Marissa T Schaeffer, SPT, CSCS
Dancing alone is not always enough to make you the best dancer you can be. Like any athlete, a dancer must be appropriately physically conditioned to perform at their highest level. It is also a well-known fact that dancers get injured. Research has shown that 67-95% of the dancers in professional companies are injured annually 1. Numerous factors increase a dancer’s risk for injury including, but not limited to, poor technique, decreased endurance or conditioning, and insufficient neuromuscular control 2-4.

Dancers can mitigate these risk factors and increase their level of physical conditioning by engaging in carefully crafted cross-training programs that are targeted towards addressing any gaps in a dancer’s physical conditioning, strength, range of motion or technique/neuromuscular control. Such cross training can improve a dancer’s health and wellness, advance technical skill, and promote the longevity of a dancer’s career 5-9.
Cross training seeks to improve overall fitness while reducing risk for injury.
Increasing Cardiovascular Fitness
Dancers need to have good cardiovascular fitness in order to have the stamina to complete ballets without fatigue. Once fatigued, a dancer’s ability to perform technically complicated movements can be compromised and the risk for acute – or sudden – injury increases.10 For example, if a dancer becomes fatigued after performing a long jump sequence in a ballet, he may not have the stamina to perform a subsequent sequence of lifts with proper form.
Research into the cardiovascular fitness of dancers has told us that dance class and rehearsal are not sufficient stimuli to train the cardiovascular system to meet the demands of performance.8 It is therefore important that dancers train this system by engaging in activities such as biking, swimming, circuit training or running in order to decrease susceptibility to fatigue and injury.
Improving Neuromuscular Control
Our nervous system – our brain, spinal cord, and nerves – tells our body how to move through space. This is called neuromuscular control. Sometimes these systems do not communicate properly, leading to movement habits that may increase the potential for injury. Decreased neuromuscular control, especially within the trunk, has been associated with an increased risk for injury in the lower extremity and back.8, 9, 11 Different types of cross-training, like pilates, strength training, or gyrotonic can help correct some of these movement patterns by training the neuromuscular system to move in a more efficient, healthy way.
Building Muscular Fitness4, 6, 12
Resistance training increases muscular strength, endurance, and power. This can help improve a dancer’s ability to balance, jump, hold higher extensions, resist fatigue during strenuous ballets, and more. In dancers, a decrease in muscular strength has been correlated with greater severity of injury, which can impact the time it takes to return to dance10. It is also worth noting that strength training can bring a host of other important benefits such as improved bone density, decreased risk of certain disease, improved ease and efficiency of movement, and joint protection.
Increasing Range of Motion and Mobility
It is well known that dancers must be able to move into extreme ranges of motion. If a dancer does not have adequate range of motion, they may use compensatory strategies in order to achieve a desired aesthetic. This may increase stress on surrounding joints and soft tissue structures. Among its many other benefits, cross training can help a dancer gain12 and control greater ranges of motion which will help attenuate the amount of stress put on the body.
Less often considered, but of equal importance, is the concept of unbalanced flexibility. Certain forms of dance, particularly western forms such as ballet, emphasize certain ranges of motion over others. For example, ballet technique emphasizes turned out positions (hip external rotation), and dancers tend to have a lot of turn out but limited turn in.10 Habitual use of a specific range may predispose a dancer to injury, especially when the dancer is asked to move in ways they are not used to. This can happen when learning new choreography or working on pieces that are based on other technical forms of dance. Cross-training can help dancers find control through all ranges that their joints allow adding protection against unfamiliar movements.
A Principle Governing Good Cross-Training:
The SAID Principle, which stands for Specific Adaptations to Imposed Demands, states that our body will adapt to the particular stimulus we place on it. If we practice jumping, our body will get better at jumping. If we ride a bike everyday, we will get better at cycling. With that in mind, any cross-training program for a dancer should consider the specific needs of the individual. If you are having trouble with a particular movement, you need to understand why you are having that trouble and work on that issue. For example, are you having trouble holding your leg á la seconde? This could be a problem with mobility, core control, hip flexor strength, or something else. Are you having trouble making it through a ballet without fatiguing? Maybe you need a tailored cardiovascular program. The key is to figure out what the deficit is and develop a program that will help correct the specific issue or issues.
References:
Gamboa J, Roberts L, Maring J, Ferguson A. Injury Patterns in Elite Preprofessional Ballet Dancers and the Utility of Screening Programs to Identify Risk Characteristics. Journal of Orthopeadic & Sports Physical Therapy. 2008; 38(3):126-136.
Bowerman E, Whatman C, Harris N, Bradshaw E, Karin J. Are maturation, growth and lower extremity alignment associated with overuse injury in elite adolescent ballet dancers? Phys Ther Sport. 2014; 15(4): 234-241.
Bowerman E, Whatman C, Harris N, Bradshaw E. A review of the risk factors for lower extremity overuse injuries in young elite female ballet dancers. Journal of Dance Medicine and Science. 2015; 19(2):51-56.
Roussel NA, Nijs J, Mottram S, Moorsel A, Troijen S, Stassijns G. Altered lumbopelvic movement control but not generalized joint hypermobility is associated with increased injury in dancers. A prospective study. Manual Therapy. 2009; 14(6): 630-635.
Koutedakis Y, Athanasios J. The Dancer as a Performing Athlete: Physiological Considerations. Sports Medicine. 2004; 34(10): 651-661.
Stracciolini A, Hanson E, Kiefer AW, Myer GD, Feigenbaum AD. Resistance Training for Pediatric Female Dancers. Journal of Dance Medicine and Science. 2016; 20(2): 64-71.
Angioi M, Metsios G, Koutedakis Y, Wyon MA. Fitness in Contemporary Dance: A Systematic Review. International Journal of Sports Medicine. 2009; 30.
Russell JA. Preventing dance injuries: current perspectives. Open Access Journal of Sports Medicine. 2013; 4: 199-210.
Murgia C. Overuse, tissue fatigue, and injuries. Journal of Dance Medicine and Science. 2013; 17(3): 92-100.
Twitchett E, Brodrick A, Nevill A, Koutedakis. Y, Angioi M, Wyon M. Does Physical Fitness Affect Injury Occurrance and Time Loss Due to Injury in Elite Vocational Ballet Students? Journal of Dance Medicine and Science. 2010; 14(1): 26-31.
Rickman A, Ambegaonkar J, Cortes N. Core Stability: Implications for Dance Injury. Medical Problems of Performing Artists. 2012; 27(3): 159-164.
Koutedakis Y, Hukam H, Metsios G, Nevill A, Giakas G, et al. The Effects of Three Months of Aerobic and Strength Training on Selected Performance and Fitness-Related Parameters in Modern Dance Students. Journal of Strength and Conditioning Research. 2007; 21(3): 808-812.
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