The physical stress on the body during many forms of dance is similar to that experienced in other forms of high impact sports, making the potential for injury just as likely. The most common cause of injury in dance is from overuse and the increase in the athletic nature of modern dance has resulted in a significant rise in injuries.
Every style of dance will have its own associated injuries with ballet perhaps most at risk. Many dancers, of course, practice a number of styles. Proper technique is important to avoid injury. Great dancers take time and much practice to develop the strength and dexterity required to perform, while untrained people wanting to emulate the extreme moves are at greater risk of suffering injury.
Common dance injuries include:
- Muscle strain
- Ligament sprains
- Fractures and stress fractures
The cause of the injury needs to be ascertained before rehabilitation can commence. Unless the cause is known, repeated or more severe injury may occur. Rehabilitation from dance injury often involves rest from some of their practice whilst maintaining other dance work, sometimes anti-inflammatory and analgesic medications or injections and even surgery may be recommended. This is then followed up with physiotherapy and an exercise program to improve functionality, mobility and strength of the affected area and correction of any biomechanical error that lead to the injury.
Some common dance injuries
Tendinopathy/Tendinosis: Usually experienced as pain and sometimes swelling within the tendon. In dance, the patellar tendon or tendon that flexes the big toe are commonly involved. Tendinopathy/Tendinosis in dance is often the consequence of repeated minor trauma, over-practicing and technique errors.
Muscle Tear: The continuity of muscle fibres is damaged, usually due to acute trauma. Symptoms include functional loss in an isolated muscle group, pain, swelling or some hemorrhaging or bruising in the area.
Ligament Sprain: Fibres within a ligament can be partially or completely torn, affecting stability and function of joints. Initial symptoms of a sprain usually include immediate and often severe functional loss and rapid swelling around the affected area. In more severe cases, immobilisation of the joint will be recommended as a first recovery step.
Joint Impingement: Through repetitive movements some joints can start to impinge. This is where some of the soft tissue around the joint can become inflamed and catch between the joint. The risk of this is higher when extremes of movement is required, such as with dance. The joints most commonly affected are the back of the ankle and the hips of dancers.
Dislocation or instability: When the physical connection between connected joints is lost, either partially or totally, it is called dislocation. Intense pain and total loss of function is often the result. Dislocation can involve damage to connective tissues between bones, sometimes requiring surgical intervention prior to general rehabilitation.
Fracture: Partial or total loss of bone continuity is known as a fracture. Although major trauma to the area can be the immediate cause, some fractures (stress fractures) are caused by repetitive minor traumas, typically experienced in dance. Complete immobilisation using plaster or splints is usually required to protect the bone and encourage healing. Once adequately healed, a gradual return to dance can be commenced under the guidance of a qualified practitioner or one of our sports medicine physicians.
Assessment for dancing en pointe
Dance teachers frequently recommend aspiring ballerinas be assessed before starting to dance en pointe. Our doctors or dance physiotherapist are qualified to do these assessments, checking the dancer’s age, injury history, physical ability, biomechanics and strength.
Menstrual disorders in dancers
Because dancers perform a lot of training and may feel pressure to be thin, there is a risk of not eating enough to meet energy needs. Over time, this results in hormonal changes that can present as absent or infrequent periods. Unfortunately, this state of “functional hypothalamic amenorrhoea”, otherwise known as the “Female Athlete Triad” is associated with weak bones, stress fractures and even osteoporosis in later life. If a dancer’s periods have stopped, this should be addressed by a doctor experienced in hormonal issues in dancers and other athletes. A detailed history and blood tests will need to be performed. The solution is NOT to take the oral contraceptive pill, but to adjust the food intake in balance with the training level.
Continuing to dance
It’s well known that many dancers carry niggling injuries throughout their career. With proper care, most injuries can be managed without further damage being caused, although the symptoms may be permanently noticeable. Preventing injury altogether is an ideal that is possible with proper guidance from an experienced dance instructor. However, if injury has occurred, a qualified Sports and Exercise Medicine Physician is ideally suited to guide the recovery plan.
As with all physical pursuits, it’s important to ‘listen to your body’ and be aware of any signs of discomfort experienced. Sometimes avoiding injury is as easy as stopping the activity before the damage happens. When practiced properly, dance should be a pleasurable, exhilarating and healthy experience for people of all ages and a professional career for some.