ObjectivesTo describe the incidence rate, severity, burden and aetiology of medical attention and time-loss injuries across five consecutive seasons at a professional ballet company.MethodsMedical attention injuries, time-loss injuries and dance exposure hours of 123 professional ballet dancers (women: n=66, age: 28.0±8.3 years; men: n=57, age: 27.9±8.5 years) were prospectively recorded between the 2015/2016 and 2019/2020 seasons.ResultsThe incidence rate (per 1000 hours) of medical attention injury was 3.9 (95% CI 3.3 to 4.4) for women and 3.1 (95% CI 2.6 to 3.5) for men. The incidence rate (per 1000 hours) of time-loss injury was 1.2 (95% CI 1.0 to 1.5) for women and 1.1 (95% CI 0.9 to 1.3) for men. First Soloists and Principals experienced between 2.0–2.2 additional medical attention injuries per 1000 hours and 0.9–1.1 additional time-loss injuries per 1000 hours compared with Apprentices (p≤0.025). Further, intraseason differences were observed in medical attention, but not time-loss, injury incidence rates with the highest incidence rates in early (August and September) and late (June) season months. Thirty-five per cent of time-loss injuries resulted in over 28 days of modified dance training. A greater percentage of time-loss injuries were classified as overuse (women: 50%; men: 51%) compared with traumatic (women: 40%; men: 41%).ConclusionThis is the first study to report the incidence rate of medical attention and time-loss injuries in professional ballet dancers. Incidence rates differed across company ranks and months, which may inform targeted injury prevention strategies.

Vitamin D supplementation decreased the numbers of deficient and insufficient participants within this cohort. The intervention group reported a small significant increase in muscle strength that was negatively associated with traumatic injury occurrence.

Purpose To describe the relationships between dance exposure, dancer characteristics, and injury risk across five seasons in a professional ballet company.Methods Dance exposure time and clinician-reported time-loss and medical attention injury data were prospectively collected from 118 professional dancers of The Royal Ballet between 2015/16 and 2019/20. Cox proportional hazards and shared frailty models were fitted to overuse and traumatic injuries; individualized robust Z-scores for 7-day and 28-day accumulated exposure, and week-to-week change in exposure, age, sex, company rank, and injury history were included as time-varying covariates. ResultsAcross 381,710 h of exposure, 1332 medical attention and 427 time-loss injuries were observed. Positive relationships were observed between week-to-week change in exposure and overuse time-loss (+1 Z-score hazard ratio (HR): 1.27, 95% confidence interval (CI): 1.06-1.53) and medical attention injury risk (+1 Z-score HR: 1.17, 95% CI: 1.06-1.28). A negative relationship was observed between 7-day accumulated exposure and overuse medical-attention injury risk (+1 Z-score HR: 0.74, 95% CI: 0.66-0.84). Overuse time-loss injury risk was greater in soloists compared to the corps de ballet (HR: 1.47, 95% CI: 1.01-2.15), and in dancers with a higher previous injury rate (+1 injury•1000 h -1 HR: 1.06, 95% CI: 1.02-1.10). Only age was associated with traumatic time-loss (+1-year HR: 1.05, 95% CI: 1.01-1.09) or medical attention injury risk (+1-year HR: 1.04, 95% CI: 1.01-1.07). ConclusionProfessional ballet companies should implement training principles such as periodization and progression, particularly in the case of senior-ranking dancers, older dancers, and dancers with high rates of previous injury. These findings provide a basis for future prospective investigations into specific causal injury pathways.

AIMS: Understanding the biomechanics of jumping in ballet dancers provides an opportunity to optimize performance and mitigate injury risk. This systematic review aimed to summarize research investigating kinetics and kinematics of jumping in ballet dancers. METHODS: PubMed (MEDLINE), SPORTDiscus, and Web of Science were systematically searched for studies published before December 2020. Studies were required to investigate dancers specializing in ballet, assess kinetics or kinematics during take-off or landing, and be published in English. RESULTS: A total of 3,781 articles were identified, of which 29 met the inclusion criteria. Seven studies investigated take-off (kinetics: n = 6; kinematics: n = 4) and 23 studies investigated landing (kinetics: n = 19; kinematics: n = 12). Included articles were categorized into six themes: Activity Type (n = 10), Environment and Equipment (n = 10), Demographics (n = 8), Physical Characteristics (n = 3), Injury Status (n = 2), and Skill Acquisition and Motor Control (n = 1). Peak landing vertical ground reaction force (1.4 x 9.6 times body weight) was most commonly reported. Limited evidence suggests greater ankle involvement during the take-off of ballet jumps compared to countermovement jumps. There is also limited evidence indicating greater sagittal plane joint excursions upon landing in ballet dancers compared to non-dancers, primarily through a more extended lower extremity at initial contact. Only 4 articles investigated male ballet dancers, which is a notable gap in the literature. CONCLUSIONS: The findings of this review can be used by dance science and medicine practitioners to improve their understanding of jumping in ballet dancers.

Introduction: Few studies have published data concerning the longitudinal rehearsal and performance demands experienced by professional ballet dancers. We aimed to describe the rehearsal and performance volumes undertaken across five professional ballet seasons and identify factors associated with inter-dancer and inter-production variation in dance hours. Methods: Scheduling data were collected from 123 dancers over five seasons at The Royal Ballet. Linear mixed effects models were used to evaluate differences in: 1. weekly dance hours and seasonal performance counts across sexes, company ranks, and months; and 2. factors associated with the variation in rehearsal hours required to stage different productions. Results: On average across the five seasons, a peak in performance volume was observed in December, whereas rehearsal hours peaked in October and November and between January and April. Differences in weekly dance hours were observed between company ranks (p < 0.001, range in means: 19.1 to 27.5 hours per week). Seasonal performance counts varied across company ranks (p < 0.001), ranging from 28 (95% CI: 22, 35) in principals to 113 (95% CI: 108, 118) in the rank of artist. Rehearsal durations were considerably greater in preparation for newly created ballets compared with existing ballets (77.8 vs. 37.5 hours). Rehearsal durations were also greater in preparation for longer ballets, with each additional minute of running time associated with a 0.43 hour increase in rehearsal duration (p < 0.001). Full-length ballets, however, were consistently the most time-efficient to stage due to their long performance runs compared with shorter ballets (16.2 vs. 7.4 performances).Conclusions: Training principles such as progressive overload and periodization should be implemented in professional ballet companies to manage the high and variable rehearsal and performance loads.