ObjectivesTo describe the incidence rate, severity, burden and aetiology of medical attention and time-loss injuries across five consecutive seasons at a professional ballet company.MethodsMedical attention injuries, time-loss injuries and dance exposure hours of 123 professional ballet dancers (women: n=66, age: 28.0±8.3 years; men: n=57, age: 27.9±8.5 years) were prospectively recorded between the 2015/2016 and 2019/2020 seasons.ResultsThe incidence rate (per 1000 hours) of medical attention injury was 3.9 (95% CI 3.3 to 4.4) for women and 3.1 (95% CI 2.6 to 3.5) for men. The incidence rate (per 1000 hours) of time-loss injury was 1.2 (95% CI 1.0 to 1.5) for women and 1.1 (95% CI 0.9 to 1.3) for men. First Soloists and Principals experienced between 2.0–2.2 additional medical attention injuries per 1000 hours and 0.9–1.1 additional time-loss injuries per 1000 hours compared with Apprentices (p≤0.025). Further, intraseason differences were observed in medical attention, but not time-loss, injury incidence rates with the highest incidence rates in early (August and September) and late (June) season months. Thirty-five per cent of time-loss injuries resulted in over 28 days of modified dance training. A greater percentage of time-loss injuries were classified as overuse (women: 50%; men: 51%) compared with traumatic (women: 40%; men: 41%).ConclusionThis is the first study to report the incidence rate of medical attention and time-loss injuries in professional ballet dancers. Incidence rates differed across company ranks and months, which may inform targeted injury prevention strategies.

Purpose To describe the relationships between dance exposure, dancer characteristics, and injury risk across five seasons in a professional ballet company.Methods Dance exposure time and clinician-reported time-loss and medical attention injury data were prospectively collected from 118 professional dancers of The Royal Ballet between 2015/16 and 2019/20. Cox proportional hazards and shared frailty models were fitted to overuse and traumatic injuries; individualized robust Z-scores for 7-day and 28-day accumulated exposure, and week-to-week change in exposure, age, sex, company rank, and injury history were included as time-varying covariates. ResultsAcross 381,710 h of exposure, 1332 medical attention and 427 time-loss injuries were observed. Positive relationships were observed between week-to-week change in exposure and overuse time-loss (+1 Z-score hazard ratio (HR): 1.27, 95% confidence interval (CI): 1.06-1.53) and medical attention injury risk (+1 Z-score HR: 1.17, 95% CI: 1.06-1.28). A negative relationship was observed between 7-day accumulated exposure and overuse medical-attention injury risk (+1 Z-score HR: 0.74, 95% CI: 0.66-0.84). Overuse time-loss injury risk was greater in soloists compared to the corps de ballet (HR: 1.47, 95% CI: 1.01-2.15), and in dancers with a higher previous injury rate (+1 injury•1000 h -1 HR: 1.06, 95% CI: 1.02-1.10). Only age was associated with traumatic time-loss (+1-year HR: 1.05, 95% CI: 1.01-1.09) or medical attention injury risk (+1-year HR: 1.04, 95% CI: 1.01-1.07). ConclusionProfessional ballet companies should implement training principles such as periodization and progression, particularly in the case of senior-ranking dancers, older dancers, and dancers with high rates of previous injury. These findings provide a basis for future prospective investigations into specific causal injury pathways.

A lateral bias has been previously reported in dance training. The aim of this study was to investigate whether there are any bilateral differences in peak forces, power, and maximum knee flexion during a sequence of three grand jetés and how they relate to leg dominance. A randomised observational design was selected for the study. Volunteers consisted of 20 female dancers in the last year of pre-professional training. All volunteers completed three different tests to determine leg dominance prior to completing a three grande jeté sequence. The lead leg for the jump sequence was randomised. Peak take-off power, relative landing force (BW), and maximum knee flexion angles were measured using a Myotest accelerometer and integrated goniometer. Results indicated that 90% of dancers reported right leg dominance. A significant difference was noted in peak take-off power among the jumps (p<0.01); post hoc test indicated jump 3 was significantly greater than jump 1. Mean maximum take-off knee angles increased over the three-jump sequence with the left leg having a significantly deeper plié than the right (p<0.01). Landing data showed an increase in peak force and a decrease in maximum knee angles across the jump sequence. The present data indicate different bilateral strategies during take-off and landing during grand jetés in female dancers resulting in increased forces during the jumps on the non-dominant side. These differences need to be addressed by incorporating appropriate modifications in training methodology that eliminates the observed bilateral differences.

We investigated the associations between leg length and specific ballet movements in different skill groups. Volunteers were from an undergraduate dance programme (n=18), a pre-professional school (n=43) and from an elite classical ballet company (n=45). Individual data were collected for anthropometry, vertical jump, leg dexterity, and leg active and passive ROM. ANCOVA identified both main effects as significant with regard to vertical jump (gender P<0.001 and skill P=0.017); leg length was also identified as a significant covariate (P=0.023). Analysis of leg dexterity identified no significant effects with gender, skill or leg length. Active and passive range of motion noted gender (P=0.001) and skill (P<0.001) differences. Leg length was found to be negatively associated with both active and passive ROM (P=0.002). In conclusion, the present data highlight the diverse and conflicting effects of leg length on fundamental ballet skills. The longer legs that benefit vertical jump have a negative influence on range of motion and leg dexterity except for highly skilled dancers, who through skill, seem to have overcome the effects of some of these dichotomies.

Selection criteria required that participants be 17 years old plus and dance on average 20 hrs/week for the past 3 years. Participants were asked to indicate whether they were in full-time training (defined as pre-professional) or profes