Ballet Dancer Injuries As Common, Severe As Athletic Injuries

Ronald Smith, a University of Washington psychology professor and lead author of a new study published in the current issue of the journal Anxiety, Stress and Coping, said that the injury rate for ballet dancers over an eight-month period was 61 percent. This is comparable to rates found in other studies for athletes in collision sports such as football and wrestling. The average time lost because of a ballet injury was 10.5 days, with the actual time loss ranging from one to 87 days. An injury was defined as a medical problem that restricted participation for at least one day beyond the date of the injury.

"We think ballet dancers are as vulnerable as athletes because ballet is a very pressure-packed activity with a tremendous amount of competition," said Smith, who has worked for the Houston Astros organization as a psychological consultant. "Ballet is physically grueling and the fact that other dancers are competing with them adds to the physical stress. They often perform hurt and are afraid someone will take their place. Many dancers have eating disorders and they lead very, very stressful lives. The level of precision required is comparable to that of an Olympic gymnast."

To probe dancing injuries, Smith and J.T. Ptacek, an associate professor of psychology at Bucknell University, and Elizabeth Patterson, a retired ballet dancer and former UW undergraduate student, studied 46 members of the Pacific Northwest Ballet Company in Seattle. The dancers, 31 women and 15 men, were recruited 11 weeks into the season, after they had had enough time to experience work-related life events and become involved in the ballet company's social network. On average, the dancers were slightly over 26 years of age. None of the dancers was injured when the study began. Injuries were then tracked for eight months, the remainder of the company's season.

The dancers also filled out several questionnaires that measured positive and negative life events, support available from a dancer's social network and a performance anxiety scale that measured fears about performing poorly. In an earlier published paper from this study, the researchers found that high levels of life stress and low social support were predictors of injuries among dancers.

The new study focuses on anxiety as a factor in performance injuries. Anxiety has physical and cognitive components, according to Smith. Physical anxiety includes such things as muscle tension, butterflies in the stomach, hyperventilating or a pounding heart. Cognitive anxiety is broken into two categories: a loss or lack of focus and worrying.

"There are several theories about which factors predict injuries. One is that if you are performing while physically tense you are more likely to be injured," said Smith. "Another is that if your mind is not on the task at hand, if you are worried or not focused, it is easier to get hurt. We found that it is a combination of all three factors - loss or lack of focus, worrying and physical anxiety - that puts dancers at risk for being hurt."

Knowing this, said Smith, opens to door to reducing the number of injuries because dancers at risk can be identified and there are effective stress management programs, including one developed at the University of Washington.

"We have a program that has been used on groups as diverse as businessmen, athletes and students. It teaches coping skills that were originally developed for students with test anxiety and teaches people how to control their bodies and minds in ways that reduce stress. It helps people develop coping skills utilized by highly capable people such as Michael Jordan and Tiger Woods," said Smith.

As for specifically helping ballet dancers, he said it would be useful to teach dancers how to increase levels of social support and to learn coping skills to deal with day-to-day stressors, such as interpersonal conflict and dealing with traffic, that put them at risk for injuries.

The research was funded by the William T. Grant Foundation.