Injuries can be devastating to a dance career, but you can reduce their occurrence or avoid them—if you know what to look for. To learn why certain injuries happen and what can be done to prevent them, we consulted a group of experts: Jacqui Greene Hass, director of Pilates and Dance Medicine at Wellington Orthopaedic & Sports Medicine Therapy Services; Marijeanne Liederbach, director of research and education at Harkness Center for Dance Injuries; Jennifer Deckert, assistant professor at University of Wyoming (holds an MFA in ballet pedagogy and has presented at the International Association for Medicine and Science); and Michael Kelly Bruce, associate professor at The Ohio State University (certified in Pilates and specializes in conditioning).
1. Neck Strain: Choreography that calls for excessive head movement can easily strain dancers' neck muscles, especially if dancers do not properly use the full spine when arching the head/neck. Prevention Tip: “Lengthen the neck rather than collapse it," says Bruce. “I like using the image of the fountains at the Bellagio [Resort & Casino]: a long, graceful arch."
2. Rotator Cuff Tendonitis and Impingement: Extensive use of the arms (overhead lifts and falls) can lead to tears in upper-arm tendons or even impingement, painful pressure felt in the shoulder when the rotator cuff and scapula rub together as arms are lifted. Prevention Tip: “Be aware of the actual landmarks of the shoulder girdle," says Bruce. “Once students understand the scapula is located behind them, they can have better anatomically aligned mechanics."
3. Lower-Back Strain and Muscle Spasms: Lifting, arching and improper technique can all overwork and strain the lower-back extensor-erector muscles. Dancers with lordosis (a swayed back or lower-back curve) are more prone to spasms. Prevention Tip: “I like to use the image of a cummerbund, where the student has a more three-dimensional sense of their abdominal wall," says Deckert. “Or imagine the pelvis as a bowl with water. Preventing the water from splashing will improve core strength."
4. Snapping Hip Syndrome: Iliotibial (IT) band tightness, weakness along the outside of the hip and lordosis can cause this syndrome. Dancers will experience a snapping rubber-band–like sound in the frontal hip joint, as the IT band glides over the greater trochanter (upper-leg bone) during battement or développé. Prevention Tip: Strengthen the lower abs and all pelvic stabilizers (abductors, adductors, hip flexors), and avoid turning out at the feet, which stresses the knees and hips.
5. Patellofemoral Pain Syndrome: This syndrome stems from tight hamstrings and calf muscles, weak quadriceps and repetitive force from normal movement putting pressure on the patella (kneecap), causing the knee-protecting cartilage to lose its shock-absorbing ability. Dancers with high-arched or flat fleet, wide hips and knees that turn in or out are more likely to experience this pain. Prevention Tip: “The knee is the victim between the ankle and the hip," says Liederbach. “Core strength, hip-abductor strength training and IT stretching are key."
6. Meniscus Knee Tear: Twisting knees during movement, forcing feet in turnout or losing control when landing a jump can tear the cushioning knee cartilage. Prevention Tip: “Strengthening the core is so crucial to knee health," says Bruce. “It lessens the burden on the knee, so you are not landing with so much force."
7. Posterior Tibial Tendonitis: Dropping the medial arch during warm-ups or basic barre exercises overworks the tibial tendon. This type of tendonitis also coincides with shin splints or can be the result of chronic ankle rolling. Prevention Tip: “Work to lift the arches and do not force turnout from the feet," says Deckert.
8. Achilles Tendonitis: An overuse injury caused by training extensively during a short period of time, dancing on a hard floor or putting pressure on a tightened calf muscle. Weight pressure or unbalanced range of motion will predispose dancers to this type of tendonitis. Prevention Tip: Use Thera-Bands when doing tendus, basic flexibility and resistance work, says Bruce.
9. Lateral Ankle Sprain: A ligament tear that happens when the outside of the ankle rolls inward after loss of balance from landing a jump. Prevention Tip: “Use a Thera-Band to keep the ankle flexible and strong," says Bruce.
10. Posterior Ankle Impingement Syndrome: A pinching sensation felt during repeated floor or barre work, as the heel bone comes into contact with the talus bone and tissues at the back of the ankle compress. Reaching a full range of motion when pointing the feet or in relevé will be difficult. Dancers born with an extra bone in place are more prone to this syndrome. Prevention Tip: Vary your training regimen to focus on other types of dance after excessive pointe or demi pointe work.