Common Ballet Injuries

Most dancers will complain of some foot injury at some stage in their training, and professional ballet dancers will often be plagued with injuries, ranging from mild ones that are nursed for years, to severe injuries that may be career ending.

Sprains and Strains

The most common injuries in ballet are strains and sprains. The ankle sprain is the most common acute injury in dance and once the ankle has been injured, it becomes more likely that it will become injured again. Occasionally, if the sprain is severe and it doesn't improve after time and physical therapy, surgery may be required.

Muscle strains, although not usually serious, are painful. The hamstring or is a frequent site of injury; this muscle covers two joints (the hip and knee), and because of its large blood supply, scar tissue and inflammation will occur if there is a bad tear. Dancers use the hamstring all the time in ballet, so injuries are often fairly frequent. Tight muscles are thought to be the main cause. As there is an imbalance during growth spurts of bone, muscle and tendon lengths, hamstrings lose some flexibility and are more likely to overcompensate by working harder.

Foot and Ankle Injuries

Many common foot and ankle injuries occur as a result of poor intrinsic foot muscle strength. The "intrinsic" foot muscles are tiny little muscles that start and end within the foot, which help control the position of a ballet dancer's arch, and are responsible for the control of the toes within the shoe en pointe. If these small muscles are not working effectively, larger muscles known as the extrinsic foot muscles (which originate further up the leg), become overused as they attempt to perform two roles. This often leads to conditions such as:

• Anterior Compartment Syndrome
• stress fractures of the shin bone (tibia)
• Medial Tibial Stress Syndrome (also known as shin splints)

Weakness in the intrinsic foot muscles and overuse of the extrinsics will also result in the toes 'clawing' both when rising, and en pointe; this is the biggest cause behind the nasty blisters that are often seen in photos of professional ballet dancers. Proper control of the intrinsic muscles will enable the middle joint of the toes to remain straight while fully pointing the rest of the foot.

Back Injuries

There are many different types of back injury suffered by dancers, such as:

• lower back muscle strain and spasm
• herniated lumbar disk
• Schuermann's disease (a deformity in the vertebrae)
• kissing spines (where the spinous processes touch)
• spondylolithesis (slipping forward of the vertebra on to the next one)
• spondylosis (spinal osteoarthritis)

Most injuries are caused when the spine is moved quickly in many different directions. The back has hyper-flexibility and mobility and can lock. Sometimes the muscle will go into spasm to protect the joint. Exercises for deep abdominal muscles stabilize the back and pelvic girdle and help core stability. Physical therapy and the use alternating cold and heat packs may also help.

Hip Injuries

There are many types of hip injuries in ballet such as:

• snapping hip
• stress fracture of the femoral neck
• bursitis
• tendonitis
• labral tear

Some of these injuries may be due to the structure of the bones (for example, shallow hip pockets), whilst some are just overuse injuries. Most of these injuries will improve with rest, and if needed, physical therapy. Stress fractures should heal, but if not, then they may result in a complete fracture and require surgery. If the joints are continued to be worked, the dancer may develop arthritis when they are older.

Knee Injuries

The knee is also a joint that has a lot of stress on it. All the ligaments in the knee are at risk for tears and sprains. If the tear is bad then surgery will be required. Osgood Schlatter's disease is the inflammation in knee caused by strain on the patella tendon. Patellar subluxation or dislocation is when the kneecap is unstable and does not slide in its groove or track. The doctor may order an x-ray to make sure it's not dislocated, physical therapy for muscle strengthening exercises and taping or bracing is helpful.

Prevention

By taking a few precautions, you can help prevent common ballet injuries.

• Warm up before you begin intense practices or performances. As with other sports and activities, cold muscles are more prone to injury and so warming up can help prevent muscle injuries and soreness.
• Stay in good shape. Injuries are more likely to happen when the dancer is out of shape or out of practice.
• Practice on a shock absorbing surface. This can help cut down on the shock and pressure the legs and feet endure whilst jumping, leaping and dancing. Practicing ballet on a hard surface can lead to shin splints and other injuries.
• Wear properly fitting ballet shoes. Choosing shoes that are too tight or too large can cause falls, slips and other injuries.
• Tape the feet to provide additional support. By using tape or other supportive devices, the legs and feet can be provided with greater stability. This can help prevent repetitive use injuries as well as sprains and other muscle strains.
• Strengthen the leg and foot muscles with special exercises and stretches. For ballet dancers, the ankle, in particular, needs to be strong and flexible. Look for exercises that improve balance and strength such as standing on one foot and heel raises.
• Learn how to perform techniques properly.
• Stop if it hurts. Listen to your body.