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Preventing Musculoskeletal Injury for Dancers

Preventing Musculoskeletal Injury for Dancers

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Published by: aerialartsasia8383 on Mar 06, 2009
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11/10/2012

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Back or neck pain may occur for various reasons related to injury or irritation of the
vertebrae, intervertebral discs, muscles, tendons, or ligaments. These injuries and
irritations are common in the general population, but may also be related to the specific

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occupational activities of dancers and musicians.

What is it?

There are two categories of back and neck pain:
• mechanical pain
• nerve-related pain
Mechanical pain is due to localized inflammation that usually arises from injury or
irritation of the back muscles, ligaments, facet joints, or intervertebral discs. Sprains and
strains are mechanical pain injuries. Disc irritation is sometimes called discogenic pain.
Nerve-related pain is due to compression or irritation of nerve roots as they leave the
spine’s protection. Nerve-related pain may result from several sources of nerve-root
compression, including the following:
• Disc herniation involves a bulge in the intervertebral disc that may place direct
pressure on the nerve. In severe cases, the disc may rupture.
• Segmental instability or vertebral subluxation is a shifting in position of one vertebra
relative to another, which results in pressure on the nerves above or below the vertebral
level of the subluxation.
• Spinal stenosis is a narrowing of the canal through which the nerve passes. This
narrowing may occur as a result of disc degeneration and the development of bone
spurs.

Signs and symptoms

Back problems are typically characterized by localized tenderness and pain, but may also
result in referred pain or numbness in the buttocks, groin, or legs. Similarly, neck
problems may result in headaches or pain radiating into the shoulders or arms.
Individuals may also experience muscle spasms or cramping as well as a reduced range
of back or neck motion. In severe cases, loss of bowel and bladder control may occur,
which requires immediate medical attention. Symptoms may include numbness, pain, or
tingling in the extremities (legs or arms), with no pain in the back or neck. Careful
attention to which activities increase or reduce pain and the exact location of symptoms
can help clinicians determine the cause of the symptoms and the most appropriate course
of treatment.

What causes it?

Various factors may cause back and neck pain, but back and neck pain are typically
associated with overexertion or cumulative trauma involving repetitive or sustained
awkward postures. General risk factors for back pain include:
• anatomical misalignment of the lower extremities
• imbalances in the leg muscles (the quadriceps and hamstrings)
• weakened abdominal muscles
Dancers are at risk of back pain as a result of faulty dance technique, repetitive awkward
postures, and high forces required for throwing or catching partners.
Musicians are at risk of back pain for opposite reasons, since they are often required to sit
for long periods. Some instruments require awkward neck, shoulder, and back postures
that must be maintained throughout practice, rehearsal, or performance. Neck pain may
be associated with postures that require support of the head while the neck is twisted,
flexed, or extended, or with postures that require prolonged support of the arms above
shoulder level. Psychological stress increases the likelihood of back and neck pain.

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Treatment

Seek professional advice and treatment if symptoms involve numbness or pain in the
extremities, loss of bowel or bladder control, or overly painful muscle spasms, or if
symptoms persist or progressively worsen. Treatment typically involves physical
therapies that vary according to the nature of the injury.
Movement awareness training (for example, the Alexander Technique, Feldenkrais
Method, Pilates Method, yoga, or Tai Chi) and ongoing education regarding dance or
instrument technique can help:
• alleviate postural imbalances
• identify problematic postures
• correct faulty technique that may contribute to aggravating back or neck injuries
Physical manipulation (chiropractic or physiotherapy) and massage therapy may assist
with some conditions. Treatment of symptoms may involve the use of non-steroidal anti-
inflammatory drugs, muscle relaxants, and modified activity. In severe cases such as a
disc herniation, surgery may be advocated.

Prevention

A balanced exercise program is key to maintaining a healthy spine. The back, abdominal,
leg, and arm muscles need to be strengthened in unison to ensure balance. Maintaining
hamstring muscle flexibility has also been identified as important for low back health.

Dancers

Dancers typically wear a slipper style of shoe that has little support or cushioning for
absorbing shock. Dancers can help reduce the force exerted on their spines by wearing
thicker-soled shoes or well-designed street shoes with low heels, arch supports, and
cushioning. Further, dance studios can be designed (or redesigned) with sprung floors
that absorb shock. Ongoing education regarding dance technique can help identify faulty
biomechanical technique that may contribute to muscle imbalance and back pain.

Additional information

For more information, refer to the following sections:
• “Risk Factors
• “General Prevention and Treatment,”
• “Preventing Musculoskeletal Injury for Dancers,”

References

Norris, R. 1993. The musician’s survival manual: A guide to preventing and treating
injuries in instrumentalists. St. Louis: MMB Music Inc.

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