By: Dinesh Dhanaraj, M.D.
For a dancer, an acute injury can happen suddenly.
One minute you’re gliding across the floor. The next minute you’re on the floor – in agony.
Other injuries happen over time, caused by the repetitive movements of dance.
Fortunately, most injuries can be treated and prevented with specific rehabilitation programs designed to improve flexibility, joint stability, endurance and conditioning, so dancers can get back to the barre.
Common Dance Injuries
The body has over 600 muscles, 206 bones and countless nerves, ligaments and tendons – all at risk for strain, sprain, pull or break.
Beyond the physical demands, the requirements of a beautifully executed plié, pirouette or glissade add another element for the dancer–stress. And, a dancer under pressure to perform might ignore pain or push through to avoid losing competitive advantage.
Common dance injuries include:
- Ankle sprains. When the ligaments that support the ankle stretch beyond their limits, a tear occurs. Most sprains are minor and heal with rest and ice. Without proper treatment, a more severe sprain can weaken the ankle causing the injury to reoccur. Repeated ankle sprains can lead to long-term problems, including arthritis and ongoing instability.
- Posterior ankle impingement. The dancer experiences pain at the back of the ankle because of compression of the bone or soft tissue. Dance movements often involve maximum ankle plantar flexion motion (the foot points away from the leg at an extreme angle).
- Ostrigonum syndrome, or “Nutcracker Phenomenon.” An os trigonum is a small, extra bone found at the back of the ankle. It can cause pain and stiffness made worse when pointing the toes. When this unfused bone is combined with an ankle injury, the syndrome develops.
- Trigger toe. Dancing en pointe puts pressure on the big toe, which can irritate and inflame the sheath protecting the tendon in the toe. Symptoms are mild in the beginning and sometimes ignored. Left untreated, trigger toe can cause chronic, debilitating pain.
- Fracture of the fifth metatarsal bone. Breaks are common on the fifth metatarsal, the long bone on the outside of the foot that connects to the little toe. There are two types. An avulsion fracture occurs when the ankle rolls and a small piece of bone is pulled off the main bone. A Jones fracture is a special type of fifth metatarsal fracture toward the base of the bone that is prone to slower healing because the area receives less blood.
- Snapping hip syndrome, also called “dancer’s hip.” The repetitive and physically demanding movements of dance cause this syndrome. The onset is slow. Initially dancers report non-painful sensations, or audible snapping, clicking or popping when moving and turning.
- Hip labral tear is a painful condition that may require surgery. The labrum is the rubbery cartilage that helps keep the ball part of the joint in the hip socket. With a tear, pain is felt at the front of the hip or in the groin. Sometimes the hip clicks, locks, catches or gives way.
- Patellofemoral syndrome, sometimes called “jumper’s knee.” The condition ranges from uncomfortable to extremely painful — with pain felt at the front of the knee and around the kneecap. It is caused by overuse of the knee joint.
Treatment and Prevention
Depending on the nature of the injury your doctor may order an imaging test, such as an X-ray or MRI to rule out a broken bone or ligament damage.
Often, injuries can be treated with the RICE method – rest, ice, compression and elevation. Anti-inflammatory medications can be used to help relieve pain and swelling, and physical rehabilitation can help get dancers back on their feet. In some cases, depending on the injury and its severity, surgery may be necessary.
Proper conditioning and training are critical to helping prevent injury. Other tips include:
- Warm up and cool down thoroughly with stretches of the toes, feet, ankles and calves before and after a workout.
- Strengthen the lower leg and foot muscles and improve the mobility of the ankles with strength training exercises.
- Fatigue is often a factor with injuries, especially ankle sprains. Maintain a balanced schedule, eat nutritiously, stay hydrated and get enough rest.
- Be vigilant in observing early symptoms. If an injury is left untreated, long-term problems may develop.
For more information or to find a physician affiliated with Penn Medicine Princeton Health, call 888.742.7496 or visit www.princetonhcs.org.
Dinesh Dhanaraj, M.D., specializes in orthopaedic sports medicine and orthopaedic surgery. He is a member of the medical staff of Penn Medicine Princeton Health.
