Journal of Dance Medicine & Science

Forty elite female dance students (mean age: 14.92 years) were followed at the School of American Ballet to distinguish the physical and mental factors associated with dropping out of the profession. The dancers were evaluated for injury patterns, eating behavior (EAT-26; food diary), personality (OSIQ-R), menstrual functioning, pubertal development (Tanner stages), and orthopaedic parameters. During the four-year period of this study 55% of the sample stopped dancing. Those in this 55% had a higher rate of injuries and eating problems. Furthermore, deficits on an orthopaedic screening exam accurately predicted dancers who dropped out of training at the advanced level from those who became professionals (p < 0.009). As a group, dancers with an eating disorder profile had more anatomical deviations that compromise dance technique. These results suggest that classical ballet weeds out students without the right bodies, similar to Darwin's “selection of the fittest.” In addition, ballet dancers may develop eating problems to compensate for a suboptimal technique. The orthopaedic exam is recommended as a useful screening tool in diagnosing potential problems in dancers but is not intended to exclude students from training.

This study was carried out to assess changes in the foot arches of young ballet dancers that may arise from training. Twenty-one ballet dancers (age: 17.00 ± 1.18 years) were evaluated for rise or fall in the plantar longitudinal and transverse arches. The assessment methods used were determination of the height-length ratio for the plantar arch and diameter measurements made with a caliper at the level of the metatarsal heads for the transverse arch, under weight-bearing and non-weight-bearing conditions. The results were compared with those attained from a control group of 21 non-dancers (age: 17.52 ± 1.21 years) with sedentary life style. The evaluation showed that there was a rise in the longitudinal arch with a concomitant fall in the transverse arch in ballet dancers. The results were significantly different from the control group (p < 0.05). The findings also correlated with evaluations made by assessing depression in the navicular tubercle in relation to the Feiss’ line and podoscopic observations.

This study compared the physical effort imposed on teachers and students during dance training sessions as well as on the students when they were teaching as a part of their education. Eleven dance teachers (mean age: 39 ± 7 years) and 11 dance students (mean age: 24 ± 2 years) participated. Before the study maximal heart rate was measured in a maximal cycle ergometer test and maximal oxygen uptake (V˚O₂ max) was estimated from the heart rate during a submaximal test with correction for the individual maximal heart rate. Heart rate (HR), blood lactate concentration, and fluid loss were measured during the dance training sessions. Effort during sessions was expressed as the percentage of the individual maximal heart rate. V˚O₂ max was not significantly different between teachers and students. During training as well as teaching the average HR was approximately 70% of maximal and did not differ between training students, teachers, and students as teachers. It may be questioned whether these findings and the amount of teaching hours (25 to 29 hours per week) can explain why most dance teachers leave the profession before official retirement age.

The response of supine jump height and pelvic alignment to a conditioning and alignment program using the Current Concepts Reformer is evaluated. A total of 24 subjects (first and second year dance students at California State University, Long Beach) participated in the study; 14 in the experimental group received 8 weeks of Reformer instruction and 10 in the control group received no Reformer instruction. The two variables assessed were jump height from a supine position on the Reformer and the maintenance of pelvic alignment while executing jumps in a standing position. A significant improvement was found in jump height for each group, however, there was no significant difference in the amount of improvement between the groups; the experimental group had a p-value of 0.0016 and the control group had a p-value of 0.0008. Differences in alignment between groups were found in 3 of 8 pelvic alignment assessment questions as determined by independent observers. An average change in mean score toward the poor alignment grade was found in the experimental group (0.71 ± 0.61). A very slight shift toward the excellent alignment grade was found in the control group (0.06 ± 0.58; 0.11 ± 0.42; 0.22 ± 0.51). Inter-observer reliability was determined for each of the pelvic alignment assessment questions and a p-value of 0.05 was obtained for one of the eight assessment questions using the Spearman Rank Order Correlation. A correlation between pelvic alignment and jump height was unable to be determined.

Dislocated tibialis posterior tendon is a rare condition in the absence of trauma. We report a case of a 17-year-old classical ballet dancer who dislocated her tibialis posterior tendon while performing a relevé. She was unable to bear weight on that leg subsequently but she did have full active range of motion and her pain resolved quickly. She reported feeling a “flicking” at the ankle when the injury occurred. On examination it was possible to dislocate the tendon with the foot fully plantar flexed (pointed). Investigations are not diagnostic in this condition. Treatment consisted of surgical repair of the flexor retinaculum, 6 weeks non-weight-bearing, and progressive functional rehabilitation with attention to strengthening foot musculature and regaining ankle range of motion, particularly dorsiflexion (plié). The dancer returned to full ballet performance 5 months after injury.