Medical and Rehabilitation Issues in Classical Ballet

Abstract

Classical ballet is a demanding professional occupation, with participants who are often underserved in terms of accurate diagnosis and appropriate comprehensive medical care. The view that follows is designed to be as global and insightful as published to date. Specific rehabilitation considerations, dance mechanics, idiosyncratic differential diagnosis, and personality and equipment issues are discussed, and a rational view of dogma is presented.

Injury patterns in young, non-professional dancers

“…An inefficient distribution of force throughout the foot, transverse plane rotation of the lower limb, and inadequate experience in proper balance and landing technique have been cited as probable causes of knee injuries (Liederbach, 2000;Orishimo, Kremenic, Pappas, Hagins, & Liederbach, 2009). The turnout position required at the foot may also place exaggerated forces on the medial aspect of the knee (Hamilton et al, 2006;Stretanski & Weber, 2002). The incidence of these injuries increases with age, as do impacts and loads on the knee joints.…”

Cognitive and Mobility Profile of Older Social Dancers

“…Professional dancers are reported to have better balance and may show different postural adaptation to balance perturbations than nondancers. 1,22,23 For instance, dancers rely more on proprioception and less on visual input than nondancers. 23 Ballet dancers are trained to have a stable visual reference.…”

Dancers With Achilles Tendinopathy Demonstrate Altered Lower Extremity Takeoff Kinematics

“…Though the prevalence and incidence of AT has not been specifically identified in the dance literature, it is considered an injury common to the dance community. 14,21,25,34 During dance, the triceps surae complex must possess strength for various movements, such as dancing on pointe or demi-pointe (standing on the toes or the balls of the feet), sufficient flexibility to allow maximal dorsiflexion for plié (a bending of the knees while the torso remains upright), and optimal stiffness to transfer a powerful calf muscle contraction to the calcaneus during a takeoff for a jump or leap. 1,25 Should any of these mechanical characteristics (strength, flexibility, or stiffness) be insufficient and, moreover, coupled with strength or control limitations in other regions of the lower extremity and trunk, the Achilles tendon may be more susceptible to overload.…”

“…In dancers, specifically, contributing factors to AT are thought to include poor training, technical errors, unfamiliar choreography, excessive pronation, poor flexibility of the gastrocnemius-soleus, fatigue, and flooring surfaces. 22,29,34,35 The saut de chat is a leap common to ballet that is also used extensively in other forms of dance. The goal of this leap is to launch from 1 foot, gain as much height as possible, attain a fully extended split-legs posture at the peak of the airborne period, then land on the opposite foot (FIGURE 1).…”