Dancers are tremendous athletes with a unique variety of health & sports medicine related issues that require a strong knowledge & appreciation of their craft. They are both artists & athletes, performing at the highest levels of human performance. Scientific studies have been done trying to determine what is the “toughest, most difficult to master, most challenging sport”. Researchers looked at 60 sports & rated them based on over 20 performance criteria including physical, intellectual, & environmental. The “toughest sport” was Ballet!
What is Dance Medicine?
Dance Medicine is a form of Sports Medicine but with some very unique characteristics. The dancer is different in many ways. This includes not only their types of injuries but also their physical exam, evaluation and treatment. Injuries to dancers are very common. In evaluating injured dancers, one must not only focus on the injury but an effort must also be made to understand .the reason for the injury. This is true for all types of dance, from jazz, tap and ballet to hip-hop and folk dancing. In understanding the types and patterns of injury we can hopefully prevent many in the future, or lessen the extent of the injury if it should occur. There are only a handful of physicians nationwide with in-depth experience in the medical care of dancers and other performing artists.
An understanding of the dancers physical demands and techniques are essential to both the treatment and prevention of dance injuries. There are several types of injuries that occur. A single macrotrauma represents the more obvious acute injuries as illustrated by ankle-sprains, lumbar strains, collisions and falls. Evaluation and treatment of these injuries are very similar to other areas of Sports Medicine.
Injuries also can occur as a result of repetitive microtrauma. These are the chronic overuse type injuries. These are much more common in dance and make up the majority of the injuries seen. They are often subtle and related to improper dance technique. Treatment should not focus only on the injury but should involve an evaluation of the dancers biomechanics and technique. Examples in this category include any types of tendonitis, bursitis, chronic ligament strain, and stress fractures. Also an acute injury can occur superimposed on a chronic overuse injury. An example of this would include a chronic achilles tendonitis which then ruptures acutely. Possible reasons for the chronic overuse injuries must be assessed.
The “Why” of Injuries
The reason that injuries occur, other than accidents, are several fold. There is no ideal sport, and imbalances can occur as a result of any single activity or sport done repetitively. Also specific sports (especially dance) have very specific patterns of injury as a result of technique and repetitive stresses. Also individuals can have “weak links” in their musculoskeletal system which when overstressed can begin to breakdown. Patterns of injuries in ballet are fairly predictable. Anatomically, usually 50% will involve the foot ankle region. Different types of injuries occur depending on the stage of development of the dancer.
The younger dancer commonly has the knee and hip. problems which are often related to forced turnout. The older or professional dancer tends to have problems with the lower leg, foot .and ankle. Back injuries occur at any age or level of skill. Darwinism (Survival of the Fittest) is a factor. Males are spared many of the foot problems females experience related to point work. Instead, the male dancer experiences more ankle and back injuries secondary to lifting, jumping, partnering.