INTRODUCTIONDancers represent a medically under-served occupational group at high risk for work-related musculoskeletal disorders (WMSD). They are highly trained individuals who perform repetitive, reproducible, and consistent movements. 1 The annual incidence of injury in professional dancers is 67-95%. [2][3][4][5][6] Traditionally, dancers are considered to be both artists and athletes. Accordingly, medical practitioners have adopted a sports medicine model in the care of dancers within their respective organisations. Activities such as annual screenings and performance coverage pattern themselves after pre-season team screenings and game coverage. This approach has been effective enough to produce a recent offspring, dance medicine, which has sought to describe patterns of, and risk factors for, dance-related injury. As dance medicine continues to grow, many of its specialists are also drawing from another model, occupational medicine, to develop injury prevention and management programmes tailored to the special needs of this population.In this article, we borrow from both the sports and occupational medicine models to review some of the issues in addressing WMSD in dancers. Consideration will be given to injury risk factors and options for organisational management of injury. To further our discussion, Figure 1 illustrates a dance medicine conceptual model demonstrating the interaction of intrinsic risk factors of the dancer/worker with extrinsic risk factors of dance/work that may result in musculoskeletal injury and the points at which prevention measures can be introduced.
MULTIFACTORIAL RISK FACTORSWMSD incur enormous health and financial costs. They account for over 85% of workers' compensation (WC) claims in the US, with estimated annual costs ranging from $13-54 billion. 7,8 In order to design optimal prevention and intervention strategies for workers, it is important to ascertain the nature of risk for WMSD. Risk factors are attributes or elements ABSTRACT Professional dancers are a medically under-served occupational group at high risk for workrelated musculoskeletal disorders. Historically, a sports medicine approach has been used in the treatment of dancers and dance companies. Recently, health care providers have also applied occupational medicine concepts to the dance organisation. Consideration of risk factors and the application of organisational programmes to prevent work-related musculoskeletal disorders in dancers are discussed. Deficiencies in our understanding of the contribution of risk factors towards injury are outlined for future consideration. The majority of dance organisations are non-profit and have no injury prevention strategies in place, viewing medical programmes as an unaffordable luxury. The application of a customised sportsoccupational medicine approach shows promise in reducing the human and financial costs of work-related musculoskeletal disorders.
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