Musculoskeletal problems of performing artists

Angry posture

Postural abnormalities can affect the emotions and vice-versa. The aim of the present study was to investigate the existence of a relationship between subjective anger and body posture in 28 women, aged between 20 and 39 years, with a normal body mass index (or underweight) and an absence of neurological, psychiatric or musculoskeletal disorders. The postural parameters photographed were the inclination of the shoulders, protrusion of the head, hyperextension of the knees and shoulder elevation. The degree of anger was rated by analogue scales representing current and usual anger. The results indicated that a relationship exists between current anger and the inclination of the shoulders (p = 0.03), protrusion of the head (p = 0.05) and hyperextension of the knees (p = 0.05). Correlations were found between usual anger, shoulder elevation (p = 0.05) and hyperextension of the knees (p = 0.05). In conclusion, posture is associated with emotions, and usual anger can lead to shoulder protraction.

Expert care of the performing artist

Compared to elite athletes, elite performers, especially musicians and dancers, invariably lack expert medical backup even though their needs are just as great as the sportspeople. In some countries, this is now being realised and addressed. It is hoped that a new MSc in Performing Arts Medicine, recently introduced in the UK, will go some way towards correcting this, and its syllabus has provided the catalyst for this themed issue.

Mechanics of Jazz Shoes and Their Effect on Pointing in Child Dancers

There has been little scientific investigation of the impact of dance shoes on foot motion or dance injuries. The pointed (plantar-flexed) foot is a fundamental component of both the technical requirements and the traditional aesthetic of ballet and jazz dancing. The aims of this study were to quantify the externally observed angle of plantar flexion in various jazz shoes compared with barefoot and to compare the sagittal plane bending stiffness of the various jazz shoes. Sixteen female recreational child dancers were recruited for 3D motion analysis of active plantar flexion. The jazz shoes tested were a split-sole jazz shoe, full-sole jazz shoe, and jazz sneaker. A shoe dynamometer measured the stiffness of the jazz shoes. The shoes had a significant effect on ankle plantar flexion. All jazz shoes significantly restricted the midfoot plantar flexion angle compared with the barefoot condition. The split-sole jazz shoe demonstrated the least restriction, whereas the full-sole jazz shoe the most midfoot restriction. A small restriction in metartarsophalangeal plantar flexion and a greater restriction at the midfoot joint were demonstrated when wearing stiff jazz shoes. These restrictions will decrease the aesthetic of the pointed foot, may encourage incorrect muscle activation, and have an impact on dance performance.

Musculoskeletal injuries and pain in dancers: a systematic review

OBJECTIVE

To assemble and synthesize the best evidence on the epidemiology, diagnosis, prognosis, treatment, and prevention of musculoskeletal injuries and pain in dancers.

DATA SOURCES

Medline, CINAHL, PsycINFO, Embase, and other electronic databases were searched from 1966 to 2004 using key words such as dance, dancer, dancing, athletic injuries, occupational injuries, sprains and strains, and musculoskeletal diseases. In addition, the reference lists of relevant studies were examined, specialized journals were hand-searched, and the websites of major dance associations were scanned for relevant information.

STUDY SELECTION

Citations were screened for relevance using a priori criteria, and relevant studies were critically reviewed for scientific merit by the best evidence synthesis method. After 1865 abstracts were screened, 103 articles were reviewed, and 32 (31%) of these were accepted as scientifically admissible (representing 29 unique studies).

DATA EXTRACTION

Data from accepted studies were abstracted into evidence tables relating to the prevalence and associated factors, incidence and risk factors, diagnosis, treatment, economic costs, and prevention of musculoskeletal injuries and pain in dancers.

DATA SYNTHESIS

The scientifically admissible studies consisted of 15 (52%) cohort studies, 13 (45%) cross-sectional studies, and 1 (3%) validation study of a diagnostic assessment tool. There is a high prevalence and incidence of lower extremity and back injuries, with soft tissue and overuse injuries predominating. For example, lifetime prevalence estimates for injury in professional ballet dancers ranged between 40% and 84%, while the point prevalence of minor injury in a diverse group of university and professional ballet and modern dancers was 74%. Several potential risk factors for injury are suggested by the literature, but conclusive evidence for any of these is lacking. There is preliminary evidence that comprehensive injury prevention and management strategies may help decrease the incidence of future injury.

CONCLUSIONS

The dance medicine literature is young and heterogeneous, limiting our ability to draw consistent conclusions. Nonetheless, the best available evidence suggests that musculoskeletal injury is an important health issue for dancers at all skill levels. Better quality research is needed in this specialized area. Future research would benefit from clear and relevant research questions being addressed with appropriate study designs, use of conceptually valid and clinically meaningful case definitions of injury and pain, and better reporting of studies in line with current scientific standards.