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Preventing dance injuries

In dance, artistic statements are presented through great displays of athletic skill. Dancing requires flexibility, strength, coordination, balance, and endurance. The training required to dance is no less physically strenuous or mentally challenging than the training required for any competitive sport.

Like any althete, a dancer is at risk for a range of injuries. Dance-related injuries commonly affect feet and ankles, low back, hips, and knees.

Dancers typically specialize at a young age, which puts them at risk for certain injuries as they grow and develop. Dancers are particularly susceptible to overuse injuries because repetitive practice is central to dance training. Without proper recovery and treatment, overuse injuries may grow worse over time.

A group of ballet dancers stand in a dance studio with their hands up over their heads.

Research highlight

Hip pain is different in dancers. Dynamic ultrasound sheds light on hip microinstability.

What are the most common dance injuries?

Foot and ankle injuries

A dancer’s feet and ankles withstand a tremendous amount of impact, repetitive load, and a unique range of motion that can lead to injury. This is especially true for young dancers who are growing and developing at the same time as they’re learning dance technique. Injuries include sprains, bony stress injuries (stress reactions/fractures), tendinitis, and impingement.

Leg pain

Jumping on a hard floor or landing improperly may lead to tenderness and pain in the front and inside of the lower legs. This pain can start with irritation to the soft tissue lining of the bone, (periostitis, also known as shin splints). However, dancers are also at risk of bony stress injuries in the tibia that can be difficult to differentiate from periostitis.

Knee pain

Turnout, turning, twisting, jumping, and landing may lead to patellofemoral pain and increase the risk for sprains and strains.

Hip pain

The extreme range of motion common in many forms of dance can lead to hip pain. Hip pain in the front often originates from the hip flexor (iliopsoas tendinitis) and can be associated with snapping.

Other sources of hip pain include muscle and tendon strain or irritation, hip impingement, and hip labral tears. While not caused by dance, symptoms of adolescent hip dysplasia may become apparent earlier in dancers due to the demands they place on their hips.

Lower back pain

Repetitive extension or flexion mixed with sudden muscle contractions and imbalanced strength and flexibility may produce lower back pain. Bony stress injuries (stress reaction/fracture known as spondylolysis) may also occur, especially in adolescent, still-growing dancers.

How can dancers avoid injury

  • Warm up and cool down with dynamic stretches and light aerobic exercise before every class, rehearsal, or performance. Be sure to stretch afterward. If it’s cool in the dance studio, wear a sweater and leggings until you’re warm.
  • Wear appropriate shoes for the type of dance you’re practicing or performing. Dance shoes should be snug but comfortable.
  • Sit one out if you’re tired or hurt. Dancing while in pain or overtired can lead to injuries. Don’t mask pain with ice or painkillers: Ignoring your body’s signals could put you at risk for more serious injury.
  • Focus on technique. Practicing moves with poor technique and poor body alignment can lead to soreness, strain, and injury.
  • Eat well and don’t overdo it. Adolescence is an important time for bone development. The combination of overtraining, poor nutrition, and hormonal disruption can prevent your bones from growing strong at a critical time. Be sure to nourish your body throughout the day and leave plenty of time for rest and recovery.

How can parents and instructors help prevent dance injuries?

  • Create a safe dancing environment. Make sure the studio floor is clear of debris and slick spots that could lead to slips and falls. Be sure dancers have enough space to preform without colliding with each other. 
  • Encourage students to speak up if they are in pain or need a break. Let them know that their health comes first.
  • Create an encouraging culture that recognizes effort and rewards progress. Pressuring a young dancer to be perfect may lead to overtraining injuries and emotional stress.
  • Pay close attention to the maturity, physical development, and skill levels of each dancer. Dancers should not move to the next level before they’re ready. Young ballet dancers should not dance in pointe shoes until their feet and technique are sufficiently developed. During periods of rapid growth, a dancer’s participation may need to be modified.

Dancers, body image, and energy availability

The aesthetic emphasis in dance can cause dancers to become overly concerned with their physical appearance. An obsession with being thin may lead young dancers (both female and male) to take extreme measures in diet and exercise.

Watch for symptoms of relative energy deficiency in sport (RED-S), a syndrome of poor health and declining athletic performance that happens when athletes do not get enough fuel through food to support the energy demands of their daily lives and training. Symptoms include:

  • fatigue
  • weight loss
  • delayed onset of menstrual cycle, increased time between cycles, or missed periods
  • delayed puberty
  • frequent illness
  • hair loss
  • trouble focusing
  • trouble staying warm
  • irritability and depression

How we care for dancers at Boston Children's Hospital

Whether injury prevention or recovery is your goal, our sports medicine specialists have the skills and dedication to help your child remain active in the sport they love.

As the largest and most experienced pediatric and young adult sports medicine practice in the country, the Sports Medicine Division at Boston Children's combines personalized care with innovative treatment for each athlete we treat.

The Performing Artist Athletes Program provides specialized care in the many areas that affect performing artist athletes, including nutrition, bone and endocrine health, sports psychology, injury prevention, and rehabilitative care for injured athletes.

The Female Athlete Program takes a comprehensive approach to diagnosing, treating, and managing sports injuries in female athletes and sees athletes of any gender with low energy availability. We start by assessing the whole athlete, including exercise habits, hormonal balance, and nutritional needs — not just symptoms and injuries — to ensure peak performance.

The Micheli Center for Sports Injury Prevention, part of the Sports Medicine Division, offers practical strategies that help young athletes reduce their risk of injury while enhancing their sports performance. Our rehabilitation and strength training programs help injured athletes return to play stronger and healthier.