How to foster a life long love of dance, injury free
Classical ballet just as tough as mainstream contact sports as injury prevention requires training at elite level
Recently I commented here on the high rate of injury in pre professional ballerinas. Discussing the causes and reasons for the two most common injuries of the lower leg; stress fractures in the foot and knee injuries.
The conversation came about after a research paper was published in the Journal of Science and Medicine in Sport and I want to share how I believe we can assist with injury prevention from a very young age.
Culturally the world of dance is going to have to shift away from competing with each other on who can kick their leg the highest and who has the trickiest of tricks in their contemporary routine. The world if ballet is definitely getting a lot more acrobatic and athletic and navigating this as a teenager whilst developing strength and stamina required to perform at an elite level with artistry and restraint will no doubt be an ongoing battle.
The high risk of injury in elite pre professional schools can be attributed to:
1. The high level of training, the repetitive nature of the work and hours involved.
Dancers are training at least 8 hours a day, often with a rehearsal and performance at night.
2. Ballet in general is becoming a lot more athletic and acrobatic.
There are now lots of big leaps, lifts, and high leg extensions. There a trend toward a world of tricks, kicks and bravado. It’s requiring a lot more physically of the dancers as far as fitness and athleticism goes, in both men and women.
3. The lack of resources (mostly time) to provide a wide variety of alternative, compatible conditioning training.
In the full time dance schools where the students attend there is not much time or equipment to mix up the training. Having a session on the stationary bike, or pilates, yoga ,swimming and massage would often be an optional extra and left to the dancer to try to fit in around their already busy schedule.
4. A pre professional student is prone to ignoring a minor injury or niggle and will often hold off on seeing a physical therapist of some form until the injury is rather serious.
In a full time school there is often no immediate access to a team of physiotherapists, osteopaths, podiatrists and/or massage therapists, as soon as the dancer feels a weird niggle in the body. Which is the type of treatment a dancer receives in a professional ballet company. So a pre professional dancer may leave a slight niggle in the knee, or ignore a tendon that is gripping in the hip flexor every time she lifts a leg, until it gets way too bad and a full blown injury or tear has occurred.
5. Peer to peer competition and staged competitions where the dancers try to out do each other with the latest trick or flick, to impress upon others to receive awards, scholarships or secure one of the few places available in a company.
Dance competitions such as the Youth America Grand Prix (which is what the movie First Position was based around) is aimed at pre professional ballerinas and a way for them to pitch their skill and artistry to the world of Artistic Directors for a job or scholarship.

Normally - a company would create an audition if needing to recruit new dancers or they would invite a few they like to come in for an internship, trial basis, so they can see the dancer in a range of regular company activities, class, rehearsals, training and conditioning.
6. The students may be carrying a minor tear or have a bad habit developed prior to entry into the elite dance training facility and the workload and competition has caused a bad injury to develop.
The trickle down affect of the big competitions is when local comps begin to set themselves on a similar playing field and local talented dancers begin to work towards skills - actually I should say ‘tricks’ - in the aim of winning. They begin pointe work before they are strong enough, they desire for hyper mobility in the spine and they are probably not eating enough nutrient dense foods to sustain this level of activity and to let the body repair after an intense class or competition. This is highly likely the environment that the dancers were in prior to commencing full time dance.
Summary
My assumption is that the dancers in the study, may have been carrying an injury or habit into their pre professional year. Once they move from this recreational level (with bad habits, alignment or a small tear developing) this is amplified 10 fold when they start full time hours in their pre professional year.
I would also say the 24% that didn’t get an injury will do so in the future, and/or genetically are gifted with a body and bone structure most ideal to the rigours of ballet.
Solutions for injury prevention in the next generation of dancers
At Big Steps Little Feet we start at a very young age with assisting children and helping them transition into the world of ballet, by focussing their early training on establishing awareness of where their body is in space and what is it doing, by working on the concept of ‘feeling before form.’
Internal Motivation not External Motivation
Instead of getting the children to learn and copy what each step is - which is an appropriation of what it should look like - and forcing their little bodies with all their might creating a habit and practice focused on external motivation. ‘What is looks like’
When you focus from the inside out, and have an awareness of the activity or what the skill feels like, the motivation becomes an internal one, the children are able to execute it perfectly for their own body type. And sustain it.
For example, instead of asking the children to copy you as you point your toes in an tendu exercise. We provide a wide range of imagery for them to attach the skill to, which could be standing at the waters edge and calling the sea horses to us by lightly touching the top of the water with their toes. All of sudden this isn’t a point exercise for the children and what we see are little dancers with a lovely long straight leg and pointed feet, lighting touching the top of the floor. It’s perfect.
Posture
We bring an awareness to posture this way as well, so from a young age, they are working internally to create a sense of awareness and elongation of the spine in both directions, this is a sustainable feel as the children start to move, rather than an old school, lift here, tuck here, hold here, which is very static and grippy.
Beta Mode
I also work a lot in parallel, from learning to bend as a 2 year old to learning how to land big jumps as 9 or 10 year old. What I believe is the most important is understanding the action, feeling and mechanics of the skill learnt. I believe this is best learnt in the parallel alignment with knees over toes when bending. I call this ‘beta mode’ a super safe way to get the skill right before exposing the body, muscles, tendons and ligaments to the more stressful rotation alignments.
Lastly
I encourage all children to not start pointe work until they have reached puberty. Traditionally pointe work commences pre puberty when the body is softening, and hormones are tearing through the body. Greatly increasing the risks of pointe work related injuries.
And to have fun doing a wide range of physical activities, trampoline park, swimming, surfing, so that all of the muscles of the body get a work out, rather than the same ones used over and over again in a ballet class.
