Professional ballet dancers' experience of injury and osteopathic treatment in the UK: A qualitative study

Must The Show Go On? A Qualitative Study Exploring Barriers And Enablers To Manual Therapists' Care Of Dancers

INTRODUCTION

Dance Medicine is a growing discipline, and healthcare for dancers requires appreciating particularities of their artistic craft. Manual therapists (MTs) are often dancers' first choice when seeking care. Whilst dancers' experiences of injury and healthcare have been extensively researched, little is known of MTs' perspectives of caring for them.

AIM

This study aimed to gain an understanding of MTs' perspectives of caring for dancers. Communication, treatment strategies and obstacles to a successful therapeutic alliance were examined to broaden knowledge and improve care.

METHODS

This was a qualitative study using Grounded Theory as a framework for data collection and analysis. A purposive sample of 8 participants was recruited-physiotherapists, chiropractors, and osteopaths with 2+ years' experience of treating dancers. Data collection was conducted via semi-structured interviews, which were transcribed verbatim, anonymized, member checked, and later analyzed.

RESULTS

Data analysis constructed 3 categories which described the range of participants' experiences. Two categories were identified-(i) A Strangled Industry and (ii) Be-all End-all Patients-and found to culminate in a core category: (iii) Beyond Hands-on, which exemplified MTs' attempts to address clinical challenges.

CONCLUSIONS

MTs experience several challenges when providing healthcare to dancers. These encompass psychosocial aspects relating to dancers' internal world and the dance industry environment. It suggests that caring for dancers demands comprehensive, collaborative, and psychologically informed approaches. Emphasis should also be given to developing and implementing dance-specific pain science for all stakeholders.

Perspectives and Experiences of Dance-Related Injuries: A Qualitative Survey of Adolescent Pre-Professional Ballet Dancers in Australia

Objective: To explore perspectives and experiences of adolescent ballet dancers in Australia in relation to dance-related injuries and their impact, injury risk factors, prevention, and treatment. Design: Adolescent ballet dancers aged from 12 to 19 years in Australia were invited to participate in an online qualitative survey. Methods: Responses to open-ended questions were analyzed thematically using grounded theory while quantitative information was summarized with descriptive statistics and triangulated with qualitative data. Results: Nineteen adolescent dancers reported experiencing pain and multiple injuries but hiding or ignoring injuries due to fear. Dancers recognized the significant physical and psycho-social impact of dance-related injuries on themselves and others. Several risks and injury prevention strategies were identified by dancers. Dancers perceived that treatments were not always informed or effective. Conclusion: Findings suggest that adolescent ballet dancers experience multiple dance-related injuries but require support to disclose injuries, participate in injury prevention, and access treatment. Health professionals may improve quality of care by increasing their understanding of ballet and providing specific management advice. Dance teachers may benefit from further education to support their students. Clinical trials are required to confirm or negate the validity of proposed injury risks and the effectiveness of injury prevention strategies and treatments.

I expected to be pain free: a qualitative study exploring athletes' expectations and experiences of care received by sports chiropractors

Background

Knowledge about patient satisfaction and experience with care they receive can guide practitioners in establishing doctor-patient relationships and improve health outcomes. Although evidence suggests high patient satisfaction with chiropractic care in general, there is limited understanding of the expectations and experiences of athletes receiving sports chiropractic care.

Objective

To explore the athletes’ expectations and experiences with care received from sports chiropractors, and their perceptions of relevant areas of future research.

Methods

A qualitative study was conducted through an interpretivist lens exploring the perspectives of elite and competitive athletes receiving care from sports chiropractors in Canada. Participants were purposively recruited and interviewed until saturation was reached. Two research team members independently analyzed the interview transcripts using a conventional approach to content analysis. Content was inductively coded and discussed by the research team to generate categories.

Results

We interviewed 18 participants between December 2018 and March 2020, 14 were national level athletes participating in sports ranging from paddling to combat sports. Reported reasons for seeking care included acute care, injury prevention, enhancing performance and maintenance care. Generated categories were organized under topics of experience with care, expectations of care, and research agenda. Participants experienced a variety of interventions, reassurance, varying treatment times, and reported positive impact on their athletic performance. They expected musculoskeletal assessment and treatment including at and beyond the injury site, symptom improvement, good communication and expertise from the chiropractor. Some participants suggested interpersonal and interprofessional communication can be improved, in particular the level of collaboration with other members of their health care team. Overall, participants reported a high level of trust and satisfaction with care received from sports chiropractors. From our participants’ perspective, suggested areas of research should focus on injury mechanics and prevention, impact of care on performance, and interprofessional collaboration.

Conclusions

In general, participants were very satisfied with care. Overall, participants’ expectations and experiences aligned but changed over time. Addressing the findings of this study can be used to enhance the quality of care provided to athletes from sports chiropractors, as well as inform future research agendas. Further work assessing if athletes in other competitive levels have similar experiences and expectations is needed.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12998-022-00426-4.

Health problems of professional ballet dancers

Ballet is a professional activity that places risky physical and psycho-emotional demands on the human body. The goal of this study was to evaluate health-related problems among ballet dancers. Within the qualitative study, in-depth interviews were conducted with ballet dancers at the State Ballet of Georgia. Participants' mean age was 23.4 ± 3.5 years, the average BMI - 21.2 ± 2.2. Dancers had spent 9.2 ± 7.4 years studying dancing professionally. On average, they spent 8.5 ± 5.8 hours in class and 16.2 ± 11.6 hours in rehearsal. Most injuries were related to ankle/feet (16%), knee (60%), and neck (13%). Common risk factors for incurring pain and injury included overuse (19%), previous injury (11%), and fatigue (11%). Of the injured dancers, 80% chose to seek medical attention. Mostly, they visited traumatologists (40%) and physiotherapists (30%). The biopsychosocial condition of ballet artists is affected by physical workload, high risk of injuries, as well as constant stress. The result suggests high prevalence and recurrence of dance injuries. Ankle/feet, knee and neck are especially risky topological areas for injuries as particularly big pressure is placed on the feet and ankle joints. The majority of respondents sought advice from medical specialists rather than family physicians. It is necessary to prevent injuries and stress through raising awareness. A team of professionals (family physician, orthopedist, psychologist, nutritionist, endocrinologist, physical therapist, nurse) is needed to prevent injuries. Family doctors should pay more attention to the promotion of a healthy lifestyle during the consultation with ballet dancers.

What Makes an Osteopathic Treatment Effective From a Patient's Perspective: A Descriptive Phenomenological Study

OBJECTIVES

This study aimed to describe patients' perspectives on their experience in osteopathic treatment, to contribute toward developing interpretative models on effectiveness.

METHODS

A descriptive phenomenological approach was used. The data were collected through a semistructured interview. To capture the variability of the phenomenon, a purposive sample of 12 participants with previous experience of osteopathic care was selected. The data analysis was carried out in an inductive way, and it was parallel to the recruitment to continuously monitor the data saturation.

RESULTS

Data saturation was reached with 12 participants (female = 9; male = 3). Participants' age ranged from 27 to 82 years old (mean: 55.25 ± 17.15; median: 59; kurtosis: -0.82). Participants had different reasons for consultation. The analysis showed 1 overarching theme, "Osteopathy is a path of awareness," 3 themes, and 12 categories. Themes were: (1) "The experience of pain produces awareness of the need for care," (2) "Osteopathy is a journey to be shared over time," and (3) "The effectiveness of the osteopathic treatment is the discovery of the person's unity by experience."

CONCLUSION

Participants affirm that osteopathy is a path of awareness that starts from an experience of pain; leads them to contact an osteopath; and ends with their experience of the unity of body, mind, and spirit.

Evaluation of Professional Ballet Dancers Body Posture During Barre Movements

Ballet dancers have finite careers due to the demands placed upon their bodies throughout years of training, study, and performance. The average age a dancer retires is 34 due to persistent stress on their joints and injuries due to mechanical overload or overuse. Proper form is crucial to prevent injury. The aim of this study was to establish benchmarks for normal movement patterns among professional dancers. Ten professional ballerinas were studied. Reflective markers were placed on the pelvis, left and right anterior superior iliac spine (ASIS), and posterior iliac spine (PSIS) to evaluate motion during Barre movements: plié, grand battement, and développé. Pelvis flexion/extension, mediolateral rotation, and torsion were analyzed. These motions test different skills. The plié is a controlled coordinated motion using both legs. The grand battement and développé both require leg extension, one with a quick motion that creates momentum and one using controlled motion that requires strength. Each requires core and pelvis stability to perform accurately and with less injury. Dancers' motions were consistent. Maximum pelvis range of motion for the plié, grand battement, and développé were 8.0, 42, and 50 deg, respectively. This represents usable benchmarks with which other dancers may be compared, for example, those who are at different levels of training, injured, predisposed to injury, or recovering from injury. Early recognition of pathologic movement patterns could benefit professional and amateur dancers by helping to prevent injuries, and potentially improve the quality and length of their careers.

Performing artist and Athlete Health Monitor: user experience, content and conditions for use of an online dance-health surveillance system in a professional ballet company

Objectives

The user experience, content and conditions for use of an online dance-health surveillance system (Performing artist and Athlete Health Monitor, PAHM) was examined through a focus group interview with professional ballet dancers.

Methods

Nine professional dancers (56% female (n=5), average age=27.56± 5.17) completed biweekly questionnaires using the PAHM, including questions on health problems, injuries, mental complaints and illnesses. After 6 weeks, nine dancers participated in a focus group interview to investigate the user experience, content and conditions for use of the PAHM. Data were analysed using thematic analysis.

Results

25 of the 27 questionnaires were completed (response rate of 93%). Dancers were positive about using the PAHM. They recommend to clarifying the questions about pain and injury, expanding items on mental health, including items on workload, sleep, rest and nutrition, and receiving feedback regarding their own results. Dancers were reluctant regarding sharing their personal data with others. Data on an aggregated level can be shared because this might gain insight into the association between scheduling, workload and injury risk.

Conclusion

The user experience of the monitor contributes to the willingness of dancers to keep using the PAHM. Dancers recommended adjusting the content in the PAHM to match their dance activities and health problems. The conditions for using the PAHM effectively within a company are a safe and trusting culture. Even though the PAHM alone cannot change the culture in a ballet company, it can play a role in the communication between staff and dancers.

[The experience of pain among classical dance ballerinas: meanings derived from a qualitative study]

This article presents the results of a study focused on the meaning that pain assumes in the discourse of a group of classical dance ballerinas. To achieve this, we accessed their experiences and perceptions through a semi-structured interview, to better understand the pain that is an integral part of their routines before, during and after a performance. This study is based on the discourses which emerged from a group of ten ballerinas with six or more years of training, and the method chosen to tap into the underlying meanings was Grounded Analysis or Sustained Data Analysis. The analysis of the discourses collected revealed that pursuing a dancing career involves obstacles that increase the demands felt by the ballerinas, in parallel with their desire to remain in the world of performance. Thus, it is the excessive practicing and repetitive movements which give rise to pain and injuries, which are concealed and denied so as not to impede the focus of attaining perfection. In general, the results obtained emphasize the passion for dance that involves pain as an ally to this career and force the ballerinas to varied confrontation strategies. In tandem, pain is linked to fear of injury, to the end of a career as a ballerina and the relinquishment of a dream.