Physical Medicine and Rehabilitation Clinics of North America
Dance-Related Injury
Section snippets
Dance techniques and their relation to injury
Physique and dance technique receive significant attention among dancers, instructors, and clinical staff. Professional dancers embody the ultimate consequences brought about by rigorous training to master techniques that repetitively risk injury by exceeding the limits of their anatomic and physiologic capabilities. Knowledge about the technical requisites of dance is an important consideration in the care of the dancer. Understanding the biomechanics of dance is essential for dance medicine
Mechanisms of acute and overuse injuries in dance
Acute injuries are usually associated with a single episode during which normal or insufficient tissue is subjected to a sudden stress or strain that exceeds the tissue's capacity to maintain physiologic or functional integrity, resulting in macrotrauma. A potential cause for acute dance injuries is incorrect performance of movements, which may occur secondary to other factors, such as tiredness, muscle fatigue, or loss of balance [18]. In general, dancers experience acute injuries in the upper
Incidence of injuries in dancers
Medical literature profiling the incidence of injury within modern, theatrical, and classical ballet companies reports that the incidence of injuries ranges from 17% to 95% [39]. The patterns of injury seem to be fairly consistent, particularly in ballet, and the incidence of injuries in a variety of studies has been found to be greatest for the lower extremity (57%–75%), followed by the ankle and/or foot (34%–54%), and, less frequently, the lower back and/or pelvis (12%–23%) [17], [36], [37],
Conditions affecting the hip
The “snapping hip” refers to a click with a snapping sensation that occurs during movement of the thigh. Lateral (external) snapping on the hip corresponds to motion of the iliotibial band (ITB) over the greater trochanter; medial (internal) snapping that occurs medial or anterior to the hip is caused by the iliopsoas tendon moving across the femoral head or iliopectineal eminence (Fig. 1) [4], [42]. Lateral snapping more commonly affects the supporting leg while attempting rotation movements
Conditions affecting the ankle
The most common acute injury in dancers is ankle sprain. Anterior and posterior impingement syndromes may occur in association with acute and overuse injuries.
Ankle sprain is the most common traumatic injury among dancers [15], [17], [25], [40]. As in the general population, most ankle sprains in dancers involve injury to the lateral ligament complex, whereas injury to the medial ligaments is rare [56]. The mechanism for inversion ankle sprains involves foot plantarflexion and inversion, such
Female athlete triad
Similar to other athletes involved in sports activities that place a high emphasis on esthetics, the female dancer is at increased risk of the female athlete triad, (disordered eating, amenorrhea, and osteoporosis). Dancers aspiring to attain or maintain an ideal lean figure may place significant efforts on aggressive dieting and a vigorous training regimen. These efforts may lead to amenorrhea and an increased risk of osteoporosis. For dancers who maintain an intensive training regimen, these
Stress fractures: relation to dance training, nutritional factors, and hormonal factors
The structural integrity of bone is maintained by ongoing bone resorption and bone formation in a dynamic process known as bone remodeling. Stress forces, such as those that arise from weight bearing or muscle actions, are a positive stimulus for bone remodeling. According to Wolff's law, bone architecture is modified by mechanical loading on bone tissue, with sites of mechanical stress developing increases in cortical mass [86]. Piezoelectric principles also influence bone remodeling.
Considerations in management and prevention of dance injuries
Prevention is the keystone to avoid injuries, and for dance injuries, preventive strategies may be directed toward previously identified risk factors. When emphasizing prevention of new injuries, a supervised training regimen should be monitored for gradual progression of intensity (length and frequency) and type of activity (eg, initiating a new dance style) [23]. A dance screening clinic may be the most comprehensive setting to implement prevention strategies but is mainly available for
Summary
Although dance medicine has derived extensive knowledge from sports medicine, some aspects covered in the practice of dance medicine are unique to this field. Acute and overuse injuries must be analyzed within the scope of associated mechanisms of injury, mainly related to the practice of specific dance techniques. Even though most available medical literature concerning dance medicine is specific to ballet-related conditions, many of the concepts covered here and in other articles can be
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