The United Nations Arts Initiative is coordinating a special program for artist support, focusing on Performing Arts Medicine.  The following overview is on the Epidemic of Injuries in Dance.

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24 April 2012

Stephen M. Apatow
Biomechanics Specialist & Technical Consultant
Founder, Director of Research & Development
Sports Medicine & Science Institute
International Dancescience Development Program
Phone: 203-668-0282
Email: s.m.apatow@edancescience.org
Internet: www.edancescience.org
Facebook: edancescience

United Nations Arts Initiative
Internet: www.unarts.org

Photo Credit: National Geographic: Redefining Biomechanics, Injury Prevention & Performance Optimization: Sports Medicine & Science Institute, 20 March 2015.

Confronting the Epidemic of Injuries in Dance:  Psychological Issues in the Clinical Approach to Dancers

Classical ballet training is recognized as the most advanced technical movement mechanics training in the world.  The biomechanical ideal in training, represents the most stable, balanced,  integrate relationship of the spine and extremities for injury prevention, advanced sports medicine treatment and performance optimization.  The International Dancescience Development Program emphasizes the importance of education and training in classical ballet based biomechanics and orthopedic analysis for the medical community. [1]

For many years, the importance of classical ballet specific flexibility and alignment training has been emphasized for dance education programs. [2]  In classical ballet (the foundational training for all styles of dance), training is executed in a turned out alignment,and requires specific stretches that must be integrated into the pre-class warm-up.  Unfortunately this guidance is many times ignored, at a cost of progressive joint stabilization and deformities in childhood development, that make correct postural alignment a virtual impossibility, and follow the student for a lifetime.

According to the paper "Psychological Issues in the Clinical Approach to Dancers" * (Full Text: Performing Arts Medicine, 3rd ed.; page: 381-391):

Hamilton found that 47% of young dancers and 46% of older students have a chronic injury.  Ribson and Gitev found that 70% had an injury in a 2 year observation period in high school that required them to stay out of class for 3 or more days and 43% reported a chronic injury.  Most injuries occur in class (44%) than in rehearsal (16%) or performance (8%).

A Stockholm study showed a similar percentage of students injured.  Of 1,555 female dancers, 11% of those who were 8 years of age had an injury, compared to 45% of those at age 14.  The frequency of repeated injury went from 27.7% at age 9 to 46% at age 16.

Unfortunately, the lack of correct training that led to the injuries experienced by many dance teachers, is perpetuated in the classroom:

  • Many students had teachers who were critical and told injured students that they complained too much.  Up to 58% of these students are more likely to perform when injured, against medical advice.  Hamilton found that 48% of dancers had a teacher who unjustly humiliated them and 24% reported that their teacher encouraged them to work with a serious injury.
  • Injuries plague the professional dancer, as they did the student. Only by now, the prevalence of chronic injury has risen from 47% in dance students to 61% in dancing professionals and 66% in non dancing or retired dancers.  In Hamilton's survey of 960 dancers, 49% of professionals continued to work injured, and 24% said they were expected to work injured.

For Educational Purposes Only by Humanitarian Resource Institute (UN:NGO:DESA); United Nations Arts Initiative; International Dancescience Development program educational initiative for public health and injury prevention is our focus for Preventing Injuries in Sports, Recreation, and Exercise (CDC) [3]
must reach dance education programs and parents.

Confronting the Epidemic of Injuries in Dance:  Psychological Issues in the Clinical Approach to Dancers is the first of a series on Performing Arts Medicine through the United Nations Arts Initiative. 

The authoritative reference text book for this series is:

Performing Arts Medicine: 3rd ed.
The definitive textbook in Performing Arts Medicine - covering music, voice, dance, and theater - is fully revised and updated for 2010. With 21 contributors.
Edited by Robert T. Sataloff, Alice G. Brandfonbrener, and Richard J. Lederman
Available in print and downloadable e-book formats
Url: http://www.sciandmed.com/tpam/performingartsmedicine.aspx

  1. Classical Ballet Based Biomechanics and Orthopedic Analysis Level 1: Distance education course on classical ballet based biomechanics for physicians, physical therapists, instructors, parents and students. Humanitarian University Consortium Continuing Education.
  2. Child Safety, Injury Prevention and Performance Optimization: Sports Medicine & Science Institute and International Dancescience Development Program, Updated: 3 September 2011.
  3. Preventing Injuries in Sports, Recreation, and Exercise: Centers for Disease Control.



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