuse injuries represented 53% of medical-attention injuries. The most frequently injured body area and tissue/pathology were thoracic facet joint (n = 63/953, 7%) and ankle synovitis/impingement (n = 62/953, 6%). Bone stress injuries (BSIs) were the most severe with the highest median time loss (135 days, interquartile range [IQR] 181) followed by fractures (72.5 days, IQR 132). The injuries with the highest burden were tibial BSIs (13 days lost/1000 h; 95% CI: 13, 14). Jumping and lifting were the most frequently reported injury mechanisms. CONCLUSION: Almost all dancers required medical attention for at least one injury during the surveillance period. Approximately 74% of injuries resulted in time loss. BSIs and ankle synovitis/impingement were of high burden, and a high proportion of BSIs were recurrent. J Orthop Sports Phys Ther 2023;53(11):712-722. Epub 14 September 2023. doi:10.2519/jospt.2023.11858.