Both musicians and dancers are at risk for occupational diseases, which can negatively affect their careers. If a diagnosis is not made in time and proper treatment is not provided, they may be forced to take a break from or even end their careers. Therefore, early diagnosis is critical for solving issues without forcing artists to step away from their careers.

The progression of orthopedic problems in musicians and dancers is examined in five stages:

Stage 1: Pain occurs after class, rehearsal, or performance. It does not affect performance.

Stage 2: Pain occurs during class, rehearsal, or performance. It does not cause any performance limitations.

Stage 3: Pain occurs during class, rehearsal, or performance. It also starts to affect daily life. The artist may need to adjust their technique or reduce the duration of their practice.

Stage 4: Pain occurs as soon as class, rehearsal, or performance begins and prevents continuation. It significantly affects daily life.

Stage 5: Pain is present during all daily activities. The artist cannot participate in classes, rehearsals, or performances.

There are several risk factors for musculoskeletal injuries in dancers and musicians, which are categorized into three groups:

Environmental factors:

Temperature, the space where the work is performed, arrangement of equipment, technical materials and their placement, flooring, and lighting.

Physical factors:

Incorrect posture, intense and repetitive movements, long work hours, falls and collisions, vibration.

Personal factors:

Age and gender, physical fitness (strength, flexibility, endurance), nutrition, posture, habits (smoking, alcohol, etc.), psychological stress, and factors related to general health (pregnancy, diabetes, osteoporosis).

The most common scenario for musculoskeletal injuries in dancers and musicians is an increase in a single risk factor or the combination of multiple risk factors. Additionally, performance anxiety, intense work and performance schedules, and irregular and inadequate nutrition also play a role in the occurrence of injuries.

Prevention of musculoskeletal injuries in dancers and musicians occurs in two stages:

Control of risk factors: Knowing personal limits (maintaining balance between physical and psychological expectations), keeping general health in good condition.

Recognizing early symptoms and taking precautions: Taking action when pain intensity is at stage 1 or 2, seeking professional medical help.

However, dancers and musicians typically seek help only when the pain reaches stage 3 or 4.

Orthopedic Issues in Dancers

Musculoskeletal injuries are the most common medical issues in dancers. Various studies have shown that 60-80% of dancers experience an injury severe enough to require taking a break from dancing at least once in their careers. Additionally, half of the dancers complain of chronic musculoskeletal issues. Late-onset muscle pain also needs to be mentioned here.

Late-onset muscle pain is a condition that starts 24-36 hours after strenuous work or performance and is characterized by muscle stiffness. This condition is completely normal and will resolve on its own within a few days. Pain resulting from a muscle or ligament injury starts immediately and takes much longer to heal.

An important detail about late-onset muscle pain is that it can sometimes mask a developing issue. Therefore, it is advisable to consult a doctor if prolonged pain is present.

Factors contributing to injuries in dancers:

• Intense training at an early age (before puberty)
• Long and heavy rehearsals (intense schedule, insufficient warm-up, poor flooring, cold environment)
• Dancing in the “pointe” position
• The characteristics of the shoes used
• Inadequate diet

In chronic injuries, the role of incorrect dance technique is significant. Even if treatment is provided after an injury, repeated injuries can occur due to improper technique. Therefore, it is crucial for dancers who plan to dance for a long time to dance with the correct technique. Moreover, physical, mental, and environmental expectations can also play a role in the occurrence of dance injuries. For example, high expectations from a dancer can lead to anxiety, which in turn causes muscle stiffness and prepares the ground for injury. Additionally, dancers who do not receive proprioceptive therapy during the recovery period after an injury have a higher risk of re-injury.

Proprioception (deep sense) is the ability to know the position of our muscles and joints, even without seeing them, and it is essential for posture, balance, and coordination. After an injury, proprioception weakens during the rest period. If therapy is not applied during this period, the dancer will face difficulty in movements that require balance and coordination, and the risk of re-injury increases.

Dance injuries can be grouped into muscle strains, ligament injuries, and bone damage. Many injuries are observed in the lower extremities, which are under more load due to turns, the “pointe” position, falls, and the percussion use of the foot.

Most dance injuries are overuse or misuse injuries.

The areas most affected by chronic injuries are:

• Neck and back (29%)
• Ankle (20%)
• Knee (17%)
• Thigh and leg (16%)
• Hip, groin, ribs (6%)
• Foot and toes (6%)
• Upper extremity (6%)

A significant portion of dance injuries occurs during performances or rehearsals. This can be explained by the fact that dancers tend to push their limits during these times, and muscle spasms due to psychological tension are more frequent.

The distribution of injuries by time is as follows:

• Performance (32%)
• Rehearsal (28%)
• Practice (16%)
• Various locations and slow onset (7%)
• Unknown causes (17%)

Dancers should be aware of the early signs of injury. Early diagnosis and treatment are critically important in protecting the dancer’s career.

The recommended symptoms to watch for include:

• Discomfort, pain, numbness, or tingling during dancing
• Weakness or difficulty controlling movement
• Decrease in joint range of motion or joint stiffness
• Postural changes (e.g., dropped shoulders, difficulty standing up straight)
• Regional swelling