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K. Everaert1, B. Fierens1, N. Steinberg2, P. Mahaudens3, F. Balagué4, J. Gielen1, P. Gielen5, E. Van Breda1, N. Roussel1
1University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium, 2The Wingate College of Physical Education and Sports Sciences at the Wingate Institute, Netanya, Israel, 3Université Catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium, 4Fribourg-Hôpital Cantonal, Department of Rheumatology, Fribourg, Switzerland, 5University of Antwerp, Antwerp Research Institute for the Arts, Antwerp, Belgium
Background: Many adult dancers suffer from LBP, which interferes with their movement strategies. A group that merits further attention are pre-professional adolescent dancers as high levels of physical activity are associated with a higher risk to develop LBP and as LBP during adolescence seems to be a risk factor for spinal pain in adulthood. Of interest in adolescents is the skeletal age as this defines loadability of apophyseal growth areas.
Purpose: To gain more insight into LBP in pre-professional adolescent dancers.
Methods: Eligible female dancers were recruited among dancers aged 14-18y in a secondary school specialized in dance (i.e. >11h of dancing per week). Inclusion criteria were full-time enrollment and parents’ admittance. The Extended Nordic Musculoskeletal Questionnaire was used to examine the prevalence of LBP and impact on daily life. A radiography of the non-dominant hand was used to define skeletal age. The Adams forward-bend test was used to identify scoliosis. Generalized joint hypermobility was assessed using the Beighton score and an application was used to examine range of motion of the lower limbs.
Results: Fifty dancers (100% response rate) agreed to participate. Fifteen dancers (29%) reported a history of LBP. Significant differences were observed between calendar age and skeletal age in adolescent dancers (p<0.05). A considerable proportion of dancers showed delayed skeletal maturation (32%), irregular menstruation (48%) or amenorrhea (8%) but this appeared unrelated to LBP. Dancers with a history of LBP started significantly earlier with dancing (i.e. 2 years earlier, p<0,01) and had significantly less range of motion towards hip internal rotation (p<0,05). Scoliosis and generalized joint hypermobility were present in 20-22% of the dancers but this was not related to LBP (p>0,05).
Conclusion(s): Although delayed skeletal maturation and abnormal menstruation is unrelated to LBP, it appeared to be a common problem in pre-professional female dancers. Further research is necessary to examine the impact of skeletal maturation and abnormal hormonal characteristics on musculoskeletal pain and injuries in dancers.
Implications: Since a considerable number of female pre-professional adolescent dancers suffer from a delayed bone maturation, training loads should be adjusted to their skeletal age instead of calendar age. Especially, when dancers start their dancing activities under the age of 6 years old because this could be related to the development of LBP during adolescence. In addition, when dancing at a pre-professional performance level, asymmetric hip ROM and compensations strategies should be overlooked since this also could be related to LBP in female adolescent dancers. Furthermore, the irregular menstruation cycle should be an important factor to consider when working with female adolescent dancers. Although talking about menstruation cycles could be inconvenient or even taboo in the artistic world, trainers and choreographers should try to expose this topic within young dancers to avoid biopsychosocial consequences.
Funding, acknowledgements: This research received an Antwerp University funding (BOF STIMPRO). No other specific grants were received.
Keywords: Dance, adolescent, back pain
Topic: Sport & sports injuries
Did this work require ethics approval? Yes
Institution: Universiteit Antwerpen
Committee: Commissie voor medische ethiek van UZA/UA
Ethics number: B300201733096
All authors, affiliations and abstracts have been published as submitted.
