DANCE SCIENCE RESEARCH AND ACADEMIA
Dance is an incredibly popular activity worldwide with a high rate of injury. It is important for dancers to know how to protect their bodies to ensure a long-lasting career. We develop our methods through science-based evidence and research.
If you are interested in learning more about dance science, check out our list of helpful articles and resources!
INJURY PREVENTION
INJURY PREVENTION
ABSTRACT
Background: Dance is a popular activity worldwide that comes with inherently high injury rates. Despite the call for implementation and evaluation of injury prevention strategies, the utility and efficacy of injury prevention practices in dance are unknown. Objective: The primary objective of this systematic review was to describe dance-specific injury prevention strategies in any dance population. The secondary objective was to evaluate the effectiveness of these strategies in the reduction of injury prevalence or incidence rates. Methods: Six electronic databases were searched to March 2024 (Medline, EMBASE, SportDiscus, CINAHL, SCOPUS, Cochrane). Selected studies met a priori inclusion criteria that required original data describing an injury prevention strategy for any genre of dance. Studies were excluded if; no injury outcomes were reported, no injury prevention strategy was utilized, or if dance was used as a therapeutic intervention/fitness. Two reviewers independently assessed abstracts and full texts for inclusion. Study quality was evaluated using the Joanna Briggs Institute Level of Evidence tool. Results: From 2209 potentially relevant records, 8 studies met criteria for inclusion. Injury prevention strategies were diverse across conditioning and exercise programs, neuromuscular training warm-up, psychological coping skills training, and educational programs, with a range of duration and adherence measures. Due to inconsistent injury surveillance methodology, efficacy of these programs could not be determined. Quality of included studies was moderate to high, with moderate to low risk of bias. Conclusions: Efficacy and adherence to dance-specific injury prevention strategies are understudied in the dance science literature. Conditioning and exercise programs are currently the most common injury prevention strategies, with initial evidence suggesting they may be efficacious in reducing injury rates. Further research using valid injury surveillance methodologies and standardized injury definitions to examine the efficacy of these strategies in reducing dance-related injury is needed. Level of evidence: I.
Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2014 Jun;48(11):871-7. doi: 10.1136/bjsports-2013-092538. Epub 2013 Oct 7. PMID: 24100287.
ABSTRACT
Background: Physical activity is important in both prevention and treatment of many common diseases, but sports injuries can pose serious problems. Objective: To determine whether physical activity exercises can reduce sports injuries and perform stratified analyses of strength training, stretching, proprioception and combinations of these, and provide separate acute and overuse injury estimates. Material and methods: PubMed, EMBASE, Web of Science and SPORTDiscus were searched and yielded 3462 results. Two independent authors selected relevant randomised, controlled trials and quality assessments were conducted by all authors of this paper using the Cochrane collaboration domain-based quality assessment tool. Twelve studies that neglected to account for clustering effects were adjusted. Quantitative analyses were performed in STATA V.12 and sensitivity analysed by intention-to-treat. Heterogeneity (I(2)) and publication bias (Harbord's small-study effects) were formally tested. Results: 25 trials, including 26 610 participants with 3464 injuries, were analysed. The overall effect estimate on injury prevention was heterogeneous. Stratified exposure analyses proved no beneficial effect for stretching (RR 0.963 (0.846-1.095)), whereas studies with multiple exposures (RR 0.655 (0.520-0.826)), proprioception training (RR 0.550 (0.347-0.869)), and strength training (RR 0.315 (0.207-0.480)) showed a tendency towards increasing effect. Both acute injuries (RR 0.647 (0.502-0.836)) and overuse injuries (RR 0.527 (0.373-0.746)) could be reduced by physical activity programmes. Intention-to-treat sensitivity analyses consistently revealed even more robust effect estimates. Conclusions: Despite a few outlying studies, consistently favourable estimates were obtained for all injury prevention measures except for stretching. Strength training reduced sports injuries to less than 1/3 and overuse injuries could be almost halved.
Critchley ML, Rio E, Friesen KB, Räisänen AM, Kenny SJ, Emery CA. Injury Prevention Strategies in Dance: A Systematic Review. Journal of Dance Medicine & Science. 2026;30(1):65-73. doi:10.1177/1089313X251314987
ABSTRACT
Dancers experience high levels of persistent pain but continue to dance despite risk of injury. A dancer’s identity is often rigid, restricted, and powerful suggesting that the integration of pain and identity will manifest differently for dancers compared to non-dancer chronic pain populations. Using the biopsychosocial model of health may help to elucidate the interplay between dancer identity and the pain dancers experience. Semi-structured interviews were conducted with twelve professional or vocational student dancers who were either currently performing or retired. Dancers engaged in a wide range of genres including ballet, contemporary, musical theatre, HipHop, and Latin. Using reflexive thematic analysis three themes were identified: “Maintaining Dancer Identity through the Pain” which highlighted the foreclosed dancer identity and how dancers normalise and reinterpret responses to pain to maintain their identity, “Just push through: Gatekeeping the pain narrative” that discusses how the dance world valorises dancing in pain and polices the pain narrative, and “An embodied pain identity” which considers how physical pain is psychologically reconstructed to protect dancer identity. Overall dancers had an ambiguous relationship with pain where pain both strengthened their foreclosed dancer identity, thus protecting them from identity crisis, and also threatened survival of their dancer identity. The analysis highlights the importance of integrating the biological, social and psychological aspects of pain to understand pain in dancers. Furthermore it highlights the importance of bespoke interventions for different pain populations. Future research should explore the relevance of the findings in other populations with restricted identities such as elite athletes.
Clegg H, Blotor L, Tilley M. “Dancing in Pain is a Symbol of Determination” – Understanding dance related pain in relation to dancer identity using the biopsychosocial model of health. The Journal of Pain, 2026; 42
ABSTRACT
Using Moustakas’s modification of Van Kaam’s systematic procedures for conducting transcendental phenomenological research, we explored ballet culture and identity and their impact on ballet dancers’ mental health. Participants included four current professional ballet dancers and four previous professionals. Four main themes emerged: (a) ballet culture—“it’s not all tutus and tiaras”; (b) professional ballet dancers’ identity—“it is a part of me”; (c) mental health experiences—“you have to compartmentalize”; and (d) counseling and advocacy—“the dance population is unique.” Suggestions for counselors when working with professional ballet dancers and professional athletes, such as fostering awareness about ballet culture and its impact on ballet dancers’ identity and mental health, are provided. We also discuss recommendations to develop future research focusing on mental health treatment for this population.
Gregory, J. Claire & Interiano-Shiverdecker, Claudia. (2021). Behind the Curtain: Ballet Dancers’ Mental Health. The Professional Counselor. 11. 423-439. 10.15241/jcg.11.4.423.
ABSTRACT
Personal, economical, psychological, and physical factors increase a ballet dancer's stress, which can result in a higher risk for injuries. Ballet dancers experience injuries to the foot, ankle, knee, hip, or back. The constant fear of injuries is universal among dancers because injuries can lead to permanent disability and the end of their ballet career. Although early treatment of injuries is critical, there are multiple barriers to receiving treatment. Some of the barriers include misunderstanding from the health care community, cost of treatment, time constraints, fear of unemployment, and dancers' viewing injuries and pain as a way of life. Occupational health nurses are in an excellent position to start programs in this unexplored area of occupational health nursing. Nurses must advocate for this population of workers and help dancers in their battle against injury, pain, disability, and psychological distress.
Kelman BB. Occupational hazards in female ballet dancers. Advocate for a forgotten population. AAOHN J. 2000 Sep;48(9):430-4. PMID: 11760290.
Long-Term Athletic Development: Part 2: Barriers to Success and Potential Solutions
04
Lloyd, Rhodri S and Oliver, Jon L and Faigenbaum, Avery D and Howard, Rick and De Ste Croix, Mark B and Williams, Craig A and Best, Thomas M and Alvar, Brent A and Micheli, Lyle J and Thomas, D. Phillip and Hatfield, Disa L and Cronin, John B and Myer, Gregory D
February 19, 2015
ABSTRACT
The first installment of this two-part commentary reviewed existing models of long-term athletic development. However, irrespective of the model that is adopted by practitioners, existing structures within competitive youth sports in addition to the prevalence of physical inactivity in a growing number of modern-day youth may serve as potential barriers to the success of any developmental pathway. The second part of this commentary will first highlight common issues that are likely to impede the success of long-term athletic development programs and then propose solutions that will address the negative impact of such issues.
Myer, G., Cronin, J., Hatfield, D., Thomas, D., Micheli, L., Alvar, B., Best, T., Williams, C., De Ste Croix, M. B., Howard, R., Faigenbaum, A., Oliver, J., & Lloyd, R. (2015). Long-Term Athletic Development, Part 2: Barriers to Success and Potential Solutions. Journal of Strength & Conditioning Research, 29(5), 1451–1464. https://doi.org/10.1519/01.JSC.0000465424.75389.56
ABSTRACT
In the last decade, injury prevention has received a lot of attention in sports medicine, and recently international sports-governing bodies, such as the International Olympic Committee, declared the protection of the athletes’ health as one of their major objectives. In 1994, the Fédération Internationale de Football Association (FIFA) established its Medical Assessment and Research Centre (F-MARC) with the aim ‘to prevent football injuries and to promote football as a healthenhancing leisure activity, improving social behaviour’. Since then, FIFA has developed and evaluated its injuryprevention programmes ‘The 11’ and ‘FIFA 11+’ have demonstrated in several scientific studies how simple exercise-based programmes can decrease the incidence of injuries in amateur football players. This paper summarises 18 years of scientific and on-field work in injury prevention by an international sports federation (FIFA), from formulating the aim to make its sport safer to the worldwide dissemination of its injury-prevention programme in amateur football.
Bizzini M, Junge A, Dvorak JImplementation of the FIFA 11+ football warm up program: How to approach and convince the Football associations to invest in preventionBritish Journal of Sports Medicine 2013;47:803-806.
Concussion & Dance
Cardio Training
Concussion & Dance
ABSTRACT
Sport concussion receives substantial attention as a public health concern. Conversely, performing artists, including dancers, sustain concussions, but these aesthetic athletes do not receive the same level of consideration nor care for this injury as that offered to traditional athletes. The concussion literature pertaining to dance is sparse, and, to our knowledge, no recommendations exist for the crucial aspect of care related to returning to dance following a concussion. The purpose of this article is to assimilate the current knowledge about post-concussion return to activity management in sport—the closest analog of the physical demands required in dance—as a means to delineate a framework for returning to dance following a concussion. Specific guidance is provided based on a review of evidence-based practice so clinicians can ensure that dancers return safely to both their dance activity and any academic work they are required to undertake. Concussion in dance is not an infrequent occurrence and dancers and healthcare practitioners alike will benefit from dance-specific guidance for returning to dance post-concussion. Overall, the principles that form the foundation for return-to-sport decisions are remarkably robust for application to dance.
Ojofeitimi, Sheyi, McIntyre, Lauren, Barchi, Elizabeth, Rae, Sarah S., Winnitoy, Brittney, Russell, Jeffrey A., Guidelines for Returning to Dance Following Concussion: Adaptations From Sport Concussion Literature, International Journal of Clinical Practice, 2024, 1449433, 14 pages, 2024. https://doi.org/10.1155/2024/1449433
ABSTRACT
Dance and other performing arts are highly physical activities, and performers are subject to head impacts from many sources. The amount of scientific literature devoted to concussions in performing arts pales in comparison with that afforded sports concussions. Dancers and other performing artists need the same type of timely and sophisticated health care for concussions that traditional athletes receive. Performing arts environments require specially designed approaches for managing concussions. Concussions today receive unparalleled attention; yet, this is virtually exclusive to the context of sports and military applications. The most recent meeting of a premier international consortium on concussion resulted in recommendations devoted entirely to sports. Despite occupational hazards in dance, theater, circus arts, and film/television stunt performance (and a large workforce in these artforms), performing arts concussions receive minimal consideration.
Jeffrey A. Russell, Lauren McIntyre, Lori Stewart, Tina Wang,. Concussions in Dancers and Other Performing Artists, Physical Medicine and Rehabilitation Clinics of North America. Volume 32, Issue 1, 2021, Pages 155-168. https://doi.org/10.1016/j.pmr.2020.09.007.
hypermobility
hypermobility
ABSTRACT
Objectives: Determine the prevalence of lower limb hypermobility in elite dancers and secondarily to describe the patterns of mobility. Design: Cross sectional. Setting: Self-report questionnaires and physical assessments were undertaken at a tertiary dance institution and a professional ballet company. Participants: Fifty-seven pre-professional and 29 professional ballet dancers (21±4years, 64% female, mean 13.7years training) were recruited. Main outcome measures: Lower Limb Assessment Score (LLAS) was used to assess hypermobility. Prevalence was determined by descriptive statistics, between-leg and -group comparisons were analysed using the chi-square statistic and the pattern of mobility by cluster analyses. Results: The right leg was significantly more hypermobile than the left for the whole cohort (44% vs 40% meeting ≥7/12 for the LLAS; LLAS mean/12(SD): right:5.0(2.4) and 7.6(1.9); left:4.8(2.1) and 6.7(2.0) in pre-professionals and professionals respectively (p = 0.02)). Subtalar pronation (p < 0.001) and hip abduction/external rotation (left:p = 0.01; right:p < 0.001) were significantly more hypermobile bilaterally in professionals. Three hypermobility profiles on the left and four on the right lower limb were identified. Conclusions: This paper presents unique lower limb hypermobility profiles identified in elite dancers.
Phan K, Nicholson LL, Hiller CE, Chan C. Prevalence and unique patterns of lower limb hypermobility in elite ballet dancers. Phys Ther Sport. 2020 Jan;41:55-63. doi: 10.1016/j.ptsp.2019.11.005. Epub 2019 Nov 14. PMID: 31759239.
ABSTRACT
Hypermobility spectrum disorder (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) can cause widespread or chronic pain, fatigue, and proprioceptive and coordination deficits resulting in functional restrictions. These conditions are common and often unrecognized, and patients are likely to present in physical therapy for musculoskeletal injuries, pain, or coordination deficits. Although physical therapy is considered central to managing these conditions, many patients report pain and iatrogenic injuries due to inappropriate interventions. The diagnostic classification for these conditions was revised in 2017 to supersede previous diagnostic categories of Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome-hypermobility type/type III. It is now known that these conditions affect multiple body systems and not just joints and that patients require a holistic approach. This Perspective article will describe the 2017 diagnostic classification system, clinical presentation, examination, evaluation, and management of patients with HSD/hEDS. Both adult and pediatric cases are presented to illustrate the patient management concepts discussed. This knowledge can lead to more effective management of this patient population.
Russek LN, Stott P, Simmonds J. Recognizing and Effectively Managing Hypermobility-Related Conditions. Phys Ther. 2019 Sep 1;99(9):1189-1200. doi: 10.1093/ptj/pzz078. PMID: 31158283.
ABSTRACT
Background: HSD and hEDS are complex and multisystemic disorders of connective tissue with arthralgia and other musculoskeletal features being acknowledged in the 2017 diagnostic criteria. Physiotherapy is a core component of management but there is no clear consensus regarding its effectiveness. For the last 21/2 years we have run an NHS group-based physiotherapy intervention consisting of four sessions focussing on patient education, exercises and lifestyle advice. The aim of this medical student-led project was to evaluate this service by canvassing patients' opinions and experiences and asking them to propose ways of improving care. Results: Analysis of the free-text fields revealed three major themes: meeting people; effectiveness of the course; and lack of written information. Patients found it particularly valuable to meet others with similar concerns and experiences. Patients reported benefit from learning exercises and relaxation techniques that they have built into their daily routines. Some patients came to realise that they can be active without causing injury and therefore incorporated regular exercise into their lifestyle. All patients reported actively implementing advice provided throughout the course. However, there was a lack of written information: patients requested leaflets relevant to the contents of classes. They also highlighted lack of information about the widespread effects of HSD/hEDS that they could share with friends, family and work colleagues. Conclusion: Patients particularly valued learning alongside others with the same condition, and many reported actively implementing advice provided. An important area for development was written patient education and a resource pack needs generating to improve this.
Dolcie M Paxton, Rachel Lewis, Shea Palmer, Emma M Clark, P85 The effectiveness of group physiotherapy interventions for hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD): a service evaluation project, Rheumatology, Volume 59, Issue Supplement_2, April 2020, keaa111.083, https://doi.org/10.1093/rheumatology/keaa111.083
mental and physical wellness
mental and physical wellness
ABSTRACT
Understanding the physical and mental health of collegiate dancers is important for developing appropriate screening protocols and treatment interventions. This study aims to provide descriptive data on the overall health, injury burden, and well-being of a group of collegiate dancers, including the interactions between injury, nutrition, and mental health, to provide insight for wellness screening and interventions in collegiate dance programs. Methods: Members of the School of Dance at the University of Utah were sent an electronic general health survey. The survey included questions regarding medical history, family history, injuries, diet, sleep quality, symptoms of depression and anxiety, and history of eating disorders. Results: Of the 231 dancers who received the survey, 198 responded (response rate = 85.7%). Fifty 2% of respondents had an active injury. Symptoms of depression and anxiety were common (35.4%), and 37.4% of the dancers were interested in receiving mental health support. Symptoms of depression and anxiety had a significant association with both a history of injury and active injuries (P = .033 and .039, respectively). History of eating disorder was also significantly associated with active injuries (P = .005). The most commonly injured body area was ankle or foot (n = 144, 72.7%), followed by lower leg or shin (n = 76, 38.4%), and knee (n = 61, 30.8%). Over a quarter of the dancers (n = 54, 27.3%) reported having trouble sleeping, and 9.1% reported having a history of eating disorder. Conclusions: This study highlights the important interplay between mental health, sleep, nutrition, and injury. These results show that in a group of collegiate dancers, active injuries and mental health concerns are common, and that there are statistically significant associations between injury, nutrition, and mental health. These data provide insight into factors that affect dancer wellness and help inform future screening and intervention protocols for dance programs.
Michaels C, Holman A, Teramoto M, Bellendir T, Krautgasser-Tolman S, Willick SE. Descriptive Analysis of Mental and Physical Wellness in Collegiate Dancers. J Dance Med Sci. 2023 Sep;27(3):173-179. doi: 10.1177/1089313X231178091. Epub 2023 Jun 1. PMID: 37264604; PMCID: PMC10456971.
ABSTRACT
Sleep is essential for athletes and dancers to optimize recovery. Poor sleep negatively affects cognitive function and injury risk in athletes. Increased athletic participation (hours) is associated with decreased total sleep and quality in athletes. Still, information about how sleep is related with exposure hours and injury in collegiate dancers remains unclear. We examined the relationships among the Athlete Sleep Behavior Questionnaire (ASBQ), dance exposure hours (DEHr), and injuries in collegiate dancers over a 7 -month period (August 2019-February 2020). Methods: Seventy-two dancers (58 female, 14 male; 19.7 ± 1.4 years) completed the 18 question ASBQ at the start of each month (Scale:1 = Never, 5 = Always; Global Scores ≤36 = "good sleep behavior" and ≥42 = "poor sleep behavior"). A DEHr was recorded as 1 hour of dance participation in class, rehearsal, or performance. Injuries were defined as any condition where the dancer sought medical attention, and we calculated an injury rate for total injuries (IR/1000 DEHr). Pearson correlations examined relationships among ASBQ, DEHr, and injuries (P ≤ .05). Results: Dancers participated in 467.8 ± 45.7 DEHr over 7 months, with 14 dancers suffering 18 injuries (IR = 0.5/1000-DEHr; 95% CI:0.3-0.8). Overall, dancers reported poor sleep behaviors (42.6 ± 6.4). ASBQ scores, DEHr, and injuries in August-October, and December-February were not related, except for a weak positive relationship between ASBQ scores and DEHr in November (r = .28, P = .04). Conclusions: Sleep, DEHr, and injuries were inconsistently related in collegiate dancers. Sleep and DEHr were only correlated during the month where dancers had 2 performance weeks. While we did not observe this relationship every month, performance weeks may have negatively affected sleep in November. Despite consistent poor sleep, sleep did not seem to negatively affect injury risk during the 7 -month study period. Future researchers should validate the ASBQ in dancers.
Fauntroy V, Stork A, Hansen-Honeycutt J, Deu R, Klee H, Martin J, Ambegaonkar JP. Sleep, Dance Exposure Hours, and Injury Risk in Collegiate Dancers. J Dance Med Sci. 2023 Jun;27(2):92-98. doi: 10.1177/1089313X231177179. Epub 2023 Jun 1. PMID: 37264640.
Balance Training
Balance Training
ABSTRACT
To assess the effects of a specific injury prevention neuromuscular training programme (IPP) on balance and lower-limb asymmetry in female competitive dancers (age 12–20 years; height 1.57 ± 0.06 m; weight 24.27 ± 2.79 kg) were randomly allocated to an active general control (GIPP, n = 7) and specific (SIPP n = 7) group. Both programmes were conducted for 6 weeks, with a frequency of three sessions per week. Dynamic balance and lower-limb asymmetry were assessed before and after the intervention. A greater improvement in right-leg total balance (86.6[84.0–90.5] vs 93.8[86.7–99.4];p = 0.035), left-leg total balance(87.8[81.0–89.1] vs 93.6[90.6–100.0];p = 0.013), left-leg anterior balance (71.9[69.1–72.2] vs 74.6[72.0–77.3];p = 0.041), left-leg posteromedial balance (80.5[72.9–83.3] vs 85.9[83.0–94.0];p = 0.048), and left-leg posterolateral balance (79.5[70.4–84.5] vs 85.0[80.0–88.5];p = 0.048) was observed in the SIPP group compared to the GIPP group. No other significant intra-group changes nor inter-group differences were noted. Therefore, compared to a GIPP, a SIPP induced greater improvements in lower-limb dynamic balance in female dancers, potentially leading to greater reduction in lower-limb injury risk.
Cofré-Fernández, V., Burgos-Estrada, N., Meneses-Hermosilla, V., Ramirez-Campillo, R., Keogh, J. W., & Gajardo-Burgos, R. (2023). Effects of a specific injury prevention neuromuscular training program for young female dancers. A randomized-controlled trial. Research in Sports Medicine, 31(2), 90–100. https://doi.org/10.1080/15438627.2021.1943388
ABSTRACT
Objective: To investigate the effects of a 6-week integrated training program on the ankle joint reposition sense and postural stability in ballet dancers. Methods: Sixteen female ballet dancers participated in the study and underwent a 6-week integrated training program consisting of plyometric, proprioception and core stability exercises along with a home program involving additional ankle muscle strengthening and stretching. The ankle joint reposition tests and the parameters of the center of pressure (COP) while performing grand-plie (deep squatting) and releve en demi-pointe (standing on balls of foot) movements were measured before and after training. Results: After 6 weeks, participants showed significantly smaller absolute ankle joint reposition errors in dorsiflexion (p = 0.031), plantarflexion (p = 0.003) and eversion (p = 0.019) compared to the pre-training measurement. Furthermore, after training, a significantly slower average COP speed at pre-equilibrium during grand-plie movement (p = 0.003) and pre-equilibrium phase of releve en demi-pointe (p = 0.023) were observed. In addition, the maximum COP displacement in the medial-lateral direction was significantly smaller at pre-equilibrium phase during grand-plie (p = 0.044) and releve en demi-pointe movements (p = 0.004) after training. Conclusions: The 6-week integrated training program improved the ankle joint reposition sense and postural control in the medial-lateral direction during grand-plie and releve en demi-pointe movements.
Lin C-W, You Y-L, Chen Y-A, Wu T-C, Lin C-F. Effect of Integrated Training on Balance and Ankle Reposition Sense in Ballet Dancers. International Journal of Environmental Research and Public Health. 2021; 18(23):12751. https://doi.org/10.3390/ijerph182312751
ABSTRACT
This study aimed to understand the acute responses on the muscular activity of primary movers during the execution of a half-squat under different unstable devices. Fourteen male and female high-standard track and field athletes were voluntarily recruited. A repeated measures design was used to establish the differences between muscle activity of the primary movers, the body centre of mass acceleration and the OMNI-Perceived Exertion Scale for Resistance Exercise (OMNI-Res) in a half-squat under four different stability conditions (floor, foam, BOSU-up and BOSU-down). A significant correlation was found between the highest performance limb muscle activity and body centre of mass acceleration for half-squat floor (r = 0.446, p = 0.003), foam (r = 0.322, p = 0.038), BOSU-up (r = 0.500, p = 0.001), and BOSU-down (r = 0.495, p = 0.001) exercises. For the exercise condition, the half-squat BOSU-up and BOSU-down significantly increased the muscle activity compared to half-squat floor (vastus medialis: p = 0.020, d = 0.56; vastus lateralis: p = 0.006, d = 0.75; biceps femoris: p = 0.000–0.006, d = 1.23–1.00) and half-squat foam (vastus medialis: p = 0.005–0.006, d = 0.60–1.00; vastus lateralis: p = 0.014, d = 0.67; biceps femoris: p = 0.002, d = 1.00) activities. This study contributes to improving the understanding of instability training, providing data about the acute muscular responses that an athlete experiences under varied stability conditions. The perturbation offered by the two BOSU conditions was revealed as the most demanding for the sample of athletes, followed by foam and floor executions.
Buscà, B., Aguilera-Castells, J., Arboix-Alió, J., Miró, A., Fort-Vanmeerhaeghe, A., & Peña, J. (2020). Influence of the Amount of Instability on the Leg Muscle Activity During a Loaded Free Barbell Half-Squat. International Journal of Environmental Research and Public Health, 17(21), 8046. https://doi.org/10.3390/ijerph17218046
ABSTRACT
Kinesio tape and proprioceptive exercises are both used for increasing balance in dancers. The purposes of this study were to: a) determine the acute effect of kinesio tape (KT) application on the ankle joint on balance performance, b) investigate the effects of an 8-week proprioceptive-neuromuscular (PN) training program on balance performance, and c) compare their effects vs modern dance technique classes alone. Thirty-three trained, university-level modern dance students (9 male, 24 female) were divided randomly into three groups: kinesio tape (KT, n=11), proprioceptive-neuromuscular (PN, n=11), or control (n=11). Static (turn-out passé-opened eyes/relevé and turn-out passé-closed eyes/flat foot), semi-dynamic (airplane), and dynamic balance (monopodalic-straight and -transverse in a turn-out passé-eyes opened/flat foot) tests were performed before and after the intervention. One day after pre-tests, KT mechanical correction technique was applied to the left ankle joint (supporting leg) in the KT group, and tests were repeated to determine the acute effect of KT. The PN group participated in an 8-week balance training program (2 days/wk, 60 min/day) involving exercises using stable and unstable surfaces. Significant improvements were observed for all static and dynamic balance tests in the PN group; semi-dynamic airplane and dynamic monopodalic-straight and transverse tests improved in the KT group; and only semi-dynamic airplane test scores changed significantly for the control group (p<0.05). Our findings suggest that with the exception of the semi-dynamic airplane test, both PN training and KT application were more effective at improving balance performance for modern dancers than modern dance technique classes alone.
Tekin, D., Agopyan, A., & Baltaci, G. (2018). Balance training in modern dancers: Proprioceptive-neuromuscular training vs kinesio taping. Medical Problems of Performing Artists, 33(3), 156–165. https://doi.org/10.21091/mppa.2018.3022
SCOLIOSIS & BACK
SCOLIOSIS & BACK
The Impact of Competitive Asymmetric Sports on the Development of Idiopathic Scoliosis in Young Athletes: A Literature Review
01
Paulina Jakubowska, Mikołaj Szaryński, Martyna Jakubowska, Kamila Prokopczyk, Antoni Wasilczuk, Michał Józef Peszt, Julia Matuszewska, Martyna Poręba, Kacper Poręba, Rafał Rusiłowicz, Aleksandra Lewandowska-Mackiewicz
December 31, 2025
ABSTRACT
Sleep is essential for athletes and dancers to optimize recovery. Poor sleep negatively affects cognitive function and injury risk in athletes. Increased athletic participation (hours) is associated with decreased total sleep and quality in athletes. Still, information about how sleep is related with exposure hours and injury in collegiate dancers remains unclear. We examined the relationships among the Athlete Sleep Behavior Questionnaire (ASBQ), dance exposure hours (DEHr), and injuries in collegiate dancers over a 7 -month period (August 2019-February 2020). Methods: Seventy-two dancers (58 female, 14 male; 19.7 ± 1.4 years) completed the 18 question ASBQ at the start of each month (Scale:1 = Never, 5 = Always; Global Scores ≤36 = "good sleep behavior" and ≥42 = "poor sleep behavior"). A DEHr was recorded as 1 hour of dance participation in class, rehearsal, or performance. Injuries were defined as any condition where the dancer sought medical attention, and we calculated an injury rate for total injuries (IR/1000 DEHr). Pearson correlations examined relationships among ASBQ, DEHr, and injuries (P ≤ .05). Results: Dancers participated in 467.8 ± 45.7 DEHr over 7 months, with 14 dancers suffering 18 injuries (IR = 0.5/1000-DEHr; 95% CI:0.3-0.8). Overall, dancers reported poor sleep behaviors (42.6 ± 6.4). ASBQ scores, DEHr, and injuries in August-October, and December-February were not related, except for a weak positive relationship between ASBQ scores and DEHr in November (r = .28, P = .04). Conclusions: Sleep, DEHr, and injuries were inconsistently related in collegiate dancers. Sleep and DEHr were only correlated during the month where dancers had 2 performance weeks. While we did not observe this relationship every month, performance weeks may have negatively affected sleep in November. Despite consistent poor sleep, sleep did not seem to negatively affect injury risk during the 7 -month study period. Future researchers should validate the ASBQ in dancers.
AKUBOWSKA, Paulina, SZARYŃSKI, Mikołaj, JAKUBOWSKA, Martyna, PROKOPCZYK, Kamila, WASILCZUK, Antoni, PESZT, Michał Józef, MATUSZEWSKA, Julia, PORĘBA, Martyna, PORĘBA, Kacper, RUSIŁOWICZ, Rafał and LEWANDOWSKA-MACKIEWICZ, Aleksandra. The Impact of Competitive Asymmetric Sports on the Development of Idiopathic Scoliosis in Young Athletes: A Literature Review. Quality in Sport. Online. 31 December 2025. Vol. 48, p. 67058. [Accessed 23 July 2026]. DOI 10.12775/QS.2025.48.67058.
ABSTRACT
Musculoskeletal abnormalities have been reported among female professional ballet performers due, in part, to intrinsic predispositions related to joint and/or connective tissue laxity and extrinsic effectors such as reduced energy availability, low body mass, and high training volumes that may increase the risk of developing idiopathic scoliosis (IS). The purpose of this investigation was to characterize IS prevalence in this population. We hypothesized that there would be elevated prevalence in female performers and that those with IS would exhibit reduced bone mineral density (BMD), body mass, fat mass, and lean mass. Conclusions: Female professional ballet performers demonstrate a heightened prevalence of IS that, in addition to intrinsic predisposition, is associated with modifiable factors such as reduced fat mass commonly associated with reduced energy availability known to impact musculoskeletal health in athletes. Future investigations should seek to determine the prevalence of IS in other young female athlete populations commonly exposed to high degrees of activity and reduced energy availability.
Bondar, K., Haghshenas, V., Lambert, B., McCulloch, P., Hirase, T., Aflatooni, J., Saifi, C., & Harris, J. (2025). Increased Prevalence of Scoliosis in Female Professional Ballet Performers. Journal of Bone and Joint Surgery, 107(11), 1227–1234. https://doi.org/10.2106/JBJS.24.00670
ABSTRACT
Background: The prevalence of Idiopathic Scoliosis (IS) is 2% to 3% in the general population. The presence of a hump can be detected clinically, but only X-rays can confirm the diagnosis. Early detection and treatment can prevent IS progression and complications. There is a lack of knowledge about the actual prevalence and predictors of IS among dancers. Purpose: To investigate the prevalence of IS in dancers, how it is diagnosed and classified, and explore possible predictors. Study Design: Prevalence systematic review with meta-analysis. Methods: PubMed, Embase, Scopus, CINAHL Plus databases and the Cochrane Central Register of Controlled Trials were searched up to August 2024. Results: Fifteen studies, accounting for 5709 dancers aged 8 to 41 years, were included in the analysis. The overall prevalence of IS was 15.8% (10%-22%). When X-rays were not performed, clinical examination alone skewed the prevalence, making it appear 48.1% to 73.4% higher. Conclusions: The prevalence of IS in dancers, regardless of level of training or age, has been found to be at least three times higher than in the general population. However, the lack of standardized assessment and diagnostic tools makes these results questionable. Dancers’ screening for scoliosis, with standardized testing procedures, should be used for X-rays referral, to allow for early diagnosis and treatment.
Contri A, Muccioli S, Castagnoli F, De Bartolomeo O. Prevalence and Characteristics of Idiopathic Scoliosis in Dancers: A Systematic Review and Meta-Analysis. Journal of Dance Medicine & Science. 2026;30(2):176-201. doi:10.1177/1089313X251332712
Factors Influencing Optimal Bracing Compliance in Adolescent Idiopathic Scoliosis: A Single-center Prospective Cohort Study
04
Tomoyuki Asadac, Toshiaki Kotania, Tsuyoshi Sakumaa, Yasushi Iijimaa, Kotaro Sakashitab, Yosuke Ogatab, Tsutomu Akazawad, Shohei Minamia, Seiji Ohtorie, Masao Kodab, Masashi Yamazaki
December 15, 2024
ABSTRACT
Objective: To identify factors contributing to optimal bracing compliance in adolescent idiopathic scoliosis (AIS). Background: Poor brace compliance is a key factor affecting brace treatment success in AIS. Predictive factors influencing optimal brace compliance to achieve brace treatment success remain unknown. Results: Among 122 patients, 59.0% achieved optimal bracing time by six months. The achieved group indicated higher scores in the satisfaction domain before bracing (3.3±0.7 vs. 3.1±0.6; P=0.034). Multivariable logistic regression analysis demonstrated that the satisfaction domain before bracing was an independent factor associated with the achievement of the optimal bracing time [OR 1.97 (95% CI: 1.00–3.89), P=0.049]. The model with bracing at one-month follow-up also demonstrated the bracing at 1 month was a significant factor [OR 1.52 (95% CI: 1.30–1.79), P<0.001]. Conclusions: Optimal bracing compliance in AIS is significantly influenced by prebracing satisfaction and brace compliance at earlier time points. These findings highlight the need to address psychological factors and early compliance in AIS bracing treatment. SRS-22r can be useful to identify the need for psychological support.
Ohtori, S., Akazawa, T., Minami, S., Ogata, Y., Koda, M., Yamazaki, M., Iijima, Y., Sakuma, T., Kotani, T., Sakashita, K., & Asada, T. (2024). Factors Influencing Optimal Bracing Compliance in Adolescent Idiopathic Scoliosis: A Single-center Prospective Cohort Study. Spine, 49(24), 1708–1715. https://doi.org/10.1097/BRS.0000000000004997
ABSTRACT
Background: Many adult dancers suffer from low back pain (LBP), which interferes with their movement strategies. A group that merits further attention are adolescent dancers as high levels of physical activity are associated with a higher risk to develop LBP. Objective: The aims of this cross-sectional study were (i) to investigate if delayed bone maturation and aberrant menstrual cycle were present in pre-professional female adolescent dancers and (ii) whether these ailments or other physical impairments could be related to LBP. OUTCOME MEASURES: Bone maturation, menstrual cycle, hypermobility, scoliosis, and LBP. Reults: Fifteen out of 50 dancers reported a history of LBP. Significant differences were observed between calendar age and skeletal age in adolescent dancers (p<0.05). A considerable proportion of dancers showed delayed bone maturation (32%) or an aberrant menstrual cycle (53%), but this was not related to LBP (p>0.05). Scoliosis and generalized joint hypermobility were also not related to LBP (p>0.05). However, dancers with a history of LBP started dancing 2 years earlier (p<0.01), had significantly less hip internal rotation (p<0.05), and showed asymmetrical hip ROM (p<0.05). Conclusion: Based on the results of current study, delayed bone maturation and menstrual cycle disorders are common in pre-professional female dancers, but this was not related to LBP. Additionally, out of 27 variables, only starting dance activities under age 6 years old, showing hip asymmetry, and showing less internal hip rotation may be contributing factors for the development of LBP in pre-professional dancers.
Everaert, J., Fierens, B., Steinberg, N., Mahaudens, P., Balagué, F., Gielen, P., Gielen, J., van Breda, E., & Roussel, N. (2024). Association between bone maturation, menstrual cycle, hypermobility, scoliosis, and low back pain in pre-professional female adolescent dancers. Medical Problems of Performing Artists, 39(4), 162–168. https://doi.org/10.21091/mppa.2024.04019
Aristic sports
Aristic sports
figure skating
figure skating
Jumping Performance Development in Junior Single Figure Skating at International Championships and Competitions and Its Implications for Higher Risk of Acute and Overuse Injuries: A Retrospective Observational Study from 2005 to 2020
01
Zoé Stehlin, Felix Karl-Ludwig Klingebiel, Hans-Christoph Pape, Bergita Ganse, Thomas Rauer
July 1, 2025
ABSTRACT
Background: Although the difficulty level of figure skating programs has increased in the last two decades, particularly at the junior level, trends in performance have not been reported. This retrospective observational study investigated performance development trends among the top five junior figure skaters competing at international levels in both the ladies’ and men’s singles disciplines from 2005 to 2020. Data from 160 junior single ladies and 160 junior single men were analyzed. The focus was on the progression of technical elements—particularly jumps—and their potential correlation with injury risk. It was hypothesized that younger athletes are increasingly performing jumps with more revolutions, thereby enhancing overall competition standards. Results: The results indicate a significant increase in the execution of higher-revolution jumps among junior athletes. Between 2005 and 2012, the frequency of double jumps declined across all events, with the most pronounced reductions observed in the Ladies’ Junior World Championships (Δ = 0.216, p = 0.004, d = 1.64) and the Men’s Junior World Championships (Δ = 0.500, p = 0.001, d = 1.82). From 2005 to 2011, the frequencies of triple and quadruple jumps increased, while double jumps remained stable or showed only slight increases. Triple jumps showed slight downward trends (e.g., R2 = 0.0202 at the Men’s Junior World Championships). Conclusions: In summary, increases in more difficult jumps were found, with simultaneous decreases in less difficult jumps. As jump complexity rises, a parallel increase in sport-specific injury incidence can be anticipated, highlighting the need for proactive strategies for injury prevention and athlete well-being.
Stehlin, Z., Klingebiel, F. K.-L., Pape, H.-C., Ganse, B., & Rauer, T. (2025). Jumping Performance Development in Junior Single Figure Skating at International Championships and Competitions and Its Implications for Higher Risk of Acute and Overuse Injuries: A Retrospective Observational Study from 2005 to 2020. Journal of Functional Morphology and Kinesiology, 10(3), 251. https://doi.org/10.3390/jfmk10030251
ABSTRACT
Background: Overuse injuries and stress fractures are common in figure skating. Risk reduction strategies based on the current available evidence may not be fully utilised by senior elite skaters in the UK. This study aimed to establish the training practices of this cohort and identify areas for improvement. Methods: An anonymous survey with 34 questions was distributed to all athletes from the senior British National Figure Skating Championships in the UK (n = 28) detailing training practices, injury prevention strategies, nutritional habits, and injury history and knowledge. Comparisons were made against recommended best practices from available literature with analyses for injury prevalence and gender or discipline (Fisher's exact test). Results: Responses from 16 athletes demonstrated previous major injury (4 weeks away from training) in 81 %, and 13 % had sustained stress fractures. High uptake in the use of rest days (100 %) and strength and conditioning training (94 %) was demonstrated. No skaters regularly monitored jump loads. Dietary monitoring was performed by 31 % of respondents, with 44 % of skaters reporting previous nutritional deficiency diagnosis. All skaters (100 %) desired better injury prevention education. Conclusion: Load monitoring, including jump counts, dietary tracking, and provision of accessible educational resources for skaters and coaches are areas of potential improvement in practice and future research. Screening for vitamin D and iron deficiency may be of benefit in this population.
Thomas A. Naylor,. Identifying training factors for injury risk reduction in UK elite figure skaters – A pilot study. JSAMS Plus. Volume 6. 2025. https://doi.org/10.1016/j.jsampl.2025.100112.
ABSTRACT
Figure skating is associated with a high prevalence of sport-specific injuries and overuse symptoms. Impacts are of greater magnitude in jumps with more revolutions that are thus connected to a greater risk of injury. While figure skating programs seem to have recently increased in difficulty, performance trends have not yet been reported in the literature. We hypothesized increasing performance and decreasing age trends of the best athletes who competed at international level in recent years. Furthermore, we aimed to identify and analyse objective performance parameters and to assess a potential link between age and the risk of injury. The development of the number of double, triple and quadruple jumps in the singles figure skating events at the World and European Championships since the introduction of the new ISU Judging System in the 2004/2005 season was analysed using regression statistics and Student’s T-Tests. In all groups, the numbers of jumps with fewer rotations significantly decreased in the favour of jumps with more rotations. Women only started to perform jumps with four rotations in 2019. In the men, the number of quadruple jumps increased from an average of less than one to more than three in recent years (European and World Championships, both p < 0.001). In the European, but not in the World Championships, the average age increased in the men and decreased in the women (European Championships, men and women p = 0.006). Our study was the first to assess performance trends in elite figure skating. The incidence of injuries and overuse syndromes in figure skating needs to be monitored cautiously, as increases can be expected following recent gains in performance and jump complexity.
Rauer T, Pape H-C, Knobe M, Pohlemann T, Ganse B (2022) Figure skating: Increasing numbers of revolutions in jumps at the European and World Championships. PLoS ONE 17(11): e0265343. https://doi.org/10.1371/journal.pone.0265343
ABSTRACT
Objective: To analyze the characteristics of injuries sustained by young figure skaters who were evaluated at regional pediatric sports medicine clinics. Results: Eight hundred sixty-four figure skating-related injuries were identified. Approximately 68.9% were overuse and 31.1% were acute. In female figure skaters, the most frequently injured body areas were foot/ankle (29.6%), knee (19.3%), and back (15.8%). In male figure skaters, they were foot/ankle (25.4%), hip (16.4%), and knee (14.9%). Most common diagnoses at these body areas were tendinopathy (foot/ankle), extensor mechanism (knee), and posterior column bone stress injuries (back). All injuries to anterior knee structures, excluding bone contusions, were categorized as extensor mechanism injuries. About 11.8% of all injuries were bone stress reactions/fractures with the majority occurring at the back (42.2%), foot/ankle (32.4%), and lower leg (15.7%). Conclusion: Most injuries sustained by figure skaters were overuse and occurred most commonly at the foot/ankle (29.6%), knee (19.3%), and back (15.8%). Approximately 1 in 10 injuries were bone stress reactions/fractures, and nearly 1 in every 3 skaters who presented with back pain was diagnosed with a posterior column bone stress injury. Health care providers who take care of young figure skaters need to maintain a high index of suspicion for overuse injuries, especially bone stress reactions/fractures.
Kowalczyk AD, Geminiani ET, Dahlberg BW, Micheli LJ, Sugimoto D. Pediatric and Adolescent Figure Skating Injuries: A 15-Year Retrospective Review. Clin J Sport Med. 2021 May 1;31(3):295-303. doi: 10.1097/JSM.0000000000000743. PMID: 30985309.
ABSTRACT
Athletes who participate in various figure skating disciplines could benefit from specific strengthening exercises targeting the trunk, hip, and lower extremity to prevent injury and enhance performance. Particular attention should be placed on strengthening the transverse abdominis, multifidus, and gluteal muscles followed by balance and power training. The exercise programs presented should also increase postural control and reduce the incidence of hip-related injury in skaters. In addition, these exercises can be completed during the entire training year, with reduced intensity and volume of work lower during specific competition periods.
Hanson, N., Miller, M. G., & Mohney, G. (2017). Strengthening the Figure Skater: Considerations for Injury Prevention and Performance. Strength & Conditioning Journal, 39(3), 58–65. https://doi.org/10.1519/SSC.0000000000000220
gymnastics
gymnastics
ABSTRACT
Back pain is prevalent among gymnast populations and extreme flexion or extension of the lumbar spine along with high ground reaction forces (GRFs) are known to increase intervertebral stress. The aim of this study was to determine which postures and dynamic conditions among common floor movements provide the greatest risk of injury in men’s artistic gymnastics (MAG). For this purpose, lumbar spine curvatures, obtained through a full-body subject-specific kinematic model fed by motion capture data, and GRFs on feet and hands were compared between typical floor movements of MAG (pike jump, round off back handspring, front handspring, forward and backward tucked somersaults) performed by six adolescent gymnasts. The round off back handspring and the pike jump resulted respectively in the largest lumbar extension and flexion, and the forward tucked somersault take-off in the highest GRF. At ground impacts, the largest lumbar flexion was during the backward tucked somersault landing and only the back handspring hands ground contact phase led to lumbar extension. Such identification of high-risk conditions should enable better back pain management in gymnastics through more tailored training adaptations, particularly in case of pathologies or musculoskeletal specificities.
Eyssartier, C., Billard, P., Robert, M., Thoreux, P., & Sauret, C. (2025). Which typical floor movements of men’s artistic gymnastics result in the most extreme lumbar lordosis and ground reaction forces? Sports Biomechanics, 24(3), 638–653. https://doi.org/10.1080/14763141.2022.2140702
ABSTRACT
Background: The hindfoot region is commonly injured in gymnasts, and musculoskeletal ultrasound can be used to identify structural abnormalities in this region. Although prior studies have shown that sonographic abnormalities may not correlate with symptomatic pathology, the presence of asymptomatic sonographic abnormalities of the hindfoot in Division I collegiate gymnasts has not been evaluated. Objective: To identify and describe commonly seen asymptomatic sonographic abnormalities of the hindfoot region in Division I collegiate gymnasts. Results: A total of 37 of 39 gymnasts included in the study were found to have at least one asymptomatic sonographic abnormality of the hindfoot region. A total of 28.2% of athletes were found to have sonographic abnormalities within the Achilles tendon, with Doppler flow being the most common finding, and 35.8% of athletes were found to have a Haglund's deformity. However, only 7% of athletes with a Haglund's deformity demonstrated abnormal sonographic findings within the tendon. Sonographic abnormalities of the plantar fascia and plantar fat pad were seen in 30.7% and 69.2% of athletes, respectively. Conclusions: Asymptomatic sonographic abnormalities of the hindfoot region are common in collegiate gymnasts. Clinicians should use clinical judgment when interpreting these findings as they may not represent symptomatic pathology.
Kruse RC, Rudolph L, Negaard M. Asymptomatic sonographic abnormalities of the hindfoot region in Division I collegiate gymnasts. PM&R. 2024; 16(6): 563-569. doi:10.1002/pmrj.13077
Elbow Overuse Injuries in Pediatric Female Gymnastic Athletes: Comparative Findings and Outcomes in Radial Head Stress Fractures and Capitellar Osteochondritis Dissecans
03
Philip L. Wilson, Charles W. Wyatt, William C. Searls, Connor M. Carpenter, Aaron J. Zynda, Lorenzo Vite, Henry B. Ellis
September 15, 2021
ABSTRACT
Background: Radial head stress fractures (RHSFs) and capitellar osteochondritis dissecans (COCD) are rare but may be seen in gymnasts. The purpose of this study was to compare the clinical and radiographic characteristics and the outcomes of RHSF and COCD in pediatric and adolescent gymnastic athletes. Methods: Classical gymnasts and competitive tumblers ≤18 years of age presenting with RHSF or COCD over a 5-year period were reviewed. Radiographic characteristics, clinical characteristics, and patient-reported outcomes were compared. Conclusions: RHSF with features similar to the more familiar COCD lesion may present in gymnastic athletes. Those with RHSF may present more acutely with a high competitive level and may have a better prognosis for return to competitive gymnastics than those with COCD.
Wilson, P. L., Wyatt, C. W., Searls, W. C., Carpenter, C. M., Zynda, A. J., Vite, L., & Ellis, H. B. (2021). Elbow Overuse Injuries in Pediatric Female Gymnastic Athletes: Comparative Findings and Outcomes in Radial Head Stress Fractures and Capitellar Osteochondritis Dissecans. Journal of Bone and Joint Surgery, 103(18), 1675–1684. https://doi.org/10.2106/JBJS.20.01863
ABSTRACT
Objective: To explore the use of quantitative volume assessment to identify the presence and extent of stress-related changes of the distal radial physis in gymnasts with suspected physeal injury, asymptomatic gymnasts, and non-gymnasts. Methods: Symptomatic gymnasts with clinically suspected distal radial physeal injury, asymptomatic gymnasts, and non-gymnasts (n = 69) were included and matched on skeletal age and sex. Conclusion: Increased volume of the distal radial physis can reliably be assessed and is a sign of physeal stress that can be present in both symptomatic- and asymptomatic gymnasts, but gymnasts with suspected physeal injury showed larger volume increases. Future studies should explore if volume assessment can be used to (early) identify athletes with or at risk for physeal stress injuries of the wrist.
Kraan, R.B.J., Kox, L.S., Mens, M.A. et al. Damage of the distal radial physis in young gymnasts: can three-dimensional assessment of physeal volume on MRI serve as a biomarker?. Eur Radiol 29, 6364–6371 (2019). https://doi.org/10.1007/s00330-019-06247-z
ABSTRACT
Gymnastics is a sport requiring grace, strength, and flexibility, resulting in a wide variety of injuries. This article is an overview of the sport of gymnastics and associated injury trends in the artistic gymnastics population. Injury rates in gymnastics range from 1.08 to 50.3 per 1000 h of exposure. More injuries occur in competition versus practice. Fewer injuries occur in recreational gymnastics than competitive gymnastics. The most common injury in gymnastics occurs in the lower extremity, and is an ankle sprain, followed by knee internal derangement. However, in men’s gymnastics the most common gymnastics injury occurs in the upper body (specifically the shoulder). The most common skills causing injury to a gymnast are front/back handsprings and saltos/flips. Unique injuries commonly seen when caring for the young gymnast include spondylolysis, ostoechondritis dissecans of the capetillium and talus, Gymnast wrist, Grip lock, Osgood‐Schlatter, patellofemoral syndrome, Sever’s disease, and ankle sprains. Research efforts should focus on injury rates after the 2006 rule change, injury prevention, men’s gymnastics injury patterns, concussions, hip injuries, and ACL injuries in gymnasts.
Stracciolini, A., d’Hemecourt, P., Bae, D. S., Meehan, W. P., & Hart, E. (2018). The Young Injured Gymnast: A Literature Review and Discussion. Current Sports Medicine Reports, 17(11), 366–375. https://doi.org/10.1249/JSR.0000000000000536
diving
diving
ABSTRACT
High diving, an emerging extreme sport with dives from heights up to 27 m, presents unique biomechanical and psychological risks. Athletes face high-velocity water entry, generating intense forces that can result in musculoskeletal and soft tissue injuries, especially during entry. Injury rates are higher in practice than competition, possibly linked to overfatigue and technical errors. Psychological stress — such as fear, fatigue, and mental blocks — may contribute to injury risk but is understudied. Preventative strategies including limiting the number of dives, technical training, and psychological support are proposed. Despite lower acute injury rates compared to contact sports, the repetitive high-impact nature of cliff and high diving raises concerns for long-term health consequences. Existing gaps in injury surveillance and athlete education highlight the need for targeted, sport-specific health initiatives. As high diving aims to be included in the Olympics, evolving comprehensive safety frameworks are vital to protect athlete well-being and support performance longevity.
Provance, A., Lenz, A., & Provance, B. (2025). Cliff and High Diving: Literature Review on Injury Patterns with Expert Commentary. Current Sports Medicine Reports, 24(11), 366–371. https://doi.org/10.1249/JSR.0000000000001299
ABSTRACT
Context: The Olympic sport of diving involves the competitive disciplines of 3 m springboard and 10 m platform. Although it is generally accepted that lumbar spine injuries are common in diving athletes, the existing literature of health problems in diving athletes remains scarce. Results: The search identified 2554 potential articles, with 28 studies meeting eligibility criteria. The surveillance setting of most studies was restricted to competition-based events, with the reported injury incidence proportion ranging from 2.1% to 22.2%. The reported injury incidence rate ranged from 1.9 to 15.5 per 1000 athlete-exposures. Injuries to the shoulder, lower back/lumbar spine, trunk, and wrist/hand were reported most frequently. The prevalence of low back pain was reported as high as 89% (lifetime), 43.1% (period), and 37.3% (point). The illness incidence proportion ranged from 0.0% to 22.2%, with respiratory and gastrointestinal illness reported most frequently. Conclusion: Up to 1 in 5 diving athletes sustain an injury and/or illness during periods of competition. A reporting bias was observed, with most cohort studies limiting surveillance to short competition-based periods only. This limits the current understanding of the health problems experienced by diving athletes to competition periods only and requires expansion to whole-of-year surveillance.
Currie, B. M., Drew, M. K., Hetherington, M., Waddington, G., Brown, N. A. T., & Toohey, L. A. (2024). Diving into the health problems of competitive divers: A systematic review of injuries and illnesses in pre-elite and elite diving athletes. Sports Health, 17(3), 594–602. https://doi.org/10.1177/19417381241255329
ABSTRACT
Competitive diving is a popular sport that attracts numerous participants worldwide; unfortunately, competitive divers experience a notable frequency of injuries during training and competition. Despite this, injuries in diving often received less attention compared to those in other aquatic sports. The purpose of this study was to conduct a systematic review to update the scientific evidence on injury incidence in competitive divers to offer insights into the prevalent injury patterns and help develop injury prevention strategies. This involved analyzing injury data collected from the Injury Surveillance Programme (ISP) across various levels of competition events and assessing case reports involving a wide spectrum of diving injuries. Four online bibliographical databases were consulted: Google Scholar, PubMed, Scops, and Web of Science from their inception until December 6, 2023.819 studies were initially identified, and 15 studies were finally included in this review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISM) guidelines and PRISMA in Exercise, Rehabilitation, Sport Medicine, and Sport Science (PERSiST) were followed. Two independent reviewers evaluated the methodological quality of the studies. The majority of diving injuries are concentrated on the upper body/trunk, including the shoulder, spine, hand/wrist, head/face, and neck, with overuse injury being a main contribution. Regarding diving incidence, the actual injury rate in competitive athletes could be even higher than currently reported, primarily due to limitations in implementing injury surveillance protocol for diving athletes. The latest injury data for diving in big competition events is absent, and there is a strong expectation for more new injury surveillance data to be published in the future. Additionally, the specific injury pattern, prevention strategy, and rehabilitation training plan for diving injury are severely deficient in the current literature.
Xin Wang, Meizi Wang, Ming Zhang. Attention to competitive diving injuries: A systematic review. Medicine in Novel Technology and Devices. Volume 23. 2024. https://doi.org/10.1016/j.medntd.2024.100316.
ABSTRACT
Growth plate injury of the proximal humerus is rare. We herein report a traumatic growth plate injury of the proximal humerus in an elite diving athlete. A 16-year-old female diving athlete injured her left shoulder during 7.5 m platform hands-first diving practice. At the first visit, she presented with upper left shoulder tenderness and left shoulder range-of-motion limitation. There was no fracture or dislocation on X-ray and computed tomography (CT), but magnetic resonance imaging (MRI) showed a high-intensity zone in the left lateral epiphysis of the proximal humerus. We treated her conservatively by rest with sling and rehabilitation. She partially restarted diving practice five weeks post-injury and returned to competition eight weeks post-injury. Even if there is no sign of fracture or dislocation, we should consider MRI for patients who are before the age of growth plate closure.
Xin Wang, Meizi Wang, Ming Zhang. Attention to competitive diving injuries: A systematic review. Medicine in Novel Technology and Devices. Volume 23. 2024. https://doi.org/10.1016/j.medntd.2024.100316.
artistic swimming
artistic swimming
ABSTRACT
Introduction: Artistic swimming is a highly technical sport that requires a large volume of training and forced positions that generate a high risk of injury. Objective: to compile scientific evidence on the incidence of injuries in artistic swimming. Literature study: PubMed, Web of Science, and SPORTDiscus databases were used to search for studies that analysed the epidemiology of injuries in artistic swimmers of any age and gender until June 2024. Methodology: the methodological quality of the studies was analysed with the Strengthening the Reporting Scale of Observational Studies in Epidemiology (STROBE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) were followed. Synthesis: eleven studies met the inclusion criteria showing a clear trend of joint-ligament or muscle-tendon injuries in the shoulders, back, and knees. Conclusions: despite the publication of an injury surveillance document and a consensus on data collection and injury surveillance, there are methodological limitations that do not allow firm conclusions to be drawn. More epidemiological studies that follow data collection and injury surveillance guidelines are needed to establish differences by gender, age groups, and test.
Rincón AB, Trinidad A and López-Valenciano A (2025) Epidemiological study of injuries in artistic swimming: a systematic review. Front. Sports Act. Living 7:1509081. doi: 10.3389/fspor.2025.1509081
ABSTRACT
Artistic swimming is a highly challenging discipline, requiring physical skills and creativity. There are almost no published data on trauma. We aimed to assess the incidence and the nature of injuries in artistic swimmers. Results: The injury rate was 0.95 injuries/season/athlete and 1.05 injuries/1000 hours of practice. The most frequent injuries were rotator cuff tendinopathy (13.6%), acute low back pain (13.6%), and patellofemoral syndrome (11.9%). Swimmers in the youth and junior categories had significantly more injuries than those in the future category (P = 0.009), possibly because of more training hours (P < 0.001). Twelve major injuries occurred, all in the same group of youth swimmers. Conclusion: This is the first study investigating trauma during artistic swimming practice. A better knowledge of the main injuries is necessary for the physician to provide optimal care for athletes and to develop prevention. Attention should be particularly paid to the swimmers' shoulders and knees.
Menu, P., Daley, P., Vignaud, E., Grondin, J., Fouasson-Chailloux, A., & Dauty, M. (2023). Artistic Swimming Injuries in Young Elite Athletes: An 11-year Follow-Up. Clinical Journal of Sport Medicine, 33(4), 421–427. https://doi.org/10.1097/JSM.0000000000001139
male-focused research
male-focused research
ABSTRACT
What is art? It is not just nature. It is nurtured nature. It is intelligence applied to what physical ability you have (Rudolf Nureyev). This study investigates ballet directors’ roles in identifying and developing talent in elite male ballet dancers in professional companies. Framed within an interpretative paradigm and employing a qualitative descriptive design, we conducted in-depth interviews with seven expert ballet directors using participation criteria adapted from sports research. Data was analysed using reflexive thematic analysis. Directors use declarative and tacit knowledge to examine natural ability, systematic benchmarks, and work ethic to identify talent. The initial identification process focused on anthropometric measures and pas de deux skills, with work ethic and ambition being assessed later. In a pas de deux partnership, collaboration and creativity depend on emotional intelligence (EI) and character traits like self-regulation and generosity. However, the study highlights that male dancers initially identified as talented but lacked self-regulation and embodied intelligence and did not progress to the higher ranks. In addition, male dancers tend to be identified and promoted faster than women. These results shed light on gender bias during the TID process and directors’ approach to identifying and developing an elite male ballet dancer.
Pace, M., & Nash, C. (2025). Unveiling talent: ballet directors’ role in identifying and developing male dancers within classical ballet companies. Research in Dance Education, 1–16. https://doi.org/10.1080/14647893.2025.2486245
ABSTRACT
Lower back injuries are common in ballet dancers. Allegedly there is a higher incidence in males than in females due to their lifting requirements. This study analyzes the estimated forces generated at the L5/S1 joint in five professional and three pre-professional male dancers performing full press (FP) and arabesque (AR) ballet lifts. The estimated peak lumbar anterior shear force (PLASF) was identified using a 3D motion analysis system, and was found to occur at the beginning of each lift, approximately 0.01 seconds prior to the ballerina moving vertically into the lift. Data representing the male dancers’ posture at the point of PLASF were input into a 3D Static Strength Prediction Program (3DSSPP, University of Michigan, Centre for Ergonomics, 2006) to calculate the PLASF and corresponding compression forces. The compression forces identified in this way were found to be greater than the National Institute of Occupational Safety and Health, Back Compression Design Limit (3400N). This suggests that administrative controls such as monitoring the number of lifts performed daily are required to reduce the risk of lower back injury in male dancers. Comparison of the two lifts found significantly (p < 0.05) higher compression forces in the FP versus the AR lift. This could be attributed to a significantly (p < 0.05) larger horizontal distance between the male dancer and the ballerina, or the eccentric loading of the male dancers’ lower limb and trunk musculature in the preparation phase of the FP. Retrospective regression analysis indicated that peak trunk extension velocity and the horizontal distance between the male dancer and the ballerina were significant (p < 0.05) predictors of PLASF.
Alderson J, Hopper L, Elliott B, Ackland T. Risk Factors for Lower Back Injury in Male Dancers Performing Ballet Lifts. Journal of Dance Medicine & Science. 2009;13(3):83-89. doi:10.1177/1089313X0901300303
ABSTRACT
Although previous research has investigated men in feminized sports, we took a different approach in this study and examined men in ballet. Because ballet is one of the most highly gender-codified sports, male ballet dancers must negotiate their identities as men while performing a dance form that is highly stigmatized as effeminate. We investigated how five self-identified heterosexual male college dance majors perceive and perform heteromasculinity within male ballet culture using qualitative data gathered from structured interviews. Results provide three unique contributions to the literature. First, we found that these men develop and contextualize their heteromasculinity in the context of a male ballet culture. Second, the results demonstrate three unique stigma-management techniques within male ballet culture. Third, men described a hegemonic heteromasculinity and the roles of masculinity and emotionality in male ballet performance as parts of male ballet culture. We hope this study will stimulate future research that can help personnel and faculty to better understand how college ballet programs can be informed by the ways masculinity may be institutionalized and reproduced within the context of dance programs, as well as the ways male ballet dancers can challenge heteromasculine hegemony in the sports world.
Haltom, T.M., & Worthen, M.G.F. (2014). Male Ballet Dancers and Their Performances of Heteromasculinity. Journal of College Student Development 55(8), 757-778. https://dx.doi.org/10.1353/csd.2014.0084.
