Physical Therapy for Dancers
Dance is a full-body sport and art form, demanding incredible muscular strength, flexibility, and stamina. Dancers engage in long hours of training and performance, requiring extraordinary feats of athleticism, repetitive movements, and extreme flexibility. Due to the intense physical demands of dance, dancers are susceptible to injuries of the ankle, foot, leg, and lower back. Physical therapy can effectively treat dance-related injuries for a safe return to dance, helping the dancer regain full function and range of motion, addressing muscle imbalances, improving strength and conditioning, and providing bio-mechanical analysis for injury prevention.
Common Dance-Related Injuries
Dancers are athletes in which explosiveness and stamina are required in combination with precise technique, tremendous flexibility, excessive range of motion, and incredible physical fitness. Dancers put in long hours of training that involve repetitive movements, which can lead to overuse injuries. Dance places unique demands on the dancer’s joints, particularly the hip, knee, and foot-ankle complex.
Approximately 80% of all ballet-related injuries are in dancer’s legs. Ballet in particular places extreme demands on the foot and ankle when ballet dancers dance “en pointe” (in pointe shoes). When dancing in pointe shoes, the bones, ligaments, and tendons of the foot-ankle complex are placed in a unique position, stretching the soft tissues to their end limits and the talus bone to the end of its anatomical motion. It is critical that dancers wait to begin dancing on pointe until skeletal development is mature; starting too early on pointe (when the skeletal development is immature) can lead to lifelong foot and ankle problems.
Ankle sprains are the #1 traumatic injury in dancers, occurring when ligaments on the inside or outside of the foot are twisted or overstretched, which may cause them to tear. Ankle sprains can result from improper landing from a jump, misaligned ankles, or poorly fitted shoes. Shins splints are a very common overuse injury due to repetitive movements and dancing on various types of floors. If ignored, shin splints can progress to microfractures in the shin.
The most common dance injuries include:
Hip injuries: snapping hip syndrome, hip impingement, hip labral tears, hip flexor tendonitis, hip bursitis, sacroiliac joint dysfunction
Ankle & Foot Injuries: ankle sprains and impingement, Achilles tendonitis, plantar fasciitis, trigger toe
Knee Injuries: Patellofemoral pain syndrome, meniscus tears, and ACL injury
Leg Injuries: shin splints, stress fractures in the tibia (due to unaddressed shin splints) as well as to the metatarsal bones and lumbar spine
Back injuries: low back pain, herniated discs, lumbar strain
Arthritis of the knee, hip, ankle, and foot
Physical Therapy for Dancers
Physical therapy can effectively treat dance-related injuries for a safe return to dance. The therapist treats the specific injury through a variety of treatments, including pain management, manual therapy, aquatic therapy, a progressive exercise program, targeted stretching and flexibility exercises, and functional training.
The physical therapist conducts a biomechanical analysis to identify muscle imbalances and weaknesses as well as areas of hyper-mobility or decreased mobility to target and address those areas during treatment and improve overall body function to prevent future injury. The physical therapist’s aim during rehabilitation is to help the dancer regain full function and range of motion in the injured area. The therapist targets the knee, hip, and foot with strengthening and stabilization exercises as these joints require a significant amount of strength and stability to absorb the shock of repetitive jumping and turning when dancing. The therapist also focuses on core strengthening as a strong core helps to decrease low back pain and injury as well as absorb the impact of repetitive jumps and turns.
The physical therapist guides the patient through a strength and conditioning exercise program to improve the dancer’s strength and cardiorespiratory fitness. To increase strength without building muscle mass, the dancer uses resistance bands and does core stabilization exercises during rehabilitation.
As dance requires both aerobic and anaerobic capacity, the therapist directs the dancer through an aerobic conditioning program. Anaerobic activity refers to intense activity over a short period of time, such as when performing a sequence of fast-moving technique or an expansive leap sequence across the stage. Dance often involves intermittent, high-intensity, anaerobic exercise. To build cardiorespiratory fitness for these anaerobic intervals, the dancer engages in aerobic conditioning so that the dancer can recover faster between intervals of intense dance exercise. The better the aerobic system works, the less the anaerobic system must kick into gear during a high-intensity dance sequence.
Dance places incredible physical demands on a dancer’s body, requiring extreme flexibility, range of motion, stamina, and technique. When an injury occurs, whether due to overuse or trauma, physical therapists are here to help dancers regain function, range of motion, and strength to safely return to dance.
