Ballet dancers are a unique type of athlete whose art is harmonious and physically scrupulous. The anti-anatomic positions used by ballet dancers, throughout their long duration and high intensity training, place tremendous stress on the musculoskeletal system, exposing them to greater risk of sport injury and thus physical damage.
It is visible that ballerinas possess extraordinary physical abilities, remarkably apparent in the feet and ankles which is why lateral ankle sprains (LAS’s) in the ballerina are common.
Causative factors of LAS during dance include:
· Biomechanical and physical form
· Previous injury
· Ground force reaction; dependent on a controlled landing technique and on landing surfaces
· Sprung wooden flooring is important in a ballet studio. The more pliant the floor, the more force it may absorb and dissipate, reducing risk of injury.
There are different grades of LAS in ballet dancers. Grade I and II LAS’s have a positive prognosis while grade III sprains require more tedious rehabilitation. These differently graded sprains may be diagnosed by a physiotherapist, making prognosis clearer.
· Pain and swelling
· Sensorimotor alterations
· Ligamentous laxity
· Peroneal muscle weakness
· Postural sway (medial-lateral postural instability)
These impairments cause reduced proprioception and therefore reduced ankle stability, influencing a ballerinas ability to dance. This highlights the importance of specific treatment and rehabilitation following LAS.
Sports physiotherapists and ballet instructors are important in the specific rehabilitation of the ballerina from LAS. The aim of treatment and rehabilitation is to address the individual ballet dancers’ impairments following LAS, before the ballerina returns to training. This prevents further damage and injury recurrence.
In order to do so, a physiotherapist would initially need to fully assess the biomechanical and physical form of the injured ankle and entire kinetic chain. A clear diagnosis and treatment plan will be made and patient specific goals will be set in order to optimise treatment outcome and limit time off dance. Footwear may also need to be analysed. Early treatment would be directed towards reducing pain and inflammation and increasing strength and stability as soon as possible. It is vital that mid to later stage rehabilitation is made more ballet dance specific, aiming to prepare the individual dancer to return to dance safely. Prior to returning to dance, the ballerinas dance technique, especially in this case their landing technique, should be assessed in order to prevent re-injury.
Function360 aims at making our treatment and rehabilitation individualised and specific to each patient. Our patients’ sports and hobbies are always considered during treatment. Our aim is to safely return all our patients to their professional sport or to their recreational hobby as quickly but as safely as possible.
Author Jordane Zammit Tabona
Physiotherapist and Sports Rehabilitation Specialist