Evaluation of movements of lower limbs in non-professional ballet dancers: hip abduction and flexion

<p>Abstract</p> <p>Background</p> <p>The literature indicated that the majority of professional ballet dancers present static and active dynamic range of motion difference between left and right lower limbs, however, no previous study focused this difference in non-professional ballet dancers. In this study we aimed to evaluate active movements of the hip in non-professional classical dancers.</p> <p>Methods</p> <p>We evaluated 10 non professional ballet dancers (16-23 years old). We measured the active range of motion and flexibility through Well Banks. We compared active range of motion between left and right sides (hip flexion and abduction) and performed correlation between active movements and flexibility.</p> <p>Results</p> <p>There was a small difference between the right and left sides of the hip in relation to the movements of flexion and abduction, which suggest the dominant side of the subjects, however, there was no statistical significance. Bank of Wells test revealed statistical difference only between the 1^stand the 3^rdmeasurement. There was no correlation between the movements of the hip (abduction and flexion, right and left sides) with the three test measurements of the bank of Wells.</p> <p>Conclusion</p> <p>There is no imbalance between the sides of the hip with respect to active abduction and flexion movements in non-professional ballet dancers.</p

National survey to evaluate musuloskeletal health in retired professional ballet dancers in the United Kingdom

Objectives: To explore the musculoskeletal health of retired professional ballet dancers in the United Kingdom (UK). Design: Online national survey Participants: Retired professional ballet dancers living in the UK. Methods: The survey explored: what musculoskeletal injuries or diseases are experienced by retired professional ballet dancers; which anatomical regions were affected by musculoskeletal injuries or diseases in retired professional ballet dancers; whether ballet dancers were forced to retire from professional ballet due to musculoskeletal injuries or disease. Results: Forty-six retired ballet dancers responded. Thirty-six percent (n=17) of respondents reported retiring from ballet due to musculoskeletal injury. The median age when respondents retired from professional ballet was 29 years. The most common issues that caused people to retire were hip and back pain (25%; n=9 respectively), followed by hamstring injuries, ankle injuries, cervical spine injuries, and anterior knee pain (13% respectively; n=5). Ninety-one percent (n=42) reported experiencing muscle and joint pain post-retirement. Conclusions: Musculoskeletal pain and disease was a problem for respondents in this study. Further investigation is needed to define the problem, so management can be examined. Comparing performance and training regimes to injury rates in professional dancers, and then following these cohorts into retirement, would increase knowledge on this population

Bone stress injury of the ankle in professional ballet dancers seen on MRI

<p>Abstract</p> <p>Background</p> <p>Ballet Dancers have been shown to have a relatively high incidence of stress fractures of the foot and ankle. It was our objective to examine MR imaging patterns of bone marrow edema (BME) in the ankles of high performance professional ballet dancers, to evaluate clinical relevance.</p> <p>Methods</p> <p>MR Imaging was performed on 12 ankles of 11 active professional ballet dancers (6 female, 5 male; mean age 24 years, range 19 to 32). Individuals were imaged on a 0.2 T or 1.5 T MRI units. Images were evaluated by two musculoskeletal radiologists and one orthopaedic surgeon in consensus for location and pattern of bone marrow edema. In order to control for recognized sources of bone marrow edema, images were also reviewed for presence of osseous, ligamentous, tendinous and cartilage injuries. Statistical analysis was performed to assess the strength of the correlation between bone marrow edema and ankle pain.</p> <p>Results</p> <p>Bone marrow edema was seen only in the talus, and was a common finding, observed in nine of the twelve ankles imaged (75%) and was associated with pain in all cases. On fluid-sensitive sequences, bone marrow edema was ill-defined and centered in the talar neck or body, although in three cases it extended to the talar dome. No apparent gender predilection was noted. No occult stress fracture could be diagnosed. A moderately strong correlation (phi = 0.77, p= 0.0054) was found between edema and pain in the study population.</p> <p>Conclusion</p> <p>Bone marrow edema seems to be a specific MRI finding in the talus of professional ballet dancers, likely related to biomechanical stress reactions, due to their frequently performed unique maneuvers. Clinically, this condition may indicate a sign of a bone stress injury of the ankle.</p

Cortical and trabecular bone analysis of professional dancers using 3D-DXA: a case-control study.

Given the lack of relevant data, the aim of this study was to examine femur cortical and trabecular bone in female and male professional ballet dancers. 40 professional ballet dancers and 40 sex- and age-matched non-exercising controls volunteered. Femoral bone density was scanned by dual-energy X-ray absorptiometry (DXA) scan. A 3D-DXA software was used to analyse trabecular and cortical bone. Anthropometry, maturation (Tanner staging), menstrual parameters (age at menarche and primary amenorrhea), energy availability and nutritional analysis (3-day record) were also assessed.Compared to non-exercising participants, dancers exhibited significantly higher volumetric density for integral, cortical and trabecular bone, and thicker cortex at the femur. Ballet dancers demonstrated lower body weight compared to controls (p < 0.01). Female dancers had their menarche later than controls, and the prevalence of primary amenorrhea were significantly higher in dancers than controls (p < 0.01). Dancer's energy availability was below the normal range (<30 kcal/kgFFM/day). Despite the presence of certain osteoporosis risk factors such as low energy availability, primary amenorrhoea and lower body weight, professional ballet dancers revealed higher bone density for both cortical and trabecular bone compartments compared to controls

Bone mineral density in vocational and professional ballet dancers

Summary: According to existing literature, bone health in ballet dancers is controversial. We have verified that, compared to controls, young female and male vocational ballet dancers have lower bone mineral density (BMD) at both impact and non-impact sites, whereas female professional ballet dancers have lower BMD only at non-impact sites. Introduction: The aims of this study were to (a) assess bone mineral density (BMD) in vocational (VBD) and professional (PBD) ballet dancers and (b) investigate its association with body mass (BM), fat mass (FM), lean mass (LM), maturation and menarche. Methods: The total of 152 VBD (13 ± 2.3 years; 112 girls, 40 boys) and 96 controls (14 ± 2.1 years; 56 girls, 40 boys) and 184 PBD (28 ± 8.5 years; 129 females, 55 males) and 160 controls (27 ± 9.5 years; 110 female, 50 males) were assessed at the lumbar spine (LS), femoral neck (FN), forearm and total body by dual-energy X-ray absorptiometry. Maturation and menarche were assessed via questionnaires. Results: VBD revealed lower unadjusted BMD at all anatomical sites compared to controls (p < 0.001); following adjustments for Tanner stage and gynaecological age, female VBD showed similar BMD values at impact sites. However, no factors were found to explain the lower adjusted BMD values in VBD (female and male) at the forearm (non-impact site), nor for the lower adjusted BMD values in male VBD at the FN. Compared to controls, female PBD showed higher unadjusted and adjusted BMD for potential associated factors at the FN (impact site) (p < 0.001) and lower adjusted at the forearm (p < 0.001). Male PBD did not reveal lower BMD than controls at any site. Conclusions: both females and males VBD have lower BMD at impact and non-impact sites compared to control, whereas this is only the case at non-impact site in female PBD. Maturation seems to explain the lower BMD at impact sites in female VBD

An exploratory study of passion in professional ballet dancers

An exploratory study of passion in professional ballet dancer

Extreme hip motion in professional ballet dancers: dynamic and morphological evaluation based on magnetic resonance imaging

Objective: To determine the prevalence of femoroacetabular impingement (FAI) of the cam or pincer type based on magnetic resonance imaging (MRI) in a group of adult female professional ballet dancers, and to quantify, in vivo, the range of motion (ROM) and congruence of the hip joint in the splits position. Materials and methods: Institutional review board approval and informed consent from each volunteer were obtained. Thirty symptomatic or asymptomatic adult female professional ballet dancers (59 hips) and 14 asymptomatic non-dancer adult women (28 hips, control group) were included in the present study. All subjects underwent MRI in the supine position, while, for the dancers, additional images were acquired in the splits position. Labral abnormalities, cartilage lesions, and osseous abnormalities of the acetabular rim were assessed at six positions around the acetabulum. A morphological analysis, consisting of the measurement of the α angle, acetabular depth, and acetabular version, was performed. For the dancers, ROM and congruency of the hip joint in the splits position were measured. Results: Acetabular cartilage lesions greater than 5mm were significantly more frequent in dancer's hips than in control hips (28.8 vs 7.1%, p = 0.026), and were mostly present at the superior position in dancers. Distribution of labral lesions between the dancers and the control group showed substantially more pronounced labral lesions at the superior, posterosuperior, and anterosuperior positions in dancers (54 lesions in 28 dancer's hips vs 10 lesions in 8 control hips). Herniation pits were found significantly more often (p = 0.002) in dancer's hips (n = 31, 52.5%), 25 of them being located in a superior position. A cam-type morphology was found for one dancer and a retroverted hip was noted for one control. Femoroacetabular subluxations were observed in the splits position (mean: 2.05mm). Conclusion: The prevalence of typical FAI of the cam or pincer type was low in this selected population of professional ballet dancers. The lesions' distribution, mostly superior, could be explained by a "pincer-like” mechanism of impingement with subluxation in relation to extreme movements performed by the dancers during their daily activitie

Incidence of musculoskeletal injuries in professional dancers

Background: Professional ballet dancers focus on the high levels of discipline, perfection and mobility to achieve the fluid, controlled lines of movement presented on the stage. Dancers undergo long hours of strenuous, repetitive training which increases the risk of developing overuse or traumatic injuries and may compromise the longevity of dancers' careers. Relevant research, particularly in the South African context, is needed to provide recommendations on the intrinsic and extrinsic factors contributing to musculoskeletal injuries in professional ballet dancers. Aim: The aim of this study was to determine the incidence of musculoskeletal injuries and their associated risk factors over a three-month period in adult female professional ballet dancers in South Africa. Specific Objectives: The specific objectives of this study were: • To determine the incidence of traumatic and overuse injuries per 1000 dance hours over a three-month training and performance period in South African female professional ballet dancers; • To determine the relationships between a) Functional Lower Extremity Evaluation (FLEE) scores and injury incidence; b) intrinsic factors (amenorrhoea; body mass index; skinfold measurements; caloric intake) and injury incidence; and c) extrinsic factors (training hours; performance hours) and injury incidence respectively, in South African female professional ballet dancers. Methods: This study had a prospective, descriptive design. Eighteen female dancers were recruited from professional dance companies in the Gauteng, Western Cape and North West provinces of South Africa. Data were collected over a three-month period and included a subjective questionnaire, three-day food diary, skinfold measurements and the Functional Lower Extremity Evaluation (FLEE). Injuries were reported using an injury reporting form over the three-month period. Results: Participants had an average age of 22.1 ± 3.0 years. The dancers had an average BMI of 21.4 ± 2.1 kg.m⁻²; LBM of 41.7 ± 4.9 kg and body fat percentage of 24.7% ± 2.9%. Injury incidence was 3.3 injuries per 1000 dance hours with a total of 4605.58 hours reported overall. Of the 15 injuries reported, 13 occurred in the lower limb, with eight in the ankle and foot. Overuse injuries accounted for 93.3% of the total injuries, with only one traumatic injury reported. None of the descriptive characteristics was associated with increased injury risk. The average caloric intake of 1810.0 ± 503.7 calories, while lower than what is recommended for female athletes, also showed no significant relationship to injury. There were also no significant associations between pre-injury FLEE measurements and training loads; and injury incidence over the course of the study. Conclusion: An overall injury incidence of 3.3 injuries per 1000 dance hours was found in professional female ballet dancers in South Africa, which is higher than the injury incidences identified in previous studies in high-income countries. With regards to injury profile, overuse injuries are 86% more prevalent than traumatic injuries among this population type. We were unable to identify any intrinsic or extrinsic risk factors associated with injury incidence; however, we recognise the limitations of the small sample size in this study. With a high level of injury incidence and inconclusive results on injury risk factors, there is a clear need for significant further research in the field of injury prevention in professional ballet dancing. Further, this study identified a strong need for further research in South African dance companies to facilitate injury prevention and management in South Africa