Hip Labrum Tears in Ballerinas

A hip labrum (or labral) tear is a tear in the cartilage that runs along the hip
socket. The labrum is there to add cushion to the hip joint and socket. This tear can be
caused from normal daily activities, sports related injuries, trauma impacts, and structural
abnormalities. It is commonly seen in older patients with the normal stresses of life or
seen in younger teenaged patients, mainly those of ballet dancers and football players.
This injury can be seen in young athletes and dancers to professional athletes and
ballerinas alike. Although, this injury is especially seen in many ballet dancers due to the
repetitive motions and jumping, the extreme stretching, and the unnatural pose of the
turnout of the hips and feet.1
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Injuries in Ballet
Why Injuries are so common in Ballet Dancers
Hip Labrum Tears
Hip Labrum Tears in Ballet Dancers
Hip Labrum Tears in Professional Ballet Dancers
Life after Labrum Hip Surgery for A Ballet Dancer

Injuries in Ballet:
Pelvic, hip, knee and foot injuries are the most common due to the extreme
turnout of ballet dancers. Injuries in ballet are very common due to the fact of that in the
world of professional ballet, ballerinas are often not only competing with themselves but
many others in order to try and keep their spots and jobs. They will often perform injured
due to not wanting to show the injury and thus not be able to perform and their spot get
taken.7 Unlike most sport injuries that are related to contact, much like a football injury,
ballerinas usually become injured because of technique and turnout problems,
resulting in stress fractures, tendonitis, bursitis and other slowly developing "overuse
injuries."2 In a study from the American Journal for Sports Medicine, the types of injuries
and how they correlate to each individual person among dancers was observed. It focused
on whether or not gender, age, body types, style of dance, or flexibility, pervious injuries

1 Labral Tear/Torn Labrum of the Hip. Hospital for Special Surgery.
https://www.hss.edu/ condition-list_labral-tears-hip.asp Accessed 26 Oct 2016.
2

Krohm, Sudan. Ballet Dancers get Racked up about as often as the Rams or
Raiders. Los Angeles Times. June 1988. http://articles.latimes.com/1988-0623/news/vw-7053_1_ballet- dancers. Accessed 18 Oct 2016.

lead to more injury prone dancers. Out of 148 dancers, aged 12 to 38, 83 were reported to
have lower-limb injuries, the most common being ankle sprains.3
Why Injuries are so common in Ballet Dancers:
Many do not understand how intensive the world and art of ballet dancing truly is.
Most do not understand how much work must go into being a professional ballerina.
Professional dance as a career requires a high level of commitment, passion, extensive
training, and then a professional life that is very brief.4 Professional ballerinas are a
different type of athletes, their bodies are put under tremendous amounts of stress that
many do not even realize since it is not a typical sport. Every athlete has the desire for
excellence, but every type of athlete has a different motivation. Dancers, tend to focus on
the length of their career rather than risk all for one great moment due to the fact that
their career can be extremely short. They also earn modest pay, rarely get endorsement
opportunities and fame is usually not as high as other professional athletes.5 The chance
of injury is also so high that many do not want to risk the length of their career. But what
many do not realize is that studies have found that professional ballerinas suffer from
serious injuries just as much as professional athletes playing contact sports.2
Hip Labrum Tears:
Hip labrum tears are one of the many injuries seen in a large number of
professional ballet dancers. The process from symptoms to treatment is:
Symptoms- Common symptoms are pain in hip and groin area, a locking
sensation in the hip joint, and limited mobility of hip.4
Diagnosis- A hip specialist may perform a physical exam and move the leg in
order to evaluate the hips range of motion. A MRI is also used and a material may be
injected into the joint in order to see if a tear exist. A steroid injection into the hip joint

3
Weisler, Ethan R., Monte Hunter, David F. Martin, Walton W. Curl, Helena
Hoen. Ankle Flexibility and Injury Patterns in Dancers. The American
Journal for Sports Medicine. December 1996 vol. 24 no. 6 754-75.
ajs.sagepub.com /content/24/6/754.full.pdf. Accessed 13 Oct 2016.
5

Muzaffar, Maroosha. A Dancer Dies Twice: The Unique, Sad Challenge of

Retiring From Ballet. The Atlantic. Mar 2014. http://www.theatlantic .com
/entertainment/archive/2014/03/a-dancer -dies-twice-the-unique-sad-challenge-ofretiring-from-ballet/284187/ Accessed 18 Oct 2016.

may be used in order to see if the pain lessens with the steroids, which possibly could
mean there is a tear. 6
Treatment- Treatment for this labral tear depends on the extent of the tear and
how painful it is for the patient. The first step is taking an anti inflammatory and going to
physical therapy. If the pain worsens or does not get better then the next step in an
arthroscopic surgery.2 The goal of arthroscopic treatment of a torn labrum is to relieve
pain by eliminating the unstable flap tear that causes hip discomfort. The goals of these
treatments are to maintain the function of the hip joint and decrease the development of
premature arthritis.7 Labral tears can be surgically fixed in two different ways depending
on the extent of the tear, either a repair of the labrum with a suture or a removal of a
small part of the labrum. 7

(http://www.moveforwardpt.com/image.axd?id=fcbae22c-d84e-425a-8d06621a5aa58fc6)

6
Hip Labral Tear. Mayo Clinic. Apr 2014. http://www.mayoclinic.org/diseasesconditions/hip-labral-tear/basics/tests-diagnosis/con-20031062. 26 Oct 2016.
7

Kelly, Brian T., Daniel E. Weiland, Mara L. Schenker, Marc J. Philippon.Arthroscopic

Labral Repair in the Hip: Surgical Technique and Review of the Literature.
Science Direct: Arthroscopy: The Journal of Arthroscopic & Related Surgery,
December 2005 vol 21 issue 12. http://www.sciencedirect.com/science
/article/pii/S0749806305011710. Accessed 13 Oct 2016.

Hip Labrum Tears in Ballet Dancers:

Ballet dancing requires an extreme amount of flexibility. Whether it is natural or
acquired, dancers have hypermobility that can cause many problems, specifically in the
hips. This hypermobility can put stress on the hip joints and cause impingement. Also due
to the intense amount of hip motions it can affect the soft tissue in the hips, which can
also lead to impingements. Dancing also involves great amount of hip flexion, extension,
abduction, and external rotation, which can thus lead to labrum strains or tears. One
specific movement of dance that is believed to lead to hip labrum tears is the act of
turning out. This is when the legs and feet are turned outward; this movement is done
with about 50-70% of the hips, which thus puts strain on the hip joint and hip labrum.8
Hip Labrum Tears in Professional Ballet Dancers:
Wendy Whelman was a professional ballerina with the New York City Ballet
Company for twenty-eight years before she was forced to quit due to a hip labrum tear.
She had overcome many injuries during her career, but once she tore her labrum, she was
forced to quit forever.9 Another professional ballerina, Tracy-Kai Maier, is a dancer for
the San Francisco Ballet and denied that she had a serious injury for long, until it was
unbearable and she found out she too had a labrum hip tear. Maiers doctor, James
Garrick, is the go to doctor for most dancers in the SF Ballet and he states "There were
just slightly more injuries in the (San Francisco Ballet's) company in the course of last
year that required time out than there are people in the company. That injury rate is about
what it is in professional football." According to Dr. Garrick A recent study of 85
ballerinas over a three-year period revealed that 72 of the study group suffered 268
injuries collectively.4

8 Weber, Alexander E., Asheesh Bedi, Lisa M. Tibor, Ira Zaltz, Christopher M. Larson.
The Hyperflexible Hip. Sports Health. July 2015. www.ncbi.nlm.nih.gov
/pmc/articles/PMC4481673/. Accessed 15 Nov 2016.

9
Schwarz, Joel. Ballet Dancer Injuries as Common, Severe as Athletic Injuries. UW
Today. Oct 2000. http://www.washington.edu/news/2000/10/11/ballet-dancerinjuries-as-common-severe-as-athletic-injuries/ Accessed 26 Oct 2016.

(http://www.nationwidechildrens.org/document/get/113123)

Life after Labrum Hip Surgery for A Ballet Dancer

While the outcome of most surgeries is normally a guaranteed end result, hip
labrum tear surgery is not. The outcome is different for each and every person. Annabel
M. is a young teenaged ballet dancer and twirler who recently under went a hip labrum
tear arthroscopy on both hips. According to her blog, A Twirler/Dancers Journey
Through Hip Arthroscopy, she is recovering well. At 9 weeks post surgery on one hip
and 19 weeks post surgery on the other hip, she is able to do most of her normal exercises
without any pain. 10

10 Annabel M., A Twirler/Dancers Journey Through Hip Arthroscopy. Blogspot.com
March 2013. http://dance-hip-arthroscopy.blogspot.com/ Accessed 29 Nov 2016.