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Injuries in Street Dancers. A Guide to Injury Recovery & Prevention.

Injuries in Street Dancers. A Guide to Injury Recovery & Prevention.

Street dance encompasses many different styles of dance, all with their own unique history, culture, and evolution over time. PhysioTec’s dance physiotherapists regularly assess and develop dance injury prevention and management programs for dancers. This blog will highlight some common street dance injuries and what you can do to prevent or recover from these injuries if you are a street dancer. Research in this area has been emerging gradually as many of these styles are relatively new in comparison to other genres. Street Dance styles appearing in research so far has included hip hop, breaking, popping, locking, house, and krump.

COMMON STREET DANCE INJURIES

Street Dance styles have originated from different scenes including streets and clubs, with these various styles being expressed through freestyle, cyphers, grooves, and choreography. Street dance is increasing in popularity as these dance forms appear more and more across social media and competitions. Physical demands are becoming higher, and dancers are expected to have high levels of fitness, strength, agility, coordination, and motor control to meet the unique demands of each genre.1

Hip hop dancers have a similar injury incidence rate to gymnasts, and this rate of injury is higher when compared to modern dance and ballet. This highlights the importance of prevention strategies as this has been found to greatly influence the number of injuries sustained over a dancer’s career.2

 

COMMON INJURIES IN STREET DANCERS

KNEE INJURIES IN STREET DANCERS

Knee injury comes in at number one as the most common injury in street dancers, accounting for 42% of all street dance injuries.3 Street styles involve dancing techniques that require quick and intricate footwork – twists, sudden changes in direction, moving the body into unnatural positions and deep squats. Some hip hop components are quite acrobatic in nature and require dancers to land or stomp with great force. The risk of knee injury is therefore relatively high when considering the volume of rotating and jump landings with either flexed or extended knees.

It is common for dancers to have a dominant side which poses a challenge when it comes to group performances where dancers are required to perform in unison. Dancers with a larger preference for one side increase their risk of knee injury as there will likely be a lack of strength on the non-dominant side.4

Knee injury risk in street dancers is also increased during lengthy performances as the muscles gradually become more fatigued and efficiency in controlling the knee joint subsequently reduces. Choreographers are of course more interested in the way a move looks, than how it feels to the dancer, meaning that some moves may be particularly challenging for the knee, placing this joint at greater risk of injury.5

LOWER BACK INJURIES IN STREET DANCERS

Lower back injury is the second most common injury in street dancers (32%).3 Dance techniques in street styles often involve a combination of footwork and fluid movement from upper body grooves which require use of core muscles and trunk control. All turns, jumps, and landings require dancers to have high levels of control around the back and hips.6

Lower back injuries in street dancers are most commonly reported to be linked to the way the muscles around the back, pelvis and core activate and coordinate, with altered muscle strength and/or behaviour potentially increasing risks of injury. Risk of lower back injury is increased during high-impact, repetitive loading involved in street dance training and performance.7

ANKLE INJURIES IN STREET DANCERS

Ankle injury ranks as the third most common injury in street dancers (15%).4 This should come as no surprise due to the volume of jumping, hopping, and variations in landing involved in street dance. Factors that increase the risk of ankle injury in street dancers include poor technique, inadequate muscle control around the ankle and/or dynamic balance but may also occur from external factors such as performing on an uneven surface, unsupportive footwear or contact with another dancer.8 It is essential to address these external factors to reduce the risk of sustaining an ankle injury in street dancing.

 

TYPES OF STREET DANCE INJURIES

Street dancers have been found to injure themselves mostly by overuse (50%), landing (42%), twisting (36%), or slipping (31%).9 Dancers predominantly experience more overuse and chronic injuries due to poor technique, strength, and balance.10

When looking specifically at breaking, dancers are most likely to injure their wrist (69%), finger (61.9%), and knee (61.9%). Injury mechanisms are typically joint sprains, muscle strains and tendon injuries.11 It is important to consider breaking as a potentially high-risk dance sport.

It has been found that even when breakers sustain severe injuries, they only allow a limited time for recovery before returning to training.12 A lack of recovery and rehabilitation will increase the risks of developing an ongoing issue. A new injury might also occur due to the dancer needing to protect the injured or weakened area, moving extra forces to a nearby body part.

 

WHAT CAN I DO TO PREVENT OR RECOVER FROM STREET DANCE INJURIES?

There are several ways of preventing dance injuries from occurring, or assisting in injury recovery.

1. WARM-UP BEFORE STREET DANCE TRAINING OR PERFORMANCES

WARM-UP BEFORE STREET DANCE TRAINING OR PERFORMANCESPrevention is key. No matter how big or small a performance, a dancer in any style should conduct an adequate warm-up. This involves increasing the heart rate with cardio exercise such as running on the spot, jumping and hopping. This cardio can be followed by dynamic lengthening of the muscles to ensure they are warm, and the body has been moved through the ranges it will need to move through during training or a performance. Dynamic warm ups are preferred over passive stretching (holding a sustained stretch), as sustained stretching can reduce the natural reactivity needed for dynamic actions in street dance.

It is important that dancers work together with their family, dance teachers, and health professionals as a team, to ensure dancers are taking care of their body properly and staying healthy. If the dancer is in the middle of a busy training period in preparation for competitions and routine rehearsals have become the focus of training, the dancer should take it into their own hands to warm themself up prior to class. This is a crucial time as dancers will know training volume increases and so does the level of expected performance, meaning it is not the time to stop conditioning the body and warming up correctly.

2. BALANCE TRAINING FOR STREET DANCERS

BALANCE TRAINING FOR STREET DANCERSResearch has found balance and proprioception (awareness of body position in space) to be a key component of injury prevention, as this helps control large forces that cross the joints.5 Positive effects can be seen from quick balance training of 4-15 minutes per session conducted twice a week.13

For street dancers, balance training needs to be more than simply practising standing on one leg or on a wobble board. Our dance physios can provide balance programs specific for the challenges of dancing.

 

3. STRENGTH AND CONDITIONING FOR STREET DANCERS

Strength and Conditioning for Street DancersStreet dancers should add strength and conditioning to their weekly routine to complement their dance training. The aim is to increase the muscles’ ability to maintain the capacity to perform the tasks required in dance, and to reduce the impact of training and performance on the body.8

It is always best to consult a physiotherapist prior to commencing a strength and conditioning program. Our dance physios aim to identify any risk factors for injury and provide a targeted exercise program to assist the dancers training and performance.

 

4. REST & RECOVERY FOR  DANCERS

REST & RECOVERY FOR DANCERS

It is also extremely important for dancers to reduce fatigue and receive adequate nutrition to sustain the body during training sessions and performances to prevent injury.6 Adequate recovery time should be allowed between training and exercise sessions.

 If a dancer does unfortunately become injured, it is vital that they do not simply push through severe pain, as we often see happening within the dance culture. Dancers must allow sufficient time for their injury to heal. Dancers are encouraged to seek advice from a physiotherapist on when they may return to dance or if they will need a graduated return to their training program.

For advice on prevention of dance injuries, or for rehabilitation and treatment of dance injuries, make an appointment with Rhianna or Joanne today. Call 3342 4284 to book.

 

References

  1. Grˇci´c, V.; Mileti´c, A.; Kuzmani´c, B. Construction of Tests for Evaluating the Level of Hip Hop Performance. Res. Phys. Educ. Sport Health 2015, 4, 57–60.
  2. Uršej E, Zaletel P. Injury occurrence in modern and hip-hop dancers: a systematic literature review. Zdr Varst. 2020;59(3):195-201. doi: 10.2478/sjph-2020-0025.
  3. Ursej E, Sekulic D, Prus D, Gabrilo G, Zaletel P. Investigating the prevalence and predictors of injury occurrence in competitive hip hop dancers: prospective analysis. Int. J. Environ. Res. Public Health 2019, 16, 3214
  4. Kimmerle, M. Lateral bias, functional asymmetry, dance training and dance injuries. J. Dance Med. Sci. 2010, 14, 58–66.
  5. Knight, K.L. More precise classification of orthopaedic injury types and treatment will improve patient care. J. Athl. Train. 2008, 43, 117–118.
  6. Russell JA. Preventing dance injuries: current perspectives. Open Ac­cess J Sports Med. 2013;4:199-210. doi: 10.2147/OAJSM.S36529.
  7. McGill, S.M. Low Back Disorders, 3E; Human Kinetics: Champaign, IL, USA, 2015.
  8. Hrysomallis, C. Relationship between balance ability, training and sports injury risk. Sports Med. 2007, 37, 547–556.
  9. Ojofeitimi S, Bronner S, Woo H. Injury incidence in hip hop dance. Scand J Med Sci Sports. 2012;22(3):347-55. doi: 10.1111/j.1600- 0838.2010.01173.x.
  10. Lee, L.; Reid, D.; Cadwell, J.; Palmer, P. Injury incidence, dance exposure and the use of the movement competency screen (Mcs) to identify variables associated with injury in full-time pre-professional dancers. Int. J. Sports Phys. Ther. 2017, 12, 352–370.
  11. Cho, C.H.; Song, K.S.; Min, B.W.; Lee, S.M.; Chang, H.W.; Eum, D.S. Musculoskeletal injuries in break-dancers. Injury 2009, 40, 1207–1211.
  12. Kauther MD, Wedemeyer C, Wegner A, Kauther KM, von Knoch M. Break­dance injuries and overuse syndromes in amateurs and professionals. Am J Sports Med. 2009;37(4):797-802. doi: 10.1177/0363546508328120.
  13. Gebel, A.; Lesinski, M.; Behm, D.G.; Granacher, U. Effects and dose-response relationship of balance training on balance performance in youth: A systematic review and meta-analysis. Sports Med. 2018, 48, 2067–2089.
Shall we dance? The health benefits of dancing at any age

Shall we dance? The health benefits of dancing at any age

Patients often ask me, “what is the best form of exercise?”. The answer I usually give is “The kind you enjoy”. My reasoning is, if you enjoy doing something then it is far more likely you will find the time to do it – an opinion supported by research1. So, if the gym isn’t your cup of tea, you don’t fancy a jog around the neighbourhood or it’s too cold for a swim – have you thought about dance as a form of exercise? Enjoyment is merely one reason to dance – once you hear about all the health benefits of dance, you’ll be shimmying back for more!

Dancing is great for fitness

Dance as exercise really is the allrounder when it comes to physical health benefits2. Studies show dance classes are as good for you, if not better, than other forms of structured exercise3. With so many types of dance available, you’re almost certain to find one you’ll enjoy. You can begin dancing at almost any age, so whether you’re 5 or 95, interested in ballet or belly-dancing, tap or tango, read on and see how dancing can help improve your health and wellness!

Cardiovascular improvement

Most of us know that physical activity and getting our heart pumping can help improve the function of our heart and lungs. The Australian government guidelines for exercise recommends adults participate in 2 ½ to 5 hours of moderate intensity physical activity (you can talk but not sing during the activity) or 1 ¼ to 2 ½ hour of vigorous activity (can’t say more than a few words without stopping for breath) each week4. A US intergenerational program showed both children and adults can reach their target heart rates through dance5. By incorporating ballet classes or line dancing lessons a couple of times a week and enjoying the petite allegro or Boot Scootin’ Boogie, you can gain the wonderful heart-pumping benefits that dancing can provide6.

Muscle strength and endurance

Ever admired the toned legs of a ballet dancer or the stamina of couples competing on dance tv shows? You too can enjoy strengthening your lower limbs and improve your endurance by attending regular dance classes.  Studies show that regardless of the type of dance, if you attend 3 hour-long classes a week, you’ll likely develop stronger legs and improved endurance in just 12 weeks7.

Balance and posture

Most everyday activity, such as walking, has us travelling in fairly straight lines without too much change in the level of our heads. Even when you’re at the gym – be it on a treadmill, stair climber or stationary bike – your movement is fairly limited. Dance on the other hand has us moving in all directions – forward, backward, sideways – often covering a lot of area. In addition to moving more in all directions, dancing often includes turns, jumps and sometimes even floor work.  When you’re performing that tango turn or jazz pirouette, you’ll be challenging your balance and dynamic postural control. This makes most forms of dancing ideal for improving our balance, and helping reduce the risk of falls, particularly as we age7,8,9.

Mobility and flexibility

We know that staying active and moving the joints is beneficial to joint health but there is some perception that dancing, particularly ballet, can lead to wear and tear on the hips.  This has not proven to be the case with an Australian study showing no difference in hip joint changes between professional ballet dancers and other athletes10. In fact, movement of the limbs during dance can help maintain flexibility, strengthen joint supporting muscles and keep the joints healthy9. Dance lessons have also been shown to help people with mobility issues, such as those with Parkinson’s disease. Recent research revealed regular dance classes improved the functional ability of people with Parkinson’s making it easier for them to move and get around11.

Dancing engages the brain and has “feel good” benefits

Not only do we see physical benefits in those who regularly participate in dance lessons, but dance can also give your brain a boost and improve your emotional wellbeing.

Memory and attention

If you’ve already attended a dance class, you’ll know how challenging remembering the combination of steps and movements can be. Perhaps you’ve also marvelled at more experienced classmates and their ability to pick up steps quickly or remember the choreography. Learning a dance sequence is like doing mental push-ups or a physical crossword for the brain, and the more you dance the better you’ll become. Challenging the brain to remember the steps and putting them all together in movement improves our “brain plasticity” and helps build our grey and white matter. In fact,  dancing improves our brains function much better than conventional exercise and can help stave off age-related mental impairments like poor memory and attention12.

Mental health and social connection

While those of us getting older will be especially keen on the mobility and memory benefits that dancing provides, there are also emotional benefits for people of all ages. Dancing can be a great way for adolescents (or people of any age) to deal with emotional distress.

A recent study found that teenage girls showed less nervousness, anxiety and and even reported less headaches and stomach aches while attending regular dance classes13.  Other studies have show similar benefits; A 12 week dance course lowered depression in a group of university students14 and a group of 60 – 82 year old’s reported improved social activities and networks through dance classes15. Regardless of dance style, people of all ages and cultural groups report a greater sense of happiness, social connectedness and life satisfaction through dance participation15.

Dance is great, whatever your age

Now that you know dancing can significantly improve balance, strength, endurance, mobility, memory and wellbeing, why not take a look to see what dance classes are available near you? Many dance schools offer classes for all ages including beginner classes for adults or those returning after a long hiatus. So grab a friend, sign up for a class and get moving!

(And if you’re isolating – there’s never been a better time to dance like nobody’s watching!)

 

As with undertaking any new form of exercise, if you have any medical concerns, please check with your doctor. Or should you feel worried about a particular physical issue – unsure if you can boogie with a “bad knee” or practice ballet with a bunion – come see us here at PhysioTec. We’ll do a thorough assessment and provide you with some individualised exercises and advice in preparation to really enjoy and gain the most from your dance classes.

Joanne Manning is a qualified physiotherapist with a special interest in dance rehabilitation and injury prevention. Call 3342 4284 to book an appointment with Joanne.

 

References

1. Dishman, R. e. (2005). Enjoyment Mediates Effects of a School-Based Physical-Activity Intervention. Medicine & Science in Sports & Exercise, Volume 37 – Issue 3 – p 478-487 doi: 10.1249/01.MSS.0000155391.62733.A7.

2. Hwang PW, B. K. (2015). The Effectiveness of Dance Interventions to Improve Older Adults’ Health: A Systematic Literature Review. Alternative Therapies in Health and Medicine, 21(5):64-70.

3. Fong Yan, A. C. (2018). The Effectiveness of Dance Interventions on Physical Health Outcomes Compared to Other Forms of Physical Activity: A Systematic Review and Meta-Analysis. Sports Medicine, 48, 933–951.

4. Government, A. (2021, March 30). Factsheet: Adults 18-64. Retrieved from The Department of Health: https://www1.health.gov.au/internet/main/publishing.nsf/Content/fs-18-64 years

5. Schroeder K, R. S. (2017). Dance for Health: An Intergenerational Program to Increase Access to Physical Activity.  Journal of Pediatric Nursing, 37:29-34.

6. Gronek P, W. D. (2020 ). A Review of Exercise as Medicine in Cardiovascular Disease: Pathology and Mechanism. Ageing and Disease , Mar 9;11(2):327-340.

7. Rodrigues-Krause J, K. M.-O. (2019 ). Dancing for Healthy Aging: Functional and Metabolic Perspectives. Alternative Therapies in Health and Medicine, Jan;25(1):44-63.

8. Wallmann HW, G. C. (2008). The effect of a senior jazz dance class on static balance in healthy women over 50 years of age: a pilot study. Biological Research for Nursing, 10(3):257–266.

9. Joung HJ, L. Y. (2019). Effect of Creative Dance on Fitness, Functional Balance, and Mobility Control in the Elderly. Gerontology, 65(5):537-546.

10. Mayes S, F. A. (2016 ). Professional ballet dancers have a similar prevalence of articular cartilage defects compared to age- and sex-matched non-dancing athletes. Clinical Rheumatology, 35(12):3037-3043.

11. Carapellotti AM, S. R. ( 2020). The efficacy of dance for improving motor impairments, non-motor symptoms, and quality of life in Parkinson’s disease: A systematic review and meta-analysis. PLoS One, 15(8):e0236820.

12. Rehfeld K, L. A. (2018 ). Dance training is superior to repetitive physical exercise in inducing brain plasticity in the elderly. PLoS One, Jul 11;13(7).

13. Mansfield L, K. T. (2018). Sport and dance interventions for healthy young people (15–24 years) to promote subjective well-being: a systematic review. BMJ Open, 8:e020959.

14. Akandere M, D. B. (2011). The effect of dance over depression. Coll Antropol , 35:651–6.

15. Sheppard A, B. M. ( 2020). Promoting wellbeing and health through active participation in music and dance: a systematic review. International Journal of Qualitative Studies in Health and Well-being, 15(1):1732526.