Fatigue and overuse major factors in dancing injuries

The Safe Dance Report IV: Investigating injuries in Australia’s professional dancers, is a collaboration between the University of Sydney and Ausdance National that surveyed 195 professional Australian dancers about their injury history and examines the Australian context and occurrence of injury in professional dancers and makes recommendations to support sustainable, healthy, and productive dancing careers.

Author and lead researcher Amy Jo Vassallo, a PhD candidate in the University of Sydney’s Faculty of Health Sciences said that while fatigue had increased as a contributing factor, poor technique had decreased.

“The proportion of dancers reporting fatigue as a contributing factor to their injury has increased from 26 percent in 1990 and 33 percent in 1999 to 48 percent in 2017.

“However, compared with previous Safe Dance survey results, fewer dancers reported poor technique or environment as a contributor to their injury. This demonstrates the benefits of education, policies and interventions regarding safe dancing practice for dancers and teachers at all stages of a dance career, including early teaching and pre-professional training,” she said

“The consequences of these injuries can be quite substantial and include missed performance opportunities and income, ongoing pain and disability, and expensive treatment including surgery. Serious injuries can even lead to early retirement from dance careers and lifelong pain and dysfunction.”

The research also found that 97 percent of respondents had experienced at least one significant injury in their dance career, compared with 89 percent in 1999. 73 percent of dancers reported experiencing a dance-related injury in the past 12 months.

Key findings

- The most common site of injury was the ankle (26 percent), followed by the knee (11 percent) and hip (10 percent).

- The most common injury type was a strain (25 percent), followed by chronic inflammation (19 percent) and a sprain (18 percent).

- There was one accidental or traumatic injury for every two overuse or gradual injuries. The most common responses regarding the self-reported contributor to injury were fatigue (48 percent), followed by new or difficult choreography (39 percent) and ignoring early warning signs (31 percent).

- Despite 62  percent of respondents reporting belief that there is still stigma associated with sustaining injuries as a professional dancer, 75 percent of dancers did say they would seek professional opinion if they suspected an injury.

- However, only 50 percent stated they would tell someone within their dance employment and 49 percent said they would also take their own preventative steps to manage their injury.

- Despite seeing a clinician for treatment of their injury, 40 percent of dancers whose injury was currently unresolved were unsure if their injury would resolve in the foreseeable future. This indicates that many dancers need to be provided with improved and realistic expectations of their injury, capacity to dance during their injury and likely return to full dance ability.

- Survey respondents’ employment as a dance performer was most commonly with a dance company (66 percent) or as an independent dance artist (38 percent).

Ms Vassallo said that strain injuries were likely the most common due to the repetitive nature of a range of professional dance styles. She said there are a number of different ways dancers and the industry can reduce the chances of injury.

"Dancers should look to get adequate rest, warm up and cool down, train and perform in appropriate dance environments including light, ventilation and floors designed for dance, improve access to affordable and dance knowledgeable clinical care for all Australian dancers and reallocate resources  within the performing arts to allow for greater job security which in turn allows independent dance artists the time to take breaks and rehabilitate their injuries."

Ausdance National President, Professor Gene Moyle said the report continues an important lineage for the Australian dance community with this paper being the fourth in a series of Safe Dance research projects.

“Hearing the words “safe dance practice” being so much a part of our language and approach within the dance sector today is a testament to the impact and contribution of the collective Safe Dance reports within our industry,” she said.

Recommendations from the report outlined that access to dance-educated or dance-specialised healthcare services is essential; addressing the cultural aspects of injury reporting is critical; and that a better acknowledgment of the psychological and psychosocial aspects of injury is required.