Sunday, 30 March 2014

Break A Leg?: An overview of ballet injuries

INTRO

Let's talk about injuries...


Photo by Corbin Smith / thegridto.com

     It may be safe to generalize that high-level athletes and dancers rarely take a break after an injury. Resting can cause you to lose your spot/job; therefore, professionals tend to dance around the injury. From my experience, I realized that dancing with injury was thought to be cool and something to be proud of. It may make them look tough and strong, but the truth is, their body is deteriorating. There are dancers that retire at age 38 -- or younger -- because their body was "worn out" by ballet. 

     That's why, every dancers, directors, and management should know that the proper care for injuries is essential to have a long-lasting career and healthy "employees." Now a days, athletic trainers and physical therapists are pushing harder to persuade companies to hire more professionals to monitor each dancer's injuries.
    


INJURIES IN BALLET
     
     A study on 52 professional dancers in a ballet company recorded all of the injuries over a period of one year. They recorded 355 injuries (mean of 6.8 injuries per dancer) just in one year!! There were: more overuse injuries than traumatic injuries; many lower leg, ankle, and lower back injuries; and most injuries occurred during classes and performances compared to rehearsals. They analyzed that many injuries came from jumping, but since there were more ankle/lower leg injuries in females than males, we can probably assume that pointe shoes play a role in some injuries.

     That study was about adult professionals. Now, let's look at younger dancers. More than a decade of medical records were examined from 476 students in Sweden. 438 injuries were recorded (remember, some injuries can be left unreported), the incidents increased with age, and 76% of the injuries occurred in the lower extremities. The most common traumatic injury was ankle sprains, and tendonitis in the foot was the common overuse injury.

     Ballet injuries in professional dancers were 4.44 per 1000 dance hours. Football injuries was once recorded as 3.5 per 1000 hours played (regardless of its severity). Newer data shows higher numbers in other sports injuries, but my point is, there's a lot of injuries in ballet (and it's not even a contact sport), and it's rarely looked after. 



MANAGE? OR PREVENT?

     I've been stressing that injuries have to be taken care of. But we can't forget that we need to prevent injuries. In one company, 309 injuries in 3 seasons cost $398,396 from worker's compensation insurance (an average cost per injury was $1289). Apparently, this number is similar to that of an athletic team, but remember that ballet companies do not get a lot of funding… 400,000 dollars is a lot of burden. 

     So how do we prevent it?
     There was an interesting study that looked at the difference between Tae-Kwon-Do and ballet. The reason behind this is that ballet and tae-kwon-do uses similar powerful motion and muscle mechanisms. Since there is less injury reporting in Tae-Kwon-Do, they believed that if they compared the two forms of activity, they might be able to find a way to prevent overuse injuries in ballet. Turns out, Tae-Kwon-Do athletes have higher risk of injury when they looked at kicks. 
     From more analyses, they predicted that we could possibly reduce injuries by: reducing the frequency and duration of repetitive movements, allowing enough repair time for recovery (rest!), and incorporate targeted strength training on small muscles involved (take barre exercises seriously!). 

     Other studies points out the different types of floor laid out on the stage and studios. If they're not used to the floor, rehearsing in different venues might raise the risk of injury. 



END NOTE

     There are many ideas about risks and prevention, but I realized that it's really hard to pin-point what causes injury in ballet. On top of that, different types of injuries have different causes and mechanisms of injury. But let me assure you that researchers are looking for answers. There are people working for you so that you won't get hurt. As for now, when you get injured, go to a health professional, and actually listen and do what they tell you to do because to everything they say, they have reasons to back it up. I am looking into focusing on injuries for prevention and management, so stay tuned for that if you're interested.



REFERENCES

Allen, N., Nevill, A., Brooks, J., Koutedakis, Y., & Wyon, M. (2012). Ballet injuries: Injury incidence and severity over 1 year.The Journal of Orthopaedic and Sports Physical Therapy,42(9), 781.

Garrick, J. G., & Requa, R. K. (1993). Ballet injuries. an analysis of epidemiology and financial outcome. The American Journal of Sports Medicine, 21(4), 586.

Leanderson, C., Leanderson, J., Wykman, A., Strender, L., Johansson, S., Sundquist, K., . . . Medicin. (2011). Musculoskeletal injuries in young ballet dancers. Knee Surgery, Sports Traumatology, Arthroscopy, 19(9), 1531-1535. doi:10.1007/s00167-011-1445-9

Shan, G. (2005). Comparison of repetitive movements between ballet dancers and martial artists: Risk assessment of muscle overuse injuries and prevention strategies. Research in Sports Medicine (Print), 13(1), 63-76. doi:10.1080/15438620590922103

Stableforth, P. G. (1990). Sports injuries. Injury, 21(5), 311-313. doi:10.1016/0020-1383(90)90049-Z

Wainwright, S. P., & Turner, B.S. 'Just crumbling to bits'? an exploration of the body, ageing, injury and career in classical ballet dancers. (2006). Sociology,40(2), 237-255. doi:10.1177/0038038506062031

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