Are you recovering from a recent dance-related injury?
Speak to our specialist team who can help you recover, while offering you support and advice on injury prevention.
For gymnasts and dance enthusiasts, overuse injuries are by far the most common issue. Rather than trauma, common injuries relate to bone stress or stress fractures, tendon and ligament injuries and muscular strains.
These types of injuries can often occur more with dancers as they progress with training, so an assessment and treatment plan should also help dancers prevent future injuries.
Dance and the performing arts can be very demanding activities that require a unique balance of athleticism and artistry. In addition, dancers are required to possess high levels of aerobic fitness, as well as have optimal strength, agility, flexibility and co-ordination.
In contrast to many sporting activities, dancers often participate in technique training sessions for long hours every day performing very repetitive movements, and this can lead to characteristic injury patterns. Recent medical studies have also shown that dancers tend to distinguish less well between pain that is “normalised” in dance performance and pain that is associated with injury.
We recognise the importance of optimal strength, flexibility and stamina, so our highly skilled team of physiotherapists are able to guide dancers back to training safely with the use of innovative equipment such as with Biodex isokinetic assessments.
In some patients, further investigations may be required to gain an understanding of the underlying causes. This could include blood screening and sports nutritional advice and support. You can also get rapid access to ultrasound and MRI scans as a private patient.
Many studies have looked at injury patterns in different types of dance. The most common injuries are seen in the lower leg, foot, ankle, as well as the knee and the lower back.
Dance injuries are generally classified into two different types: acute traumatic injuries and overuse injuries. Traumatic injuries are those that occur acutely to bones, muscles, tendons, ligaments or a combination of these structures from an event.
In contrast, an overuse injury is a term used to describe an injury that occurs from soft tissue damage resulting from repetitive activities or movements over a sustained time period.
The human body has a tremendous capacity to adapt to physical stress from exercise and activity and this is beneficial for our bones, muscles and tendons, making them stronger and more robust. This process, known as remodelling, involves both the breakdown and build-up of new tissue. However, there is a fine balance between the two, and an overuse injury can occur if tissues are not given adequate time to repair and regenerate.
It is important to note that overuse injuries can develop in dancers of all ages, level and technical ability. They are seen in both elite and recreational dancers and can cause a high level of dysfunction.
Overuse injuries can affect bones, causing bone stress or stress fractures. This problem develops when the bone fails to adapt adequately to the mechanical load experienced during physical activity. If a bone is continued to be loaded without adequate rest periods, micro damage can occur causing bone stress and ultimately a stress fracture.
Similarly, when tendons are overused, the tendon can undergo a failed healing response, and this causes an incomplete and disordered repair. This often results in the tendon becoming weaker with a change in structure and increases the risk of further injury.
It is always important to understand how and why your injury has developed, as this will allow your medical team to understand your predisposing factors and optimise your treatment.
There are several factors that can predispose someone to developing an overuse injury. Dance is a physically demanding activity and most high-level dancers perform repetitive movements for several hours a day. Studies have shown that dancing five hours a day or longer (without adequate recovery periods) can lead to an increased risk of bone stress and other injuries.
In addition, due to performance demands, many dancers do not incorporate long recovery sessions into their busy training schedules. This lack of time for structures to “remodel” causes the cycle of overuse in both bone and tendons.
Overuse injuries also occur in people who are returning to dance after injury when they try to make up for lost time by pushing themselves too fast, too soon.
Additional contributory factors also include:
- Lack of appropriate muscle strength or endurance
- Poor core stability
- Muscle imbalance (strong tight muscles versus weak stretched muscles)
- Malalignment or biomechanical issues (e.g. flat foot, hip restrictions)
- Nutrition: reduced energy availability and essential nutrients for bone health, often caused by inadequate diet for training and performance.
- Hormonal and menstrual irregularities
- Training errors
- Suboptimal technique
- Equipment issues e.g. shoe wear or dancing on hard surfaces
Certain musculoskeletal problems, such as flat feet, excessively arched feet, bowlegs, unequal leg length, and poor alignment of the spine, hips, and legs also can increase the likelihood of overuse injuries.
Dancers can reduce their risk of injury by several means and this includes addressing physical attributes, technique, training schedules and nutrition.
- Appropriate training must include muscular strength, power, and endurance; plyometrics; agility; balance; joint stability; and dance-specific techniques. Younger dancers, or dancers who are less well trained, are especially susceptible because they can strive for a technical performance level for which their bodies may not be suited or properly instructed.
- Training schedules need to be tailored to the individual and incorporate adequate rest days to allow for repair and regeneration of tissues.
- Optimal nutrition: dancers should eat appropriately for their level and volume of training. Inadequate nutrition can affect a dancer’s overall energy status and lead to symptoms known as “relative energy deficiency in sport”.
- Rest and recovery (reduction of fatigue) are essential factors in maintaining a dancer’s body that is as resistant to injury.
- Sleep is a very important aspect of both physical and physiological recovery.
- Assessment of footwear: most genres of dance employ specific types of shoes and this must be assessed on an individual basis
The diagnosis can usually be made after a thorough history and physical examination with a Sports Medicine specialist. It is important to understand how the injury developed and evaluate any underlying risk factors you may have.
In some cases, further imaging is needed such as X-rays, MRI or a bone scan. Once a diagnosis has been made, your doctor will discuss treatment options which can involve a period of “offloading” from activities and types of rehabilitation in order to return you to dancing activities safely.
- A highly experienced team, with specialist knowledge of dance related injuries
- 98% of patients would recommend us*
- Rated as ‘Good’ by the Care Quality Commission
- Part of an award-winning hospital group
- State-of-the-art rehabilitation
*Based on data published in the Private Healthcare Information Network.
The clinic is led by Dr Kate Hutchings, Consultant in Sports and Exercise Medicine, who has a background in working with elite ballet dancers at the English National Ballet and the Royal Ballet, London. Dr Hutchings is skilled in the diagnosis and management of both acute and chronic dance injuries and works alongside the clinical team to provide management of athlete wellbeing and advice on screening and injury prevention.
Our clinical team also includes expertise from consultant foot and ankle surgeons, specialist physiotherapists, sports nutritionists and clinical psychologists.