Injury patterns in elite preprofessional ballet dancers and the utility of screening programs to identify risk characteristics.

STUDY DESIGN Retrospective descriptive cohort study. OBJECTIVES To describe the distribution and rate of injuries in elite adolescent ballet dancers, and to examine the utility of screening data to distinguish between injured and noninjured dancers. BACKGROUND Adolescent dancers account for most ballet injuries. Limited information exists, however, regarding the distribution of, rate of, and risk factors for, adolescent dance injuries. METHODS AND MEASURES Two hundred four dancers (age, 9-20 years) were screened over 5 years. Screening data were collected at the beginning and injury data were collected at the end of each training year. Descriptive statistics were used to characterize distribution and rate of injuries. Inference statistics were used to examine differences between injured and noninjured dancers. RESULTS Fifty-three percent of injuries occurred in the foot/ankle, 21.6% in the hip, 16.1% in the knee, and 9.4% in the back. Thirty-two to fifty-one percent of the dancers were injured each year, and, over the 5 years, there were 1.09 injuries per 1000 athletic exposures, and 0.77 injuries per 1000 hours of dance. Significant differences between injured and noninjured dancers were limited to current disability scores (P = .007), history of low back pain (P = .017), right foot pronation (P = .005), insufficient right-ankle plantar flexion (P = .037), and lower extremity strength (P = .045). CONCLUSION Distribution of injuries was similar to that of other studies. Injury rates were lower than most reported rates, except when expressed per 1000 hours of dance. Few differences were found between injured and noninjured dancers. These findings should be considered when designing and implementing screening programs.

[1]  W. P. Bunnell An objective criterion for scoliosis screening. , 1984, The Journal of bone and joint surgery. American volume.

[2]  J. Loudon,et al.  The relationship between static posture and ACL injury in female athletes. , 1996, The Journal of orthopaedic and sports physical therapy.

[3]  R. Kronmal,et al.  Stress fractures in ballet dancers , 1992, The American journal of sports medicine.

[4]  B. Robson Adolescent development: how dancers compare with the typical teenager , 2001 .

[5]  P. Korovessis,et al.  Prediction of Scoliotic Cobb Angle With the Use of the Scoliometer , 1996, Spine.

[6]  K. Peer,et al.  INJURY PREVENTION & PERFORMANCE ENHANCEMENT Preventing Dance Injuries, Part I: Biomechanical and Physiological Factors , 2004 .

[7]  J. Perry,et al.  Relationship Between Foot Pronation and Rotation of the Tibia and Femur During Walking , 1999, Foot & ankle international.

[8]  R. Quirk Ballet injuries: the Australian experience. , 1983, Clinics in sports medicine.

[9]  M. Reinking,et al.  Intrinsic Factors Associated With Exercise-Related Leg Pain in Collegiate Cross-Country Runners , 2006, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[10]  P. Faghri,et al.  A Prospective Study of Overuse Knee Injuries Among Female Athletes With Muscle Imbalances and Structural Abnormalities. , 2004, Journal of athletic training.

[11]  S. Bronner,et al.  Profile of dance injuries in a Broadway show: a discussion of issues in dance medicine epidemiology. , 1997, The Journal of orthopaedic and sports physical therapy.

[12]  Predictors of Lower Extremity Injuries at the Community Level of Australian Football , 2004, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[13]  R. Burnham,et al.  Lower extremity flexibility patterns in classical ballet dancers and their correlation to lateral hip and knee injuries , 1987, The American journal of sports medicine.

[14]  D H Nielsen,et al.  Validity and Reliability Testing of the Scoliometer , 1990 .

[15]  W. Strong,et al.  Preparticipation health screening of young athletes , 1981 .

[16]  Lars-Erik Strender,et al.  The injury panorama in a Swedish professional ballet company , 2001, Knee Surgery, Sports Traumatology, Arthroscopy.

[17]  N. Briffa,et al.  Dance training intensity at 11–14 years is associated with femoral torsion in classical ballet dancers , 2006, British Journal of Sports Medicine.

[18]  D. Riddle,et al.  Reliability and validity of judgments of the integrity of the anterior cruciate ligament of the knee using the Lachman's test. , 1990, Physical therapy.

[19]  J Brown,et al.  Overuse Injuries in Classical Ballet , 1995, Sports medicine.

[20]  Jm. Rothstein Guide to physical therapist practice 2nd, ed. , 2001 .

[21]  R. Evans,et al.  A survey of injuries among Broadway performers. , 1996, American journal of public health.

[22]  S. Bronner,et al.  Injuries in a Modern Dance Company , 2003, The American journal of sports medicine.

[23]  J. Garrick,et al.  An analysis of epidemiology and financial outcome , 1993, The American journal of sports medicine.

[24]  P. Marshall,et al.  The rehabilitation of overuse foot injuries in athletes and dancers. , 1989, Clinics in podiatric medicine and surgery.

[25]  F. Crew THE R.A.F. MEDICAL SERVICES , 1955 .

[26]  L. E. Demann Sacroiliac dysfunction in dancers with low back pain. , 1997, Manual therapy.

[27]  S. Bronner,et al.  Occupational Musculoskeletal Disorders in Dancers , 2003 .

[28]  W. Bandy,et al.  Predictive validity of an injury score among high school basketball players. , 1997, Medicine and science in sports and exercise.

[29]  W. Curl,et al.  Ankle Flexibility and Injury Patterns in Dancers , 1996, The American journal of sports medicine.

[30]  W G Hamilton,et al.  A profile of the musculoskeletal characteristics of elite professional ballet dancers , 1992, The American journal of sports medicine.

[31]  K. R. Milan Injury in ballet: a review of relevant topics for the physical therapist. , 1994, The Journal of orthopaedic and sports physical therapy.

[32]  J. Powell,et al.  Injury prediction in the young athlete: a preliminary report , 1978, The American journal of sports medicine.

[33]  N. Briffa,et al.  Associations between turnout and lower extremity injuries in classical ballet dancers. , 2005, The Journal of orthopaedic and sports physical therapy.

[34]  T G McPoil,et al.  Relationship between three static angles of the rearfoot and the pattern of rearfoot motion during walking. , 1996, The Journal of orthopaedic and sports physical therapy.

[35]  G. Weber,et al.  Medical and Rehabilitation Issues in Classical Ballet , 2002, American journal of physical medicine & rehabilitation.

[36]  W. Bandy,et al.  Use of an inclinometer to measure flexibility of the iliotibial band using the Ober test and the modified Ober test: differences in magnitude and reliability of measurements. , 2003, The Journal of orthopaedic and sports physical therapy.

[37]  Mary Lloyd Ireland,et al.  Core stability measures as risk factors for lower extremity injury in athletes. , 2004, Medicine and science in sports and exercise.

[38]  J. Powell,et al.  Injury patterns in selected high school sports: a review of the 1995-1997 seasons. , 1999, Journal of athletic training.