Clinical Burden of Injuries in Students at a Professional Circus College: A 7.5-Year Longitudinal Study

Abstract

OBJECTIVE: To characterize clinical burden of injuries incurred by circus students enrolled in a 3-year college training program. METHODS: Student (n=334) injury data derived from an in situ clinic was examined over a 7.5-year time frame from August 2009 to December 2016. Injury incidence rate (per 1,000 training hours) was calculated and clinical incidence (injuries/year) was examined in relation to year in program, sex, age, and circus discipline. Weekly and monthly injury incidence were plotted with respect to milestones in the scholastic training year. Clinical burden (injury incidence and duration) was examined according to anatomic location and circus discipline. RESULTS: The overall injury incidence rate was 1.89 injuries/1,000 training hours and 0.94 injuries/1,000 training hours for injuries with a duration longer than 4 weeks. Clinical incidence decreased with year in program (p<0.05) and there were no sex or age differences. Temporal analysis demonstrated elevated weekly injury incidence for the 3 weeks following return from both summer and winter vacation (p<0.01) and for the weeks leading up to technical exams (p<0.01). According to anatomical location, shoulder injuries accounted for the greatest clinic burden followed by ankles and according to discipline, ground acrobat flyers followed by ground acrobats with equipment accounted for the greatest clinic burden. CONCLUSION: Overall injury incidence rate in the circus training program was within the range reported by other circus training programs and similar artistic and athletic training programs. Resources should be designated for enhanced rehabilitation efficacy and prevention of shoulder and ankle injuries and for ground acrobats with equipment and flyers. Preventative strategies to improve safety upon return-to-training after vacations should be examined.

Untangling risk factors including discipline-specific exposure for injuries in preprofessional and professional circus artists in the USA

“…Many contextual differences were apparent in our sample compared with previous studies. Circus students at professionalising schools trained 19 or more hours per week,3–5 7 whereas preprofessionals in this study trained 6.68 sessions per week on average. Sessions had close to a 1:1 relationship to hours in the pilot study 12.…”

“…The first step for developing an injury prevention strategy includes surveillance to understand how personal (intrinsic) and environmental (extrinsic) factors affect injury risk 1. Circus injury research has been limited to primarily descriptive studies of professional artists in a large company2 and students at professionalising schools 3–7. These populations represent a small segment of the overall circus context in the USA 8.…”

“…Early research compared the anatomical location of injuries for floor acrobatics versus acrobatics with equipment, including aerial (trapeze) and ground (tight-wire and slackline) disciplines with inconsistent biomechanical demands 3. A recent study found clinical injury burden (injury rate plotted against injury duration) was generally higher in ground acrobats, but the exposure was not considered 7. Two studies4 12 reported higher proportions of injuries for ground acrobatics, but the exposure was also higher for these disciplines, which may have accounted for the difference.…”

Maximal dynamic forces exerted by acrobats on nine circus apparatuses

“…Circus injury patterns and rates have been investigated among professional artists, [3][4][5][6] student artists [7][8][9] and adolescents. 10 Several longitudinal studies focused on the Cirque du Soleil company, 4 National Institute of Circus Arts in Australia, 7 National Center for Circus Arts in France 8 and the Montréal Circus School.…”

“…10 Several longitudinal studies focused on the Cirque du Soleil company, 4 National Institute of Circus Arts in Australia, 7 National Center for Circus Arts in France 8 and the Montréal Circus School. 9 Although definitions of injury are inconsistent, equipment is mentioned as an external factor of injury. 6,8,11 The safety of acrobats is a major concern in the circus community as circus practice involves design and rigging of equipment that must withstand high loads.…”