Overuse Injuries in Dance

Written by Dr. Brianne M. Dwyer, PT, DPT

When it comes to musculoskeletal injuries in the dance world, there are two types: traumatic and non-traumatic. Non-traumatic injuries, typically referred to as overuse injuries, are defined as repetitive stress to muscles, tendons, ligaments or bones. The most common injury for dancers is the variety of overuse injuries that can occur. (1)

FACTORS CONTRIBUTING TO OVERUSE INJURIES

• Poor technical execution (e.g. rolling in, forcing turnout, etc.)
• Frequent repetitive movements without adequate recovery time
• Rapid increase of the intensity, duration and/or frequency of activity
• Environmental conditions (e.g. floor type, shoe style)
• Decreased physical conditioning (i.e. muscle imbalances)
• Females with low body weight or restrictive diets. Female Athlete Triad, which is a medical condition seen in some females who are physically active. Three components are observed: low energy availability with or without disordered eating, menstrual dysfunction, and low bone density. (2)

SIGNS OF AN OVERUSE INJURY (2,3)

• No direct mechanism of injury
• Gradual onset of pain
• Pain with and after activity or persistent pain
• Warmth to the area
• Inflammation may be visible

PREVENTION STRATEGIES

• Cross training in other activities outside of dance
• Development of good technique specific to the dancer’s biomechanical condition
• Listening to your body

The mentality “no pain, no gain” is not appropriate here. Persistent pain especially is not normal and should not be overlooked. There is a 10 percent rule with training progressions. The 10 percent rule states you should increase your weekly training by 10 percent to get to your target. (4) While this is a good general rule, it is not always that simple. For example, adolescent dancers following an academic schedule may have a week off for winter break. These dancers do not need to incrementally return to prior level. However, if those dancers were returning from a summer break of greater than two or three weeks a gradual return is beneficial to reduce risk.

Dancers returning to a season, academic year or in preparation for performance season should start gradually increasing their independent training in preparation. This is where cross training and dance specific workouts come in! Our dance medicine specialists see a lot of overuse injuries at the start of summer intensives, start of the season or academic year, and in preparation for performances (i.e. nutcracker).

WHAT TO DO

Immediate self treatment:

• Activity modification: Reduce the duration, intensity, and/or frequency of dance activity, as well as, changing the pain provoking movement (i.e. change barre to floor barre).
• Ice following dance

When an overuse injury occurs, come see a dance medicine specialist. We assess dance technique and take into consideration your anatomical makeup. Slight individualized changes can make a huge difference in your dance training. Our dance medicine specialists will also develop an exercise program to assist with your current needs, as well as prevent your recurrent or potentially chronic issues.

References:

1. Sobrino, F. J., & Guillén, P. (2017). Overuse Injuries in Professional Ballet: Influence of Age and Years of Professional Practice. Orthopaedic journal of sports medicine, 5(6), 2325967117712704. https://doi.org/10.1177/2325967117712704
2. Committee on Adolescent Health Care. (June 2017). Female Athlete Triad. Committee Opinion. 702 https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/06/female-athlete-triad#:~:text=indicated%2C%20is%20optimal.-,The%20female%20athlete%20triad%20is%20a%20medical%20condition%20observed%20in,spectrum%20of%20disorders%20Figure%201.
3. Deu, R., MD, Green, A., DPT, COMT, & Lasner, A., MSPT, PMA-CPT. (n.d.). Dance Injuries: Diagnosis, treatment and prevention. http://webcast.jhu.edu/Mediasite/Play/e8683d13bc3d4ca6991387a16674df701d
4. Fitzgerald, J. (2012, May 02). The 10 Percent Rule: How to Make it Work for You. https://www.active.com/running/articles/the-10-percent-rule-how-to-make-it-work-for-you?page=2

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