Transcription
I could feel so much adrenaline pumping through me. I just felt my ankle like fill up with hot blood.
The first thought that always comes is it's over. The visa told me you have a stretch fracture. It's losing your audition reputation income. I don't want them to see me as a weak dancer.
When injuries happen, we tell ourselves it's bad luck. I'm asking my body to do things that aren't natural and we're not actually meant to be able to do them. Part of the job. But what if most injuries aren't accidents at all? We can drastically reduce the amount of injuries that a dancer gets within a season. There are patterns to those injuries. So if they're more than accidents, where are injuries coming from?
If I lose weight, I'm going to be able to jump higher. Untrue. Most important part of prevention, try to avoid those spikes. You have to treat your body as if it were a stratavarious violin. And how can we actually prevent them?
There's something almost magical about ballet for the audience. It gives the illusion of ease. Clean lines, seamless movement, invisible effort. But every dancer knows the beauty is real and so is everything it takes to create it.
It's so normal as a dancer to have pain every morning. Every day you feel some different pen and you don't give it so much attention. Injuries are definitely normal. Small or big always there. Especially when I can feel that my body is really tired. I'm worried that something will happen.
Ballet may be an art form, which is why it's often seen as something separate from sport, but physically it asks for just as much. Because if you look at the physical demands of ballet, every movement requires precision, control, and power. Every lift of the leg, every balance, point work, jumps, landings, all strung together into full choreographies. Research actually shows that ballet dancers belong in the same category as high performance athletes. And when an athlete gets injured, everything shifts.
The first thought that always comes is it's over, especially when it's a bad injury, is the fear of um yeah, losing the dream and uh the fear that the opportunity that we got that time will not come back. When you're not dancing, when you're injured, you feel that you feel a bit lost. But actually, an injury is the smallest part of the injury for a dancer. It's it's the communication, it's losing your audition, it's um your reputation, uh the place in your company, what do other people think, my income, you know, all of these things. The consequences are are enormous for a company. It's a financial impact. They may have to lay off a dancer and then if they're a small company employ somebody else. If your stars are injured, it may limit the the audience.
So before we talk about why they happen, there's a more basic question we need to explore, what exactly is an injury? Well, funny enough, the word injury means different things to different people. Schools, companies, researchers, even dancers themselves, they all have their own criteria for what actually counts as an injury. How injury is defined has a direct implication on our understanding of how much of a problem it is. First, we have the time loss injury. It counts if a dancer can't fully take part in class, rehearsal, or performance for at least a day after it happened. Another way is to only count injuries if the dancer seeks medical attention. The truth is many don't.
The fear of being cut out of things, not cast for this, not and people replacing you and if they replace you, am I going to be back in my roles again? Which means a lot of injuries never get officially recorded. And then there are definitions that include any physical problem a dancer reports, whether or not they miss time or see a doctor. So depending on how you define an injury, the scale of the problem can look very different.
However, one thing to recognize is that over the years of accumulating dance science research, the evidence indicates that regardless of the level of participation, so from students to pre-professional to professional artists, dancers are getting injured and they're getting injured a lot. Among non-professional dancers, one study found that 77% had experienced at least one injury since they began dancing. For professionals, another study reported that every single dancer surveyed had been injured at least once.
People that have never been injured are like, "Yeah, that's a legend." Another way to look at the risk is through what's called the injury rate. The number of injuries for every thousand hours of dance. In every category, from amateurs to professionals, dancers average between about 1 and four injuries for every,000 hours of dancing. To put that into perspective, a dancer training 20 hours a week could experience between 1 and four injuries in a single year. That's a lot. So, if we want to know how to minimize them, we first need to understand what we're dealing with.
So, what are the most common injuries in ballet dancers? Let's look at what we call the hot spot pyramid. Starting with the base, more than half of ballet injuries happen in the foot and ankle, making it the single most common injury site.
We ask just so much more than that structure was designed to handle. We ask so much more of its range. We ask some word the force that it's supposed to take. The ankle is constantly asked to stabilize the whole body on a very small base. When that demand gets ahead of the body's capacity, stability gives way. And that's when ankle sprains happen. But some problems don't show up all at once. With all the change of direction, the fast footwork, the loading into full demi point and then loading into full pa get the swelling in the back of the ankle which then gets pinched when someone goes into a demi point or a point position. That's what's known as posterior ankle impingement.
But sometimes problems go beyond soft tissue. In pretty much everything we do, the bones are always in play. We put force through that bone and it starts to get kind of small micro damage and starts to break down. Then before we can rebuild, we damage again. This weakens the bone and over time that cumulative micro damage can lead to what we call a stress fracture. A similar process shows up in tendons. The tissue that transfer force from muscles to bones. Especially a ballet dancer is going to be activating pointing that toe and kind of flexing and pointing and flexing and pointing over and over and over again. There's friction on that tendon. Friction creates normal wear in the tissue, but when it builds up over time, it leads to the tendon problems dancers hear about.
So often as we move up to the knee, hip, and lower back, injuries are less frequent, but the demands remain high. At the knee, it's mostly impact, excessive rotation, and the endless bending and straightening often linked to pain around the kneecap. As for the hip, it's almost always working near its limits. Your extreme need for turnout and external rotation of the hips are just the fact that you have to lift your hip above 90° for most of the time. Repeated constantly, that load accumulates inside the joint, sometimes leading to injuries like laboral tears. And in the lower back, repeated back bends and arabes compress the small joints of the spine, often leading to chronic pain.
At the top of the pyramid is the upper body. Here, injuries are less common, under 10% overall, and most often linked to partnering and sustained load through the arms and shoulders. And if you want to go deeper into understanding your body as a dancer, check out our body science essentials learning path, a collection of classes that explore the science behind how dancers move. Because the first step in taking care of your body is knowing how it works. Find these and many more classes online at dancemasterclass.com.
Now, knowing where injuries tend to strike isn't just trivia, it's a road map and it reveals patterns. Most of the time when we think of an injury, we picture a single moment, a split second when everything goes wrong. And yes, those happen. But what if the real danger isn't in that one dramatic moment, but in something far quieter and far more common? The truth is, in ballet, most injuries build up over weeks, months, even years. Stress fractures, chronic joint and tendon injuries, all the result of pushing the body over and over without the time it needs to recover and repair. These are called overuse injuries and are the most common kind in ballet. In non-professional dancers, about 75% of all injuries are overuse. Among professionals, the numbers range from around 60% to over 70%.
But if most injuries aren't accidents, what is actually putting dancers at such high risk? Well, the problem is that what puts dancers at risk often feels completely normal.
In 2014, David Halberg was at the height of his career. He wasn't just the acclaimed principal dancer at the American Ballet Theater. He also held that same title at Russia's legendary Bulloy Ballet, the first American ever to do so. With an intense schedule of rehearsals, performances, and intercontinental travel, David was at the top of his game. But then everything changed. During that year, he began to feel a persistent pain on his left ankle that gradually worsened until it forced him to stop dancing completely.
Principal dancer David Hullberg will be out of performance indefinitely. Extensive recovery and rehabilitation issues. The diagnosis, a torn deltoid ligament, not the result of a fall or a single wrong move, but of years of silent overuse, damage that had been quietly accumulating, rehearsal after rehearsal, performance after performance. Eager to return to dancing, David underwent two surgeries, but neither could fully solve the problem. He was on the verge of retirement. As a last resort, he traveled to Australia to work with world-renowned physiootherapist Sue Maize and the medical team of the Australian Ballet. Far from New York's spotlight, the Australian team helped David begin the process of building himself back. The first shift was psychological, believing that recovery was possible. Then came the gym, building a physical foundation ballet alone had never given him. And finally back in the studio, relearning everything he thought he already knew about how to dance. After more than 2 years away, David Hullberg finally returned to the stage with the American Ballet Theater. But he was not the same dancer. His art was now anchored in a newfound physical and mental consciousness.
David's story is remarkable, but it raises a key question. Not what caused the injury, but what pushed him to the edge and how long he had been moving closer to it without realizing. To really understand this, we need to look at the forces that push a dancer closer to that edge or pull them back to safety. We call it the risk balance. On one side, we have the dancer, a body in its optimal state, strong, rested, and well aligned. On the other side, the risk factors, each one adding pressure that can tip the balance toward injury.
The first type of risk factors are the intrinsic. That's everything that happens within the dancer. The first group of intrinsic factors include things like your age, stage of growth, and individual body characteristics. Every body is different. The shape of your bones, the natural alignment of your joints, the way your feet are built. Those differences mean that the same demands don't land the same way on everybody. The hip is a ball in a socket joint. The ball can have a different shape. The socket can sit more to the side or more to the front and that's going to impact how the leg can move in space. Another example is hypermobility. That is definitely a factor. If you have a high degree of joint mobility, then you have less stability.
A dancer's anatomy sets the base, but risk also depends on how prepared the body is to handle what ballet asks of it. They need to have good capacity in the muscles to prepare them for the workload. So, you're trying to learn how to do a double soda bask. If you've not got that strong foundation, then in the air, you're going to be like, wo, and you could really hurt yourself. But capacity can't exist without enough energy. Even if you weren't a dancer, if you're just sitting on the couch all day long, you still have to keep your brain functioning. You have to keep your lungs breathing. You have to keep your heart beating. All of that takes energy. Everything we do with dance is added on top of that. And so dancers require a lot more fuel than the average person. When energy stays too low for too long, it affects multiple systems in the body, including the ability to repair itself. This is known as red S, and it makes injuries much more likely.
And even with the same body and the same level of preparation, risk isn't static. It changes over time. One reason is fatigue. When muscles are exhausted, they can't control movement precisely. Stability and coordination suffer and reaction time slows down. I was dancing a lot, but I was really tired. I was just doing my ballet class and in the big jump, I was doing one cabrio. And when I'm laid down, I just twist my knee. But fatigue doesn't only live in the body. Mental fatigue and stress also change how the body responds. There's an intrinsic link between the mind and the body. It's called psychossematic. If you are stressed, your muscles are going to be inherently more tense. Stress takes a lot of energy from your body which makes you tired which invariably ends up with yes injury.
Now every movement places load on specific parts of the body. Our ballet technique is it's not arbitrary. We do things in a certain way. We play pa and make sure that our knees are going over our toes and not caving in because that's what's going to help us be kind of the most efficient in our movement patterns, but also to put the forces that are going through our body in the safest places. When technique breaks down, load moves towards structures that are less capable of handling it. Over time, that imbalance quietly increases the odds. But the body doesn't start from zero. The key factor that shows up in the evidence consistently is when dancers have a previous injury. Those dancers are automatically at risk of sustaining an injury in the future. Secondary injuries can come almost a year after the original injury because the original injury has not been rehabbed sufficiently. An injury changes how a tissue handles load. That's why injury history is one of the most consistent predictors of future injuries.
Now, if that's what lives inside a dancer, what about everything happening around them? Now, let's look at the extrinsic factors. Externally, risk is shaped by the work itself, classes, rehearsals, performances. Dancers have too much on their plate, period. But training hard on its own isn't the problem. When recovery falls behind, the body can't fully repair the normal damage from training. It's the repetitive strain, the repetitive trauma, the cumulative effect. And there is another part of the equation. High workload that stays pretty similar is actually not bad for the body. What is more of a problem is when you suddenly increase the amount that you are doing or the intensity or the speed. When load changes faster than the body can adapt, risk goes up.
But not all risk comes from training itself. Things like the floor, the fit and condition of shoes, even the temperature of the studio plays a part. Every environmental detail influences how the body handles load. Not all external factors are visible. Some belong to the non-physical environment that surrounds dancers. It's really common and almost normalized for dancers to not tell anyone that they are experiencing pain. Many times I had a lot of pain and I didn't want to complain because uh yeah because we don't complain. Um we just keep doing it. Dancers are reluctant to admit that they're injured for a start because it may have implications for their financial well-being for their status. I would try to deal with it alone to involve the teachers or like directors. I feel like then you make big of the deal. I've never felt that someone at the front of the room or a director, a ballet master, a teacher, whoever was ever like you push through pain and keep going, fight for this opportunity. But that voice is inside your head. When pain goes ignored, the chances of an injury becoming more severe and therefore the recovery a lot longer and even long-term consequences when they're aging, they are increased. Those risks are increased and those problems can be increased.
So, these are the main factors that put dancers at risk of injury. Now, when we talk about injury, it's easy to look for one single cause. A weak ankle, a long rehearsal, a slippery floor. But in reality, injury is only the breaking point where many small imbalances finally meet. An intrinsic issue like fatigue may not be dangerous alone, but when it's combined with an intense rehearsal period, the risk goes up. A previous injury can also interact with environmental changes like harder floors or different shoes, turning something that was under control into a real vulnerability.
By now, one thing is clear. In ballet, risk never really disappears. Simply because dancing always places load on the body. Problems come when we ignore it. The body is constantly sending information. Tension, fatigue, discomfort. Those signals aren't problems. They're data. When you learn to read them, risk stops being something that just happens to you and becomes something you can use to make choices that keep you safer.
But here's the catch. In ballet, most of the structure is already set. The schedule, the class, the choreography. You don't really get to change that. What you do get to choose is how you engage with the work. Because even inside a fixed structure, there are moments where your decisions change the outcome. And every choice starts by asking, "Where am I starting from?" Your starting point is mostly shaped by things you can't control. The body you bring into the studio, but it's also shaped by where you are today, how you feel right now, what your body is telling you in this moment. And the only way to know that is to check in with your body. Noticing what feels stiff, unusually tired, or just a bit off. What that means isn't always clear. This is one of the things that I had to learn to know the differences of pain when it's a minimum pain that maybe just needs an extra work for that muscle or that tendon to get stronger or when it's bad pain when it's about to become an injury or when there's already an injury. Usually soreness is something that we feel more kind of after class is over or toward the end of class. It should last only a few days and kind of subside gradually versus if we feel something that feels more sharp or stabbing or burning or electrical pain. If they can get an assessment really early, often we can prevent an injury by addressing those early little niggles.
Once you know your starting point, the first real choice comes before the work even begins. We've all heard it a thousand times. Warm up your body. But warming up the mind beforehand matters. I am strong and in control. I can perform this movement safely. Positive affirmations help replace anxious thoughts with confidence and focus. It's about settling the system before the work begins. So the body isn't holding unnecessary tension. The best affirmations are going to be that you write yourself always in the present. Always mention I am.
Now when it comes to the body, there's a difference between feeling ready and actually being ready. A lot of dancers are just passively stretching as a warm-up. Okay, I'll put my leg on the bar or I'll just, you know, get sit in a split. That essentially does not warm up your muscular sceal or cardiovascular system. It does not get it ready to perform. A good warm-up wakes the muscles up, lubricates the joints, and switches on coordination, preparing the body to handle the load ahead. On Dance Masterclass, you'll find workouts that put these principles into practice. Warm-ups, strength, flexibility, Pilates workouts, and many more. Train with us at dancemasterclass.com.
Once the work is underway, the challenge changes. We already know something important. Unmanaged load increases injury risk. The real question is, what can you actually do about it? When it comes to training in ballet, it often feels like there are only two options. You push through or you stop. But most of the decisions that matter happen somewhere in between. I must work. I need to show them what I can do. I need to do 150% every single hour, every minute of every day. In rehearsals from, you know, English National Ballet, there was a full audience dress rehearsal. And the principal dancers just, you know, marked the entire pedo section. You're like, that is working smart. That kind of choice isn't about effort. It's about how you distribute it. And most of the time you don't make those choices alone.
A few years ago and this I'm still learning about it. I just repeat repeat repeat with pen or not. I repeat and then after I had one big injury, sorry I cannot repeat. It's enough for today. I know my body and my mind need this. It's not being reactive. It's being it's being informed. Really understanding what their needs are, what their capacities are, what their limits are. But it takes thought and it takes time and it takes discussion. It doesn't take I won't do this or you have to do that.
Now training doesn't live inside a single class. Load is shaped by what happens across days, weeks, and entire seasons. Think of training for a marathon. You don't just run 42 km every day until race day. You vary effort and recovery across weeks. So your body reaches its best shape when it matters. In sports science, this is known as periodization. For professionals, that planning usually happens at an institutional level, but the principle applies to all dancers. Try to avoid spikes. When you're not busy, that's when you could be doing a lot more activity in the gym or a bit more class. And then when you are busy, you need to pull that back a little bit and make sure that you can recover well. Really tailoring what we're doing so that we're we're balancing that load at all times. In the end, managing load isn't about doing less. It's about working smart, regulating work and effort so the body can keep up over time.
And once the work is done, there's still one more choice to make. When you think about the end of a ballet class that ends with grandro usually, right? So you're doing maximal effort, maximum jumps. So if you just okay stop all of a sudden, then you could experience a big blood pressure crash. So, it's good to actually cool down your cardiovascular system by gently reducing your heart rate until it's resting. That's the time for your passive stretching. Really, how you enter the work, move through it, and finish matters.
But staying in the game takes more than that. It means giving the body what it needs to sustain the rhythm over time. If all dancers are doing is their dancing and their technique classes and their rehearsals, they're not physiologically preparing themselves for what's required of them on stage. When you repeat the same set of movement patterns every day, some muscles take on most of the work while others stay underused. This is where crossraining comes in. Activities like swimming, cycling, climbing, or yoga build capacities that dance alone doesn't. But one of the most important is strength training. Pilates is fantastic, but you do need some high resistance strengthening as well. At least three times a week. Getting in on some weighted activities where they really build up some good strength.
But what really makes the body stronger and more resilient happens after the work is done. During recovery, muscles repair, bones rebuild, and the nervous system resets. Rest doesn't mean you're lazy. Rest means you're actually very, very productive. Sleep is, you know, vital to the body recovering. Really making sure you're getting a decent, you know, good 7 to eight hours. Some people need more. The final element that holds the entire system together is nutrition. It's what allows everything else, the preparation, the training, the recovery to actually work. When you're properly fueled, your body repairs faster, responds better, and holds up over time. And if you want to dive deeper into how to meet your body's specific needs as a dancer, check out our nutrition basics class where we explore these concepts in more detail.
So, with all these tools and strategies, can injuries truly be prevented? Well, let's be realistic. The answer to that is no, right? There's no realm in which we're going to get the the risk of injury and dance to zero, but we can get it much lower than it is right now. It is a mindset shift. This is not just on the responsibility of the dancer but on the dance instructors and choreographers and directors as well. And a lot of that mindset shift comes with education and it comes with improved knowledge. And when we know better, we can do better.
As dancers, we're trained to push forward, to go past fatigue, past doubt, past what feels possible. But too often that push comes at a cost. Prevention does not mean holding back. It means moving forward smarter, stronger, and more aware. Because choosing strategy over fear, it's not only about dancing longer. It's about protecting what you love about dancing. Trust your body. Your body is always right. Get the knowledge, inform yourself, learn, and feed your soul just as much as your body. Please warm up properly, physiologically properly. Don't sit on the floor in second position having a chat with a cup of coffee. That's why I'm still dancing at my age because I absolutely do. And then supporting all that with healthy living, you know, getting out into nature and getting some vitamin D. I will give you one piece of advice because it was given to me when I started dancing by a wonderful, wonderful woman and mentor of mine called Bessie Shernburgg. And she said, "Now Maggie, you have to change the way you think about your body. You are now dancing professionally. You have to treat your body as if it were a stratavarious violin."
Fair warning, at $10 million, sold. $10 million. You have to look after it. You have to put it away in its velvet case. You have to make sure it's oiled. You have to make sure it's tuned. And that is what you have to do from this moment forward. We have to remember as dancers dancers bodies are like stratavarious violins.