Pressure and desire to perform keep injured
dancers on their toes, local study shows
The Straits Times (4 April 2017) - A small niggle turned into a big
worry for Ms Adelene Stanley when
she could not lift her legs above 90
degrees – something a nimble
dancer like her can do easily.
“It was odd. Usually, I just kick
and my leg goes high,” said the
21-year-old of the incident, which
happened in 2013.
The problem was traced to a displaced
disc in her lower back that
she suffered during her final year at
Rambert School of Ballet and Contemporary
Dance in Britain.
She believed it occurred because
she had not stretched properly
before dance class, which sometimes
lasted from 8am to 8pm.
But she persisted with training,
though her back flexibility and
range of motion were limited.
Dancers who did not seek medical
attention when they got hurt,
in the survey on injury patterns
of 365 dancers in Singapore
Dancers who had foot and ankle
Dancers who had knee injuries
Dancers who had back injuries
Ms Stanley, who is now with local
dance company Frontier Danceland,
recalled how she was worried
about being taken out of an important
graduation show as it would
have affected her job prospects.
She is one of many dancers who
press on with their physically
demanding craft despite the risks
to their body from injuries.
A study on injury patterns among
365 dancers in Singapore found
that about six in 10 (58 per cent)
dancers did not seek medical
attention when they got hurt.
Compared to other studies, the
proportion of dancers who sought
medical treatment was low, wrote
Dr Jason Chia, the author of the
study. He heads the sports medicine
and surgery clinic at Tan Tock
Dr Chia, who does contemporary
dance and ballet, said: “Injuries
should be diagnosed properly. Some
injuries can recur when not treated
Participants of the study were a
mix of professional, semi-professional
and recreational dancers.
The study was published in the
February edition of local medical
journal The Annals.
Foot and ankle injuries were the
most common. More than half of
the dancers, or 54%, surveyed had
suffered from them. Knee injuries
were a close second at 49 per cent,
followed by back injuries, which
had affected 34 per cent of the
dancers, the study found.
Fifty-three per cent of the participants
had dance-related injuries
and most of them had one to two
Professional dancers acknowledge
the link between repetitive dance
moves and injuries. Ballerinas often
have to go en pointe, where their
body weight is supported on the
tips of their toes. This strains the
ligaments, said Ms Stanley.
Meanwhile, male ballet dancers
can suffer constant lower back
strain from lifting their female
partners in dance duets.
The repetitive movements of the
foot and ankle that are required in
dance forms like ballet also pose a
risk, said the study.
As for modern dance, practitioners
often have to do deep
lunges and leg swings, said Ms Chia
Poh Hian, 24, of T.H.E Dance Company.
These moves can affect the
knees, hips and spine, she added.
The consensus among professional
dancers is that breakdancers
are more prone to serious injuries
due to the acrobatic jumps, flips,
back bends and knee drops they do.
Over-training is another risk
factor, with 12 per cent of the
dancers surveyed saying they did
not have a rest day from dance.
Often, it is not a lack of awareness
that sees dancers set aside their
injury concerns. The pressure and
desire to perform often override
such issues, they said.
The survey found that one in four
of the injured dancers chose to
ignore the injury, while nearly
one-third of them simply abstained
from dance to recover.
Ms Jasmine Lee, 29, an O School
dance artist, said: “There will be a
lot of backlash if you pull out and
there is a need to find a replacement.
Many professional dancers
will just push through the pain.”
Ms Stanley recalled how a fellow
dancer went ahead with a performance
despite a serious ankle injury.
She added: “During the intermission,
a physiotherapist gave her
a painkiller injection and she went
back on stage afterwards.”
However, there are others who
prefer not to take such a risk.
Ms Joy Wang, 24, who is with
Frontier Danceland, said she would
rather sit out and rest, lest she
aggravates her injury.
“If not, I will get rheumatism
when I’m 30 and I will need a walking
stick when I’m 40,” she said,
GETTING MEDICAL HELP
While most people would go to
doctors for medical help, the study
found this was not so for dancers.
It showed that injured dancers
often turned to physiotherapists
(33 per cent) or traditional medical
professionals (31 per cent). The
latter includes traditional Chinese
About 20 per cent of them visited
specialists such as orthopaedic
surgeons. Only 16 per cent chose to
go to a primary care physician.
Ms Wang said that when she gets
hurt, she would consult physiotherapists
or osteopaths, who are practitioners
of alternative medicine
which emphasises massages.
She said primary care physicians
usually do not understand the
demands imposed on dancers.
Ms Lee agreed, saying: “They’d
tell me to monitor for a few weeks,
then go for a magnetic resonance
imaging (MRI) scan. I can’t wait so
long, dance is a year-round thing.”
She goes for acupuncture treatment
which, she said, “doesn’t
really help in the long run”. But it is
useful as “a quick fix”.
With many dancers seeking alternative
treatment, Dr Chia said
healthcare professionals could take
this into account when devising
measures to improve the medical
care of dancers.
He suggested “dance screening”.
This is an assessment of the dancer’s
physique, such as straightness
of the spine, degree of hip rotation,
and back and leg flexibility. It is
typically done before a person joins
a dance school or company.
Dance screenings are not a
common practice in Singapore.
But Ms Chia said screening will
help dancers be more aware of their
body mechanics as well as identify
the parts that need strengthening.
Ms Elaine Heng, 28, a company
artist with Singapore Dance
Theatre, hopes healthcare professionals
can tailor exercises, as well
as fitness and rehabilitation programmes
for dancers, based on the
Dancers can benefit from doing
proper physical conditioning to
prime their bodies better. The
study said the relatively low rates of
aerobic and strength training might
suggest a lack of recognition of comprehensive
in injury prevention.
Though Ms Chia incorporates
flexibility and strength training
into her routine, she would have to
do aerobic training outside of her
work hours to build up the stamina
required for full-length dance
“It’s difficult to find a balance
between resting the body and more
training sessions,” she added.
Ultimately, Ms Wang believes
that dance places the body in
unnatural positions, bringing it
“one step closer to injuries”.
But Ms Chia is more optimistic,
saying the key to avoiding injuries
is to “figure out how to do things
within one’s bodily constraints”.
She said: “It’s all about being
master of your body.”
WARM UP, COOL DOWN
Before a dance session, it is
crucial to get the heart rate
Ms Jasmine Lee, 29, an O
School dance artist, said
training is one option.
It alternates between
bursts of intensive
exercises – jumping jacks,
push-ups and crunches –
and short periods of rest.
Dr Jason Chia, who heads
the Sports Medicine and
Surgery Clinic at Tan Tock
Seng Hospital, advocates
core training, which targets
the torso. A strong core
gives dancers more body
control and stability.
Singapore Dance Theatre
artist Elaine Heng, 28, tailors
her warm-up sessions to
the dance sequence. If it
features leg extensions, she
would do more backstrengthening
To cool down, she does
calf, quad, hip flexor, hamstring
and glute stretches.
Dr Chia said physical
conditioning should include
and strength training.
Most dancers practise the
RICE – rest, ice, compression,
elevation – method.
When Singapore Dance
Theatre artist May Yen
Cheah, 32, sprained her
ankle, she visited her
physiotherapist “to learn
how to do simple things
like walk, hop and jump”.
Applying ice or a compression
band, and elevating
the injured area to
above the heart level can
help minimise pain and
Many dancers take up yoga
and pilates to develop
flexibility and strength.
Running and swimming
build up stamina. Dancers
prefer swimming as running
can cause wear and
tear to the knee cartilage.
Source: The Straits Times © Singapore Press Holdings Limited Reproduced with permission.