Dancers, Fatigue & Injuries


           "Fatigue makes fools of us all. It robs you of your skills and your judgment, and it blinds you to creative solutions. It's the best-conditioned athlete, not the most talented, who generally wins when the going gets tough." - Harvey Mackay


Participation in any type of physical activity bears the risk of injury.  Injuries occur in all types of sports programs and across all forms of dance.  With the increased availability of educational information about cross-training and caring for the body, Sports Medicine and Dance Medicine professionals are hoping to decrease the incidence rates, but it is interesting to look at when injuries are more apt to occur and why.

            Studies within the dance community have indicated injury rates as high as 95% in professional ballet dancers and 82% in professional contemporary dancers.  Injury rates in dance are comparable to those in other professional sports.

            Research has shown that 67% of dance injuries occur late in the day and that 75% of all injuries occur during preparation for performances when bodies are tired and/or overworked.   The lack of time and resources for tissue repair, additional hours of rehearsal, and constant repetitive movements when rehearsing specific phrases from dance pieces have all been cited as causes. 

            Dancers are known for diets that are low in nutritional value.  They are constantly going to extremes to avoid foods that may cause them to gain weight or diminish the aimed for aesthetic in the dance community.  Performance and rehearsal schedules allow little time for careful meal planning and food consumption, and it is difficult for dancers to consume enough calories to equal the amount of calories burned during an intensive performance season.

             Additionally, a large percentage of female professional dancers are amenorrheic, or do not have regular menstrual cycles.  The absence of a monthly period results in abnormal estrogen levels which reduce the amount of calcium that the body can absorb and use for repair. 

            Although most athletes’ bodies are able to use protein to recover quickly from minor muscle tears, this is not the case for dancers.  Without a proper diet filled with additional calories for tissue repair, the body is placed under stress during normal situations.  Once the intense performance season begins, the body is unable to care for itself efficiently.

            When this nutrition deficit is combined with a rehearsal/performance schedule that allows little time for rest and recovery, dancers are placed at a high risk for injuries.  While a minor breakdown in body tissue can be sufficiently repaired during an interval of rest, in dancers, who do not have sufficient rest time, the breakdown of tissue becomes greater than the body’s ability to repair, or remodel. 

            When the same muscle groups are used repeatedly during long hours of rehearsal and performance, they grow tired and use up their energy reserves.  When the central nervous system (CNS) receives the message that a muscle is fatiguing and having difficulty holding a contraction, it either tries to get the muscle to work harder, or activates surrounding muscles (synergists) to help.

            Muscular fatigue is only one piece of the puzzle.  Long work hours also stress the central nervous system.  The CNS uses sensory input to determine where the body is in space.  Messages communicated through visual clues and proprioceptive clues help the CNS determine which muscles need to contract and to determine the force that must be used to keep the body moving safely.  Although the body is engineered so that the CNS will protect the tired muscles by directing adjustments in the body, when the CNS is stressed, its ability to direct these adaptations slows down.  The delayed response affects motor control and coordination.  Landings from jumps and the body’s ability to slow down after leaps or turns are affected.  As a result, the way the body normally distributes the stress over the bones and joints is also compromised.

            The change in stress distribution and the lag time in reorganizing the muscular response set the body up for injuries.  All of these factors explain why most dance injuries occur late in the day or during an intense performance season.  Since dancers have a very high pain tolerance, when they get injured, they often do not realize it immediately.  Moreover, injured dancers tend to “dance through” the pain so they do not lose roles or jobs.

            In an ideal world, major rehearsals could be scheduled early in the day before the body is fatigued, and schedules could be designed to accommodate rest periods for dancers to allow for ample recovery time.  Unfortunately, rehearsal space is not always available at ideal times, and dancers need to be able to accommodate the schedules of theater personnel, musicians, and stage, sound, and lighting crews.  Additionally, audiences are only available after the traditional workday ends – in the evening.

            Educating dancers to listen to their bodies, eat properly, cross-train, and using periodization training can be helpful.  Rather than “dancing through” pain, dancers should be encouraged to care for injuries before they become chronic or more serious.  While eating properly has always been a challenge for dancers, a bit of knowledge about healthy foods and the convenience of food today make it easier.  Cross-training will strengthen all of the muscles in the body so that when some muscles fatigue, the synergistic, or helper muscles, will be prepared to start working, and periodization training can help prepare the dancer for performance season and alleviate some of the stress on the body.

            We are given one body to last our entire life.  It is up to us to learn as much as we can about how to dance in a way that preserves its health to the best of our ability.

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       Liederbach, M. Schanfein, L. & Kremenic, I. What is known about the effect of fatigue on injury occurrence among dancers? Journal of Dance Medicine and Science. 2013;17(3):101-8.
       Murgia, C. Overuse, tissue fatigue, and injuries. Journal of Dance Medicine and Science. 2013;17(3):92-100.
      Shah, S., Weiss, D. & Burchette, R.  Injuries in professional modern dancers: incidence, risk factors and management.  Journal of Dance Medicine and Science. 2012;16(1):17-25.
      Tajet-Foxell, B. & Rose, F. D. Pain and pain tolerance in professional ballet dancers.  British Journal of Sports Medicine. 1995:29:31-4.

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