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1st Oct


Physical Therapy for Dance Injuries

Dance is a beautiful combination of art and athleticism, which requires the ultimate in human coordination and control of body movements and balance as well as strength and flexibility, to produce seemingly effortless and fluid motions, however complex they may be.

However, because of the extreme demands on the body, injuries are also common. Furthermore, a dancer’s performance depends on a unique combination of anatomy, technique and biomechanics. If the anatomy is not conducive to allowing a correct dance pattern, either due to congenital bony or soft tissue features, or due to muscle imbalances, the technique will suffer and typically lead to compensatory movements, altered mechanics and overuse tissue strain.

As an example, a classical ballet dancer with limited turnout, or outward rotation in the hip, will often compensate by over rotating the feet and knees, and even increasing the sway in the low back (lordosis), in order to achieve such rotation. This may cause a variety of injuries including strain to the hip joint capsule and predispose the dancer to arthritis, or knee and foot injuries. Therefore it has been recommended that dancers, who at the age of 15 have not achieved 60° of outward (external) rotation in the hip, should stop training for classical ballet.

It has been estimated that near 60% of reported injuries to dancers affect the ankle and foot. Studies have also shown that 60% to 80% of ballet and modern dancers have some history of back injury. A majority of the ankle injures result from performing pointe and demi-pointe work, which are the positions of being completely up on toes, or with the big toe extended upwards. Wear and tear changes of the big toe metatarsophalangeal joint is common and a condition called hallux rigiditus, or limited and painful big toe extension motion due to such arthritis has been reported to affect 30% to 40% of dancers. Other common ankle and foot injuries in dancers are lateral ankle sprains, tendinitis of the Achilles and long big toe flexor tendons, metatarsal stress fractures, plantar fasciitis and foot neuromas. Back injuries are often a result of hyperlordosis (excessive sway), causing overloading of facet joints and discs and predisposing the dancer to degenerative changes.

The physical therapist and the entire health care professional team must have an understanding of dance and its biomechanical and neuromuscular requirements. It is not only necessary to perform a thorough examination to pinpoint which tissues are compromised and painful, but also to analyze the dancer’s mobility and neuromuscular function of the back/trunk, pelvis/hips, knees and ankle-feet, since deficiencies in one area can easily produce secondary problems in other areas. Therefore, both the symptoms and the cause must be addressed. Some forms of dance, and male dancers also often require strength and high function of upper extremities.

Rehabilitation of dancers also needs to be progressed beyond traditional physical therapy exercise, to functional dance specific movements with progressively increased demands and optimal mechanics, to prepare these exceptionally gifted athletic artists for return to professional or recreational dancing.

Best wishes,


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