Common Dance & Ballet Injuries: Causes, Prevention & Rehab Guide

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As a dancer or parent of a dancer being armed with knowledge about the most common injuries dancers are most susceptible to, is the first step to prevention, quicker recovery, and better rehabilitation. For this reason, we have put together a comprehensive guide that covers the 10 most common dance injuries with both preventative tips and tried and tested rehabilitation measures.

The 10 most common injuries in dance include:

1. Ankle sprains
2. Achilles tendonitis
3. Shin Splints or Tibial Stress Syndrome
4. Pulled and Torn Muscles
5. Trigger Toe
6. Anterior/Posterior ankle impingement
7. Snapping Hip Syndrome
8. Hip Impingement
9. Patellofemoral Pain Syndrome
10. Osteoarthritis

Not all dance injuries are preventable, but there are steps that can be taken to reduce the risk of them occurring and definite steps that can be taken towards rehabilitation.

Please note that we are not medical professionals but have meticulously gathered information from various medical authoritative resources to create a highly helpful guide on dance injuries. We have activated comments on this article so that we can make this the best resource on the web for dancers and parents of dancers so if you have something helpful to add or are a medical professional and feel we are giving incorrect information please feel free to leave a helpful comment to enable us to edit the article as seen fit.

Although not stated everytime, you should always be assessed by a medical professional to confirm the severity of the injury and whether our suggested preventative and rehabilitative measures are suitable for your particular situation and body.

Sprained Ankle

What is a Sprained Ankle?

An ankle sprain is when the thick tissues called ligaments that connect your bones to each other are overstretched or torn causing inflammation and tenderness.

Causes: How do dancers get a sprained Ankle?

Dancing requires many changes of weight between the feet and during these transferences if the ankle rolls, twists or bends awkwardly the dancer can overstretch or tear a ligament in their ankle causing a sprain. Some specific causes in dance are:

• Landing incorrectly after a jete or jump.
• Tripping whilst running into position during a troupe routine.
• Not being properly trained and prepared for pointe work.
• Not being properly trained and prepared for dancing in heeled shoes.
• Collapsing heavily from releve rather than engaging muscles and lowering with control during pirouettes or fouettes.
• Dancing on uneven surfaces.
• Being too physically tired and not concentrating causing a misstep.
• Wearing the wrong footwear whilst dancing.
• Wearing footwear that is too big or old such as jazz shoes that have outworn their sole grip or have holes in the toes or ballet shoes with loose ribbons.
• Dancing outside in flip flops or on the pavement etc..

Symptoms:

The best way to determine if the ankle is sprained is too check for the following:

• Discoloration
• Swelling
• Pain or discomfort when flexing, pointing or rotating the foot.
• Inability to put weight on the injured foot.

Sprains come in different forms and severities. Most of us have misstepped and rolled our foot and after some initial rest have been back on our feet in minutes or hours. Therefore although many sprains can be treated safely at home, many can’t – let pain and the symptoms be your judge. Once you have torn your ligaments they never reheal to preinjury strength and therefore seeking the help of a medical professional is vital in getting the best care you can.

Treatment at Home

• Immediately begin the RICE method.
  • Rest -immediately stop dancing or putting weight on the foot and ankle.
  • Ice – Place an ice compact over the painful area of the ankle.
  • Compression – wrap the ankle with a bandage (never too tightly as this can inhibit blood flow)
  • Elevation: Raise the ankle to encourage fluids to flow initially away from the area so that swelling does not become so severe it restricts blood flow to the foot.

Rehabilitation

Initially, you may want to employ some of the following strategies.

• Wear an ankle brace to keep your ankle stable and to prevent further injury.
• Use crutches when walking to alleviate the pressure.

But ultimately once the initial pain has receded the MEAT method should be applied. You can read about the benefits of the MEAT process for rehabilitation in an article by Dr. Ryan Campbell, ND at goodmedclinic.com.

• Move
  Begin with gentle and regular movement of the ankle such as pointing and flexing or pretending to draw circles in the air with your big toe to rotate the ankle.
• Exercise
  Try walking and putting as much of your body weight on your ankle as possible. Ligaments actually heal quicker this way. Instead of regular dance classes, it might be wise to do floor barre, pilates or progressing ballet technique classes until the ligaments have healed.
• Analgesic
  Take paracetamol, Tylenol or natural pain relievers for the pain to enable you to move and exercise. Pain is important to remind you not to push yourself too far, but it can also hinder recovery when it is focused on. Swelling is also important in healing as it promotes more blood flow to the area and therefore icing the injury too much can inhibit recovery. Inflammation medicine can also hinder healing especially with ligament injury as ligaments rely on the blood flow of the muscles surrounding them to deliver all the nutrients and goodness it needs to heal, as they don’t have their own supply like muscles do.
• Treatment
  Your injury might require the help of a professional such as a physiotherapist to develop with you a treatment plan depending on the severity of your injury – most especially if the ligaments are torn or there is a strain which is different from a sprain meaning muscles could be torn from the bone.

Prevention

To prevent such injuries in the future, here are some key things your child can do:

• Strengthening exercises such as or slowly pointing and flexing the feet using a resistance band.
• Wearing appropriate footwear.
• Dancing on flat surfaces without obstructions.
• Slowing down and/or stop dancing when you are feeling overly tired because it can cause you to be inattentive.
• Not trying steps, moves or pointe work before you are ready for them.

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Achilles Tendonitis

What is Achilles Tendonitis:

Achilles tendonitis is the inflammation of the Achilles tendon which is the thick tissue that connects the heel bone to the calf muscle.

Causes: How do dancers get Achilles Tendonitis?

Achilles tendonitis becomes inflamed with repetitive movement and strain, but in particular for dance the consistent repetition of the following whilst dancing:

• Not correcting poor alignment.
• Forcing turnout through the feet, ankles, and knees rather than through the natural ball socket turning ability of the hip joint.
• Excessive pronation or rolling in of the foot arches creating flat feet.
• Not rising onto full releve or not standing as high on the ball of the foot as you can.
• Moving straight from a part-time to full-time training regime rather than gradually adding on more classes to condition the body in readiness.
• Asking too much of your body and not resting enough.
• Professionals who dance several roles in a show repeatedly overusing the tendon.
• An anatomical abnormality such as a profusion on the heel bone that rubs against the Achilles tendon when moving.

Symptoms:

• Pain at any point along the Achilles tendon (the pain can originate lower or higher along the tendon for different people.)
• Tightness or stiffness in the Achilles that loosens as a dancer warms up.
• Nagging pain in the Achilles that the dancer recognizes as being ‘not normal’ but is able to dance through it for some time, even for years until it becomes unbearable.
• Squeezing the tendon may cause unusual pain.

If a dancer experiences any of the symptoms in the back of the heel, unless the pain is suddenly excruciating or unbearable indicating a sudden tear, then they are most likely suffering from Achilles Tendonitis.

Treatment at Home

In the beginning, if the pain is only nagging or noticeable before warming up try some of the following tips if you are unable to see a physiotherapist or doctor. If the pain becomes progressively worse or is unbearable you need to see a medical specialist straight away as in some cases the injury can lead to surgery or the need for steroid injections which could mean even more time out of the dance classroom and ultimately a weaker side when dancing.

The aim of treatment is to get reduce and get rid of the inflammation irritating the tendon.

• Rest
  Unfortunately for this injury dancing on the irritated tendon will only make it worse. To heal, tendons shouldn’t be stretched but left to rest in a natural state. Crutches or a boot to restrict movement when walking can help promote rest of the tendon.
• Ice
  Helps reduce pain and inflammation.
• Compression
  There probably isn’t much swelling, but wrapping your ankle in a bandage is a reminder that you need to take it easy on that foot and is an outward sign to others that you are injured.
• Elevation
  Elevating your foot when you can help reduce swelling and inflammation and also forces you to rest.

• Inflammatory pain relief
  Taken as directed inflammatory pain relief such as ibuprofen may also help to reduce the inflammation and pain (all medication does come with side effects especially if taken for long periods so read the directions properly!). But the pain relief will only be temporary and therefore should not be used if it gives you a false sense that the tendon is better and ready for you to dance on.

• Turmeric Supplements
  There is gathering evidence and continuous research being done to suggest that taking turmeric supplements aids in the reduction of inflammation.

• Epsom Salt Warm Soak and Cold water Cycle
  To help flush out gathering inflamatory fluids around your heel, soak your tendon alternately for 40minutes in 10-minute cycles into
  • a small bath/tub of warm water with Epsom salts
  • a small bath/tub of cold water with up to 4 ice cubes
    
• Use a Foam Roller or Tennis Ball
  Use a foam roller to massage the calf muscle and roll your foot and ankle over a tennis ball to reduce muscle tightness in these areas.

Rehabilitation

• Although rest is the cure for tendinitis after several days of complete rest ensure you begin to gently move the tendon through its full range to ensure it does not become stiff. More rest may be required, but sporadically moving the foot will help to increase the blood flow around the tendon and move the inflammation fluids away.
• Resume training with floor barre, pilates or progressing ballet technique classes before beginning a reduced training program.
• Wear a shoe with a small heel shoe when walking to help keep the tendon in a contracted rather than the lengthened state. (This does not need to be done forever as prevention because it can also promote the shortening of the tendon which is not what we want as dancers either).

A dancer will continue to get tendonitis even after the tendon heals if they do not correct whatever it was that caused them to get the tendonitis in the first place. -Rehabilitation and future prevention, therefore, needs to include a focus on correcting the problem.

Prevention

Achilles Tendonitis is caused by repetitive strain on the tendon and as dancing is repetitive you might think it would be hard to prevent, but there are some good ways to ensure it doesn’t happen to you:

• Learning from a good teacher who teaches you to use proper alignment, helps you use your turn out properly, corrects your pronating feet and makes sure you are rising to full releve.
• Your teacher should be aware of the dangers of the most common dance injuries and therefore not overwork their students in particular exercises if the students are not conditioned for them.
• Don’t cram for an exam or performance! You should never spend an all-nighter before a performance or exam practicing your skills because you haven’t consistently practiced in blocks over the week or months before. Repeating movements over and over intensely especially when tired is a sure-fire way of getting tendonitis!
• Stretching is important before starting any activity because if you jump right into, going from zero to a hundred too fast, then that is what can cause strain.
• Condition your body – when trying a new class or dance style or move, it is best to start off slow and work your way up instead of just trying to do it all at once.
• Try to participate in other low impact exercises, such as swimming, yoga or cycling to break out of the repetitiveness of your dance class.

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Shin Splints

What are Shin Splints or Tibial Stress Syndrome?

Shin splints are when mainly the tibia bone in the shin and their linings and surrounding muscles become irritated and inflamed causing extreme pain when transferring weight onto the legs such as when jumping. When irritated the bone is no longer able to effectively absorb shock.

Causes: How do dancers get Shin Splints or Tibial Stress Syndrome?

Unfortunately shin splints are one of the most common injuries a dancer can receive. Dancers generally get shin splints from the repetitive jumping, leaping and landing they do.

• Not fully lowering heels to the ground in plie or when landing in jumps.
• Landing without control from releve or the balls of the feet.
• Incorrect alignment when landing in jumps or from releve.
• Weight too far back on the heels and gripping the floor with the foot or toes.
• Dancing on surfaces without shock absorption (concrete for example)
• Dancing on a raked stage (a stage that slopes allowing the audience to see the dancers more easily.)
• A rapid increase in training.
• Forcing turnout from the knees and feet rather than the ball socket of the hips.
• Pronating feet – rolling the arches of the foot towards the floor.

Symptoms

The main symptom of shin splints is sharp pain when transferring weight, especially when landing onto the feet which is felt along the shin. It can even become painful to simply walk. The pain felt from shin splints will usually be felt along the tibia bone, this is useful to know as stress fractures generally have more localized pain points, but it is always recommended that you see a doctor or medical professional to be sure, especially as shin splints are one cause of stress fractures of the tibia.

Treatment at Home

The best treatment for shin splints is the RICE method!

REST
Taking a break from classes is a must and reducing the amount of weight you place on your shins is also needed. This is easier to do if the pain is only felt in one leg as you can use crutches to aid your movement but if it is felt in both legs try to keep off them for a few days as much as possible!

ICE
Icing your shin bones and muscles to help reduce the pain and inflammation with help them to heal. You can ice your shins for 20-30 minutes or in cycles of 10mins on 10mins off over an hour 3 to 4 times every day during your resting period. A great tip is to freeze ice in large ice cube containers or a small ice-cream cup with a stick so you can massage the ice pop into your aching shins!

COMPRESSION
The aim is to reduce inflammation of the bone lining, connective tissue and muscles surrounding the shin bones and therefore compression will also be effective in promoting healing. You might like to wrap your shin in a bandage, wear a tube bandage or even compression socks.

ELEVATION
Elevating your shin to promote the flushing of inflammative fluids and reduce inflammation and swelling will also help. So relax and put your feet up and take the time to rest.

• Inflammatory pain relief
  In the case of shin splints, inflammatory pain relief such as ibuprofen will help to reduce the inflammation and pain temporarily, it won’t help them heal! Therefore it should really only be used if you don’t have the option of resting immediately.

• Turmeric Supplements
  There is gathering evidence and continuous research being done to suggest that taking turmeric supplements aids in the reduction of inflammation.

• Use a Foam Roller
  Use a foam roller to massage the shin. Either use your hands to roll it up and down both the front and sides of your shin and over the calf muscles. Alternatively, use your body weight and lie on your stomach moving your body forward and backward so that your shin rolls over the roller. Foam rolling helps to decrease muscle and tissue tightness and improve circulation.

Rehabilitation

You will want to ease your self back into your dance training and even stay away from corner work in jazz class that involves jumping or grand allegro work in ballet until you have re-conditioned your body and worked on your alignment if this what partly caused the injury.

• Begin with pilates, progressing ballet technique or floor barre classes before engaging in training.
• Go slowly and increase your classes and training gradually.
• Ensure you begin to correct the cause of the problem such as poor alignment, rolling in of the feet, constantly landing on the balls of the feet and not following through to the heel.

Prevention

The dancers in Celine Dion’s A New Day show years ago had to contend with dancing on a raked stage 6 to 7 times a week. After every show buckets of iced water were placed backstage and immediately after the performance dancers took turns to sit and soak their feet and shins in them to reduce the chance of them getting injuries such as shin splints.

• Ice Baths
  When there are conditions out of your control such as dancing on a raked stage, choreography that includes a lot of leaps and jumping, or you have danced on an unforgiving surface dipping your legs in an ice bath for 10-20minutes after you dance can help to reduce the chances of you getting shin splints as you are immediately helping to reduce any inflammation that might be forming.
• Foam Rolling
  As mentioned in treatment, foam rolling can help to massage the muscles and reduce muscle tightness and tension. Rolling your shins and calves should be part of a routine where you roll all you major muscle groups before or after dancing.
• Surfaces
  Make it a point of refusing to dance on unforgiving surfaces. For some dancing daily in a theme park parade down the main street may not affect them as they have the conditioning and technique for it, whereas for others one move on concrete or pavement might be how their shin splints start so be aware of your limits and how your body responds.
• Training with a knowledgeable teacher
  An experienced teacher will be able to help you correct your technique so that shin splints are no longer a recurring problem.

Pulled and Torn Muscles

What is a Pulled or Torn Muscle?

A pulled or torn muscle is a muscle strain where the muscle has been stretched beyond its limits and tears.

There are different levels of muscle strain. The first level although still painful is when only a few muscle fibres have been torn with the muscle just generally needs to recover from being overstretched. The third level is a total tear across all of the muscle fibres with the second level being somewhere in the middle of the two.

The best way to picture a muscle strain is picturing an elastic band being stretched further and further until it starts to rip and eventually tears. After being overstretched the elastic band can have white streaks (level 1) and is not as strong as it was previously and if it begins to rip slightly (level 2) you know to stop using it and if it tears in half then it is totally unusable (level 3), but luckily unlike rubber bands our muscles can heal.

Causes: How do dancers pull and tear muscles?

• Not warming up
• Pushing a stretch too far
• Bouncing in a stretch
• Cooling down between what you warmed up to do
• Tight muscles from not balancing stretching with strengthening

From experience, I will say that a big problem is not warming up effectively and keeping your muscles warm enough between warming up and whatever it is that you warmed up for. The first time I tore my adductor muscle was as I attempted a slow split during a dancing exam. I had warmed up, but the venue was freezing. The examiner sat at her table infront of me with her little foot heater and warm blanket over her lap whilst I was shivering as I waited for the music to begin. As I went down it didn’t help that my feet got stuck on the wood floor that didn’t look as though it had been sanded or polished in years and because of the weight of my torso, my bottom hit the ground at the last second and snap, my muscle tore – level 3! If you have seen that scene in the animated movie Ballerina where the girl is eliminated from the class as she couldn’t get off the floor from the split, that was me except I was no longer in split position but in the foetal one! I would have been 14 years old.

The second time I tore a muscle I was 16 and it was the adductor muscle on my other leg. I was on stage performing a troupe routine at competitions. I felt the snap but it didn’t feel painful like the previous time and so I kept going and was even able to do the final leg hold pose with my injured leg up near my ear held by my hand in second. As soon as the curtains closed though and I released my leg I knew I had a bad tear.

Both times I tore my muscles, I had stretched before dancing, but I wasn’t warmed up which is different. The second factor was that I didn’t practice my stretches nearly enough at home and had a false sense of my own flexibility as I was able to easily do what was asked of me in dance class when hot and sweaty.

Symptoms

Some of the symptoms of a pulled or torn muscle can include:

• Pain when stretching or using the muscle.
• Reduced strength in the muscle.
• Inability to properly use the limb the muscle is attached (for example you can’t use that leg to walk up a step as the hamstring muscle cannot contract properly.)
• Swelling, redness, bruising and inflammation.

Treatment at Home

If your strain is level 1 and simply overstretched then you may be able to treat your injury at home but if it is at level 2 or 3 you really should be seeing a physiotherapist or other medical specialist to treat your injury. In the meantime, here are some things you can do to help heal

Begin with the RICE method!

REST
Don’t be tempted to stretch the muscle or use it! For the first few days especially the muscle needs time to begin healing.

ICE
Ice the muscle to relieve pain and to help reduce inflammation and swelling.

COMPRESSION
Dancers most regularly tear their hamstrings or adductor muscles which are located nearby. Wearing a pair of compression tights or bike shorts can help to increase the blood flow and draining of inflammation fluids through the lymphatic system helping to decrease recovery time. You can also get compression sleeves and socks for other areas of the body.

ELEVATION
Elevating the limb with the torn muscle whilst actively making you rest will also promote less swelling and the flushing of toxins from the area.

Rehabilitation

It isn’t until the healing process has started that you will want to begin gentle stretching to ensure as the muscle fibers grow back long rather than contracted. This is when you want to begin the MEAT method which you can read about in an article by Dr. Ryan Campbell, ND at goodmedclinic.com.

• Move
  Begin with gentle and regular movement of the muscle with the tear ensuring that it gets to both lengthen and contract. In the beginning use supports such as pillows between your stomach/chest and legs if for example stretching forward over the legs so that you don’t overstretch.
• Exercise
  You are going to find that the muscle is weak, I mean it has been overstretched and torn and just won’t be as strong until it has healed. Personally, I found doing ballet exercises and gentle stretches in a swimming pool extremely beneficial – not laps though, I found out the hard way as I did a lap of breaststroke that my torn adductor just wasn’t ready for that kind of strain. Pilates, floor barre and progressing ballet technique classes with a skilled teacher who knows about your injury and limitations can also help.
• Analgesic
  Take paracetamol, Tylenol, ibuprofen or natural pain relievers for the pain to enable you to move and exercise. Pain is important to remind you not to push yourself too far, but it can also hinder recovery when it is focused on. For muscles tears, it is really important as a dancer that you stretch and strengthen the muscle as it heals otherwise the fibres will grow back too tightly and you can actually lose alot of flexibility it not treated correctly.
• Treatment
  Which leaves us with treatment. If you want the best chance of recovering with a long, lean, flexible and strong muscle with relatively little scar tissue see a medical professional. They will be able to help you incrementally add stretching and strengthening to your routine. They may also offer massage or electrical stimulation to help with the pain and breakdown the scar tissue forming.

Prevention

Prevention is key to not pulling or tearing muscles. Almost any dancer who has the injury can pinpoint one or two reasons why it happened! Therefore here are some ideas to prevent muscle strain:

• Warm-up and keep warm
  All dancers know the importance of warming up, but sometimes due to the nature of dancing such as having to wait in the wings for your turn on stage, having gaps between your turn in a performance or even warming up too early before a class our bodies begin to cool down. Wearing warm-up gear is not just a marketing ploy to get you to spend more money on cute dance gear, but can be really important in helping to keep you supple and ready to dance.
• Dont do static stretching
  Static stretching is when you get to the studio and think my teacher is going to look out the door and say – why aren’t you stretching so you plop yourself down into frog position or a split and just sit there and hold it without first having increased the blood flow to your muscles to warm them in any way!
• Have a stretching routine away from class
  When you are all hot and sweaty in class your body can sometimes do amazing things! Having a stretching routine at home where you gently warm up your muscles first (maybe with a foam roller?) before stretching will help them become more naturally flexible over time, meaning it is less likely they will be overstretched in the first place. Think sitting in second whilst watching tv – during the ads you could keep the muscles warm by adding resistance using your muscles to pull your legs back together and back out again several times, or bringing your legs into butterfly or frog and pushing down on your knees with your hands.
• Use a foam roller before and after class
  Foam rolling your muscles or even using a tennis ball or similar helps to loosen muscles similar to a massage and increases blood flow keeping your muscles warm.
  

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Trigger Toe

What is Trigger Toe?

Trigger toe is when the tendon of the toe (generally the big toe) becomes damaged over time causing it to thicken and eventually isn’t able to smoothly pass through the movements it should be able to, instead it gets locked in flexion and manually needs to be moved to resume movement.

Causes: How do dancers get Trigger Toe?

The most common cause is from consistent damage and strain from dancing en pointe in ballet, especially when using incorrect alignment and technique, not distributing weight evenly or clawing your toes to balance.

Symptoms

• Clicking sensation that makes it feel like the toe is “caught” on something
• Locking of the toe in flexion
• Pain when standing on the toe
• Corns and Calluses

It is best to get this checked out by a doctor as soon as possible to learn about the severity of the injury as surgery may be required if the tendon is too thick and has nodules. The last thing a ballet dancer wants is to leave this untreated and for the symptoms to worsen. This condition has been known to end ballet careers.

Treatment at Home

Depending on the severity, there are always home remedies that can be done, which a doctor might suggest.

• Wearing appropriate footwear is important when dealing with trigger toe to not aggravate the condition.
• Special padding such as a toe pad in your footwear can help when dealing with trigger toe because it can allow your foot to be snuggled comfortably within the shoe.
• Rest, ice, elevation, and pain relievers can be done for temporary relief, but they are not long-term methods.
• Depending on the severity, surgery may be required if it was not diagnosed soon enough.
• Moisturizing and regular care of calluses and corns

Rehabilitation

If surgery is required than rehabilitation should be completed with a trained physiotherapist. Some other steps you can take are to:

• Address the cause
  Dancing en pointe is inescapable for females in ballet so it is extremely important that the dancer is using correct technique and alignment when dancing and balances not by clawing their toes in their shoe but by pulling up through their core. Exercises should be completed to strengthen where ever the deficit is coming from.
• Strengthening the smaller muscles of the foot
  Trigger toe can occur when too much weight and reliance is placed on the big toe and not evenly distributed as much as possible through the foot and other toes. Using a resistance band to slowly go through and strengthen every muscle, ligament, and tendon of the foot whilst flexing and pointing can help train those muscles.

Prevention

• Ensuring you use proper technique and don’t ‘cheat’ to be able to dance en pointe is essential.
• Having the body conditioning and training before beginning point work to establish good habits is important.
• If your toes have protrusion or are oddly shaped seeing a podiatrist to make sure there is nothing anatomically that will cause problems in the future by dancing en pointe can help.

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Anterior/Posterior Ankle Impingement

What is Anterior/Posterior Ankle Impingement?

This injury is when a dancer experiences stiffness or pain – as if the bones and ligaments are being blocked at the front (anterior) or at the back (posterior) of the ankle and limist the range of motion. In medical terms impingement means to be squashed against and so basically it means the bones are squashing the tissues surrounding them.

Causes: How do dancers get Anterior/Posterior Ankle Impingement ?

The most common cause in dancing for Anterior Ankle Impingement is:

• Repetitively forcing the heel to stay on the floor thus squashing the tissue between the bones at the front of the ankle in a deep demi plie or on the way to grand plie.

The most common cause in dancing for Posterior Ankle Impingement is:

• Overstraining when pointing the foot essentially squashing the tissue between the bones at the back of the ankle.

A dancer who has had a previous ankle injury is more susceptible at getting an ankle impingement because the ligaments and tendons of the ankle are not as supple and do not glide as well as they used to causing them to become damaged, thicken and irritated.

There might also be anatomical reasons such as bone protrusions that cause impingement as well.

Symptoms

Some common symptoms of an anterior ankle impingement are:

• Dull ache located at the front of the ankle, which turns into a sharp pain with any form of exercise
• Swelling
• Tenderness
• Clicking sensation
• Ache whilst at rest

Some common symptoms of a posterior ankle impingement are:

• Pain at the back of the ankle, instead of the front, especially when attempting to point your toes
• Limited range of motion
• Tenderness
• Ache whilst at rest

Treatment at Home

There are several ways to help ankle impingement heal, varying on the severity of the injury.

• RICE
  As always, rest, ice, compression and elevation can help as we are dealing with inflammation.
• Anti-inflammatory medications
  Although these will not heal your inflamed and irritated ligaments and tendons, it will temporarily reduce pain and inflammation allowing you to work on rehabilitation and future prevention.

Treatments by your Doctor

• Steroid Injections
  Steroids help to reduce inflammation directly within the area they are administered. This would help reduce swelling and pain in the tissues of the ankle so that the dancer can work on rehabilitation and further prevention.
• Surgery
  may be required to help remove the blockage by eliminating the tissue and/or bone that is causing the issue.

Rehabilitation

• Physical Therapy
  To improve the range of motion and alleviate the pressure of the scar tissue physical therapy might be required.
• Use a resistance band
  to strengthen your feet and increase your arch through slow pointing and flexing exercises rather than straining.
  

Prevention

Injury while dancing is hard to avoid altogether, especially one that deals with the ankle because the dancer is constantly moving, jumping, squatting, etc. The best methods that can be taken to prevent ankle impingement as much as possible are:

• Avoid dancing in heels if you have posterior impingement as this will exacerbate the injury.
• Properly break in your pointe shoes so you do not have to strain and over point when pointing your feet.
• Don’t over-exerting or strain the ankle in plie, the injury can be avoided when you know to dial back.
• Proper execution of movements and alignment. Take things slowly when learning new moves and steps and never rush through the stuff you think is too boring or repetitive, it is all done for a reason!

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Snapping Hip Syndrome

What is Snapping Hip Syndrome?

Like its name suggests, this injury is characterized by the snapping or popping noise that one hears coming from their hip when moving the leg from the hip joint. It happens when the tendon rubs over a bony structure of the pelvis.

Causes: How do dancers get Snapping Hip Syndrome ?

The injury is generally caused when muscles on one side of the pelvis, buttocks, lower back and or hip area are weak whilst the other side is tight. It can be caused when dancers have a favorite side and tend to neglect the other side or leg as a result. It’s not usually an injury that causes the dancer to immediately have to stop. It will sometimes happen once or twice every couple of lessons before becoming more consistent and irritating. But if caught early treatement and rehabilitation is alot easier if left to become so unbearable the dancer has to stop dancing completely!

This is another lovely dance injury my body succame to! The pop or snap first began as a welcome relief when stretching in frog or in certain lunging positions. I at first thought it might be a release of nitrogen gas like happens when people crack and pop their knuckles, but as it occurred more frequently I realized the popping was actually causing damage to the long tight and thick tendon on the inside of my hip as the popping began to hurt. I believe it occurred as after I tore my adductor muscles as I had worked much harder rehabilitating the left over the right and my left was now stronger and more flexible – then my right hip started popping.

Symptoms

Symptoms that can lead towards diagnoses of snapping hip syndrome are:

• Snapping and Popping of the hip accompanied by:
  • Tightness
  • Swelling
  • Weakness in the leg
  • Limited range of motion

Treatment at Home

If the injury is not severe, meaning the popping has only just started to occur you might want to begin treatment at home with

• RICE.
  Rest, Ice, Compression and Elevation. A tendon in your pelvic area is inflamed and irritated and the inflammation needs to be reduced.
• Pain Relief
  Pain relief in the form of over the counter inflammation medicine taken as directed may help to enable you to begin rehabilitation.
• Foam rolling
  Use a foam roller to reduce the tightness of the muscles around the pelvis, thighs and buttocks.

If the above symptoms are noted and are consistent then it is best to seek medical treatment as it could be a sign of something worse such as hip impingement which we cover next. Common treatments that can be performed to help with snapping hip syndrome are as follows:

• A steroid shot in the area of the tendon may be necessary for more severe cases to reduce the inflammation and pain.
• Physical Therapy
• Lastly, surgery on reducing the thickness, scar tissue and removing nodules on the tendon if all else fails.

Rehabilitation

Rehabilitation is extremely important in ensuring the popping does not reoccur. A physiotherapist can give you a specific set of exercises once the origin of your popping has been identified because it can come from several places and affect different tendons. Some rehab ideas for home in the meantime are:

• Stretching
  Although the best way to heal a tendon is by leaving it immobile, tightness in your muscles around the tendon will have led to the inflammation in the first place and so these need to be gently stretched once healing has begun. I found that the stretching of the glute muscles, in particular, are sometimes not focused on in ballet and jazz classes and therefore I some of my personal favorite stretches that I still do today for glute and hip tightness are yoga poses; fire log, king Pigeon with forward fold, reclined pigeon, reclined twists, Shoelace, ragdoll, child’s pose, wide child’s pose, wide squat and downward frog.
• Strengthening your core
  One of the main reasons dancers favor one side over the other is because they don’t have the core strength to balance themselves out and therefore improving core strength will increase a dancers ability to execute moves on their least favored side with equal strength so that tightness does not develop on one side from consistently relying on those muscles rather than the core to do them.
  

Prevention

Prevention for hip popping and snapping is the same as rehabilitation. The dancer needs to ensure both sides of their body stay equally strong by utilizing their core strength and they need to make sure they are not neglecting to stretch out their glutes and hip muscles in non traditional ballet ways such as in various yoga stretches.

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Hip Impingement

What is Hip Impingement?

A hip impingement is when the ball and socket joint fail to glide when moved causing the cartilage surrounding the bones to become damaged called femoro acetabular impingement (FAI). Normaly with FAI, smooth movement is affected by abnormalities that have developed on the bones of the socket joint but dancers generally display no bone abnormalities, but still have cartilage damage and trauma.

Causes: How do dancers get Hip Impingement?

Dancers get hip impingements through the increased amount of stress they place on the hip joint. Studies have shown that trauma to the cartilage is most likely to occur during developpe type exercises where a leg is held to the front or side in seconde. If the dancer is not using their core muscles and is relying on their hip flexors and locking their leg into their hip joint to hold their leg in the air, a lot of stress can be placed on the joint and in turn the bones compress and grind together within the socket damaging the cartilage in between.

Overusing the hip flexors in general instead of using core strength and forcing turnout can also be factors that lead to hip impingement in dancers.

Symptoms

Symptoms of hip impingement are hard to detect early on because pain is not initially felt straight off the bat. People can go years without ever realizing anything is seriously wrong, and by the time they start worrying about the constant ache in their pelvic/hip region, the injury has progressed from minor to severe.

• Pain or discomfort in the groin area even at night
• Limited range of motion in the hip area
• Clicking and popping of the hip
• Having a feeling that the tendons are catching on the pelvic bone or are giving way when used.

Treatment at Home

Early detection is critical to treating a hip impingement injury. There aren’t one-method treats all diagnosis when it comes to this injury. Every person is different, and their injury must be taken on a case by case basis. But this is an injury where we absolutely advise you see a medical specialist to get the best care you can to recover.

• Rest is always important at any step of the injury, whether minor or severe.
• Over the Counter anti-inflammatory medications if needed
• Pain medications, if needed
• Foam Rolling the muscles around your hip to help massage and release tension and tightness.

Treatments by your Doctor

• Your doctor or physio may get you to have an MRI or CT scan to see how badly damaged the joint is.
• Your medical team might suggest a new technology where they withdraw your blood and swish it around in a laboratory making it’s healing properties become more intense (they need to do more than just swish it around obviously but you get the picture) and reinject it into you to improve the cartilage growth and recovery around the joint.
• For more severe cases hip surgery or even a hip replacement may be necessary

Rehabilitation

Physio Therapy is absolutely vital in your rehabilitation process as well as working with your dance teacher to ensure you retrain your muscles to work more effectively and with correct alignment and technique.

Prevention

The best thing you can do as a dancer to prevent hip impingement from occurring is to never cheat when dancing. By that I mean, never use whatever means you can to get a, for example, a higher leg in a developpe. It is better to have your leg at a lower height with perfect alignment and placement, held their mainly with the strength of your core, and the balanced work of the leg muscles, than one that is higher predominately using the strength of the hip flexors to lock your hip socket in an effort to have a high leg. Always think of lengthening your limbs away from your core, even thinking about creating as much space between your joints can help!

Taking progressing ballet techniques classes that focus on teaching you how to feel and activate the correct muscles in ballet can help greatly as well.

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Patellofemoral Pain Syndrome

What is Patellofemoral Pain Syndrome?

The patellofemoral joint is located behind your kneecap and the cartilage can become damaged through the consistent misalignment of the knee cap over the joint.

Causes: How do dancers get Patellofemoral Pain Syndrome?

Hmmm misalignment of the knee cap, if you are a dancer I bet $10 you already know how this common injury occurs! Yep, you guessed it by forcing your turn out from the ground up! By trying to turn those toes outwards by twisting your ankles and knees making that kneecap half slide outwards where it is attached to the shin bones whilst at the same time facing forwards as the hips are not being used to turn out or do not have the adequate flexibility to turn out as far as your feet. Then add movement to this such as a plie or even jumping and landing and that poor kneecap is sliding and being pulled all over the place and rubbing against the tissues of the joint behind it!

Overuse through jumping and getting up and down off the floor can also cause Patellofemoral Pain Syndrome as can another injury to the knee cap such as dislocation or even a broken bone.

Symptoms

The main symptom of this injury are aches and pain in the knee not just when dancing, but when walking, rolling over in your sleep, bending, walking up stairs etc…

Treatment at Home

Treating Patellofemoral Pain Syndrome needs to begin before it escalates into something more serious which might require surgery or even eventually a knee replacement!

Initially begin with the RICE method!

REST
You will need to take a break from classes or basically the activities that hurt your knee so that the damaged Patellofemoral Joint can begin to heal. You might use a knee brace to help to immobilize the knee so that there is no chance of the knee cap sliding out of alignment and irritating the joint. The point here is to protect your knee at any cost.

ICE
Icing your knee to help reduce the pain and inflammation with help it begin the healing process.

COMPRESSION
A compression sleeve can be worn over the knee to help increase the blood flow to the area, but a knee brace might be more practical to ensure the knee cap is immobilized.

ELEVATION
Elevating your knee can be tricky – be sure to keep it slightly bent and place pillows underneath it to support it.

• Inflammatory pain relief
  Inflammatory pain relief such as ibuprofen will help to reduce the inflammation and pain temporarily, but should not be used to mask the pain so you can keep dancing as you can do more damage by using the incorrect alignment which possibly caused the injury in the first place. Only use them if you need to mask the pain during rehabilitation where you are learning to use your muscles correctly.

Rehabilitation

• Seeing a physiotherapist who will develop a treatment and rehabilitation plan may help you get back into full training in as little as six weeks.
• Foam rolling of the muscles around the knee can help to release tension and tightness that might be exacerbating the misalignment of the patella when you dance.
• Stretching and strengthening the natural turn out of the hips.
• Pilates, floor barre or progressing ballet technique classes that help you focus on activating and engaging the correct muscles when dancing.

Prevention

Prevention for the syndrome includes:

• Turn out from your hips down and not the other way.
• Make sure you are learning from an experienced teacher who can tell when you are not using your hips to turn out and is able to help you understand what the difference is.
• Make sure your teacher praises correct placement of turnout rather than simply lovely turned out feet.
• Ensure you take classes at a studio with specially sprung flooring for dancing on that helps to absorb shock when you jump and leap.

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Osteoarthritis

What is Osteoarthritis?

Osteoarthritis is a type of Arthritis. Arthritis is the common name for joint pain or joint disease. Osteoarthritis happens when the tissue at the ends of the bones wears down, and that barrier between the bones and joints becomes almost non-existent and the bones then begin to rub against each other – ouch!

Causes: How do dancers get Osteoarthritis

Although arthritis sounds like something that happens to old people, Osteoarthritis is common amongst dancers at any stage in their career as it is caused by the repetitiveness of movement, especially repetitiveness of incorrect technique and not using core strength to properly support the body. Osteoarthritis can affect any joint and for dancers the hips, feet, ankles and knee joints are the most susceptible. Osteoarthritis can take years to present itself, but can start as early on as in a dancers 20’s.

Symptoms

Common symptoms of Osteoarthritis:

• Pain
• Stiffness
• Tenderness
• Limited range of motion
• Swelling

Osteoarthritis is usually found after some other initial injury has been diagnosed such as an impingement of the joint. The main symptoms are stiffness and pain around the joint. Once a treatment plan has been put in place for that injury and it is found to either work temporarily or not make any changes. A doctor can diagnose osteoarthritis from your symptoms and an examination. An x-ray can show them the thinning space between the bones and any protrusions. An MRI is actually rarely used in diagnoses of osteoarthritis, but as dancing could be your bread and butter, knowing as much as you can about your condition will help your medical team develop the best maintenance plan so you can continue your dancing.

Treatment and Rehabilitation at Home

Unfortunately, Osteoarthritis cannot be reversed and a maintenance and pain management plan should be developed with your medical team to prolong your ability to dance.

Treatment might include:

• Cortisone injections
• lubrication injections
• Surgery to realign the bones
• Surgery to replace the joint with plastic or metal parts

Prevention

• Wait for as much skeletal maturity or fusion of growth plates between the bones to occur before putting extraneous strain on them, for example, the growth plates in the foot of a female are not actually fused until about the age of 14.
• Ensure you take the time to heal and rehabilitate any injury before resuming your training schedule.
• Take as many regular breaks, rests and holidays as you can to give your body time to heal and repair from the everyday grind of class and performing.

Conclusion

With dance, injury of some sort is unpreventable. Due to the repetitive movement and the nature of the dancer to push their body beyond what it might be capable of they are more than likely to cause sprains, strains, and tears to their muscles and connective tissues. An injury does not have to be a death sentence to your dancing career, because it is all about how you handle an injury once it occurs.

The worst thing that can be done is to ignore any pain or discomfort that one is feeling.  The best cure is early detection because all that may be needed are minor simple steps such as icing the injury and taking a few days off to rest your body to be able to heal. This can be key if you have been pushing yourself more than normal.

The best thing that can be done is to listen to your body when it is telling you that something is not right. So many people make injuries worse when they continue to work through the pain because they feel like if they take a break then they will fall behind and won’t be able to be at the top of their game. The bigger problem here is that they, therefore, don’t take the time to correct whatever is causing the problem in the first place and therefore can do irreversible damage.

Dance injuries are never something that should be swept under the rug and dealt with later. They are generally an indication that you are not using your body correctly and if they are ignored for too long they can turn into bigger problems that require more time away from the activity than might have occurred if dealt with immediately.