The Association Between Stress and Injury: A Prospective Cohort Study Among 186 First-Year Contemporary Dance Students

Abstract

The demanding environment that contemporary dance students are exposed to could result in high stress levels, which can influence injury susceptibility. Therefore, this study aims to investigate the association between stress and injuries. In the period between September 2016 and March 2020, four cohorts of first-year dance students (N = 186; mean age 19.21 ± 1.35 years) were followed for one academic year. Each month, general stress was assessed on a 0–100 visual analogous scale. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used on a monthly basis to monitor injuries. Injuries were defined as “all injuries” (i.e., any physical complaint irrespective of the need for medical attention or time-loss from dance) and “substantial injuries” (i.e., leading to moderate/severe/complete reductions in training volume or performance). Mann–Whitney tests were performed to measure differences in general stress levels between injured and injury-free students, while repeated-measures ANOVA were performed to investigate whether general stress scores increased before and during injury occurrence. The overall average monthly general stress score over all cohorts for all students was 39.81. The monthly general stress scores ranged from 31.75 to 49.16. Overall, injured and substantially injured students reported higher stress scores than injury-free students, with significant differences in 3 out of the 9 months for all injuries (September, October, March, p < 0.05), and in 5 months for substantial injuries (September, October, November, December, April, p < 0.05). Within the 3-month period before and during injury occurrence, a (marginally) significant linear effect of general stress across the time periods was found for all injuries [F(1.87,216.49) = 3.10, p = 0.051] and substantial injuries [F(2,138) = 4.16, p = 0.018]. The results indicate an association between general stress and injuries. Future research should focus on effects of varying stress levels on injury risk using higher sampling frequency, for instance by measuring weekly since stress levels are likely to fluctuate daily. Practically, strategies aiming at stress reduction might have the potential to reduce the burden of dance injuries and may have positive outcomes for dancers, teachers, schools, and companies.

Elite lean athletes at sports high schools face multiple risks for mental health concerns and are in need of psychosocial support

“…An additional source of concern found in the present study was that injuries were expressed as being part of youth sports, thus a phenomenon that risks becoming normalized. Perceived illhealth related to injuries have been reported to be high in sports high school settings [51,52] and stress is one factor that has been associated with injuries amongst dance students [53]. Furthermore, research suggests that injuries related to overuse may be partly a consequence of inadequate self-perception among elite athletes, supporting the need for psychological interventions in injury prevention research [54].…”

Psychological stress responses to a live performance by professional flamenco dancers

“…Moreover, the strategies aimed at reducing stress could potentially reduce the incidence of injuries in dance, as the physical aspects seem to be related to the psychological ones, and injuries are associated with a complex combination of biopsychosocial factors ( Cahalan et al, 2015 ). Thus, improving psychological aspects could foment the development of dance in the different agents in the sector: dancers, teachers, schools and professional companies ( Van Winden et al, 2021 ).…”

Mit Leichtigkeit tanzen – Verletzungsprophylaxe im Hochleistungstanz

“…Es zeigte sich, dass vor allem im (prä-)professionellen Bereich wenig in die Verletzungsprävention von Tänzern investiert wird, selbst wenn diese Investitionen wissenschaftlich erwiesene leistungssteigernde Effekte mit sich bringen würden. Diese wahrgenommenen Stressoren stehen mit den hohen Zahlen an (Rezidiv-)Verletzungen durch Stress in Verbindung 19 , 22 .…”