Dance Medicine and Science – a developing field. Guest Blog by Dr Manuela Angioi

January 27, 2012 by 1 Comment

Dance medicine and science is a relatively young discipline, while the wealth of information available to scientists and all those working in the dance field is expanding and moving ahead rapidly. This is also reflected in the increasing number of dance-related articles now appearing in sports medicine and science journals.

Dance performance depends on a large number of physical and psychological elements, while dancers are expected to be experts in the aesthetic as well as technical side of the art and be free from injuries. On the other hand, dance is a “high risk” activity for musculoskeletal injuries, with a recorded high prevalence and incidence of lower extremity and back injuries, with soft tissue and overuse injuries predominating.

The majority of studies refer to mixed samples of dancers, in terms of levels and styles or techniques. But should we look at dancers as a uniform group of “performing” athletes?

One of the peculiar characteristics of dance is that it is NOT just “one form of performing art or exercise”. Within the “dance box” there are a number of styles (or techniques), including: ballet, contemporary (or modern), jazz, hip hop, theatrical, street dance, aerobic and ballroom dance. These styles differ significantly in terms of, at least, technical requirements, physical prerequisites and training models. It is therefore assumed that different dance styles should have different statistics in terms of injury rate, type and incidence.

It becomes more complicated when looking at levels of dancers. In the dance world there are different “employment scenarios” beyond the “ordinary” classification of professionals versus non professionals. To simplify, dancers can be classified as professionals (these are usually only ballet or contemporary dancers), in training (vocational or non vocational) and then they could be performing for a number of days per year but they also have other occupations or they are without a formal contract (independent dancers). Total hours of training and performing, as such, can vary significantly even within the same “style” according to the “employment status” which, in turn, can affect injury rate and severity. Hence, it is not a surprise discovering the heterogeneity of the dance medicine literature in terms of injury type, rate and incidence.

The majority of published research studies have focused on ballet and contemporary dance, while there is a lack of information about other styles or techniques. Again, majority of studies have looked at either professional or pre-professional dancers, while there is a paucity of data regarding recreational and amateur dancers, even if there is an estimated number of 4.7 million participants at recreational level in UK only.  There a very few published epidemiological studies while majority of reviews are weak. The overall feeling is that there is a need for more data before drawing consistent conclusions about musculoskeletal injuries of dancers. As such, similar approaches as the one recently adopted by Campoy and colleagues, who looked at injuries characteristics in four different dance styles, are needed to broaden the ongoing dance medicine literature.

Reference

Campoy S et al. 2011. Investigation of Risk Factors and Characteristics of Dance Injuries. CJSM 21(6): 493-498

(The author of this article is Dr Manuela Angioi, Research Supervisor and research methods module leader on the MSc in Sport and Exercise Medicine at the Centre for Sport and Exercise Medicine, William Harvey Research Institute, Queen Mary University London)

(Photograph, Dr Angioi practising her art)

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London Prepares series – 2012 test events in full swing

October 14, 2011 by

With less than 300 days to go until the start of the London 2012 Olympics on the 27th of July, and the Paralympics on the 29th of August, London is entering the final stages of its preparation. The City has been hosting the ‘London Prepares’ test event series in advance of the games and these commenced in May this year with the 2011 UK Athletics 20km race walking championships and an invitational marathon. Since then, there have been a number of other events including equestrian, modern pentathlon, sailing, triathlon, badminton and various cycling events.

The latest treat on the calendar was the 2011 London Archery Classic held at Lords Cricket ground from the 3rd to the 10th of October, and I was on hand to view events for myself as a Sports Medicine event doctor last weekend.

Lords Cricket ground is better known in the UK and worldwide as the home of Cricket, so it was a little strange to see such a different audience in the famous old pavilion, usually occupied by members of the Marylebone Cricket Club (MCC) in their distinctive red and yellow striped jackets and sun hats. Despite the unfamiliar appearance of the spectators, this famous old venue was a wonderful place in which to see the athletes compete in the archery event. Perhaps it was fitting that, in such a prestigious place, the archers rose the occasion by putting in some excellent and memorable performances, including two new world records. Korea’s Im Dong-Hyun managed to break his own  72-arrow world record in the ranking round, scoring 693 and exceeding  his previous record by two points, and followed this up by helping to set a world record in the men’s team competition.

From the medical side of things, everything seemed to go very smoothly with no major problems, the classic representing an ideal opportunity for the medical team to get to grips with things at the venue and to make the fine adjustments necessary to systems and resources prior to the games proper.

As far as test events go, there are many to go this side of Christmas with handball, boxing, table tennis and fencing amongst others to feature. In the new year, spectators can look forward to many more competitions including gymnastics, cycling and aquatics events before some paralympics test events commencing in April.

It is always exciting to be involved in test events prior to the main spectacle to come, and it was a pleasure to be able to watch these world class athletes perform and to talk with the other support and coaching staff. I was even fortunate enough to try my hand at the sport on a much shorter range, managing to hit the target with each of my 3 arrows. Having said that, I don’t think that Im Dong-Hyun and his colleagues have much to fear.

Archery was reintroduced to the Olympic games in the 1972 Munich games following a 52 year hiatus thought to be due to a lack of uniform rules.

Ertan and Tuzun found a prevalence of injury of 56.8% in a questionnaire study of 88 archers at the 2000 Turkish archery championships, although were not specific about their definition of a reported injury. Mann and Littke reported an injury rate of 38.1 injuries per 100 competitors from a retrospective questionnaire of 21 archers who qualified for the Canadian world championship team in 1987. Most injuries are reported to occur in the upper extremities. Ertan and Tuzun found the fingers to be the most frequently reported body part to be injured, followed by the shoulder of the drawing arm. This pattern was further supported by National Electronic Injury Surveillance System findings from the US product safety commission 2007 which included hunting-related archery injuries.

Acute injuries include blisters in the fingers and contusions to the bow forearm caused by string touches, also known as ‘bow slap.’ Most archers wear protection on their bow forearm to prevent this injury. Chronic overuse injuries include tendinopathies (see Rayan G, in Southern Medical Journal) and compression neuropathies in the arm (see Toth C et al, in Sports Medicine). For a comprehensive review of the epidemiology of injury in archery, see Hildenbrand JC (IV) and Rayan GM Chapter 2 in Caine DJ et al ‘Epidemiology of Injury in Olympic Sports’ , Wiley Publishing.

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