The purpose of the present study was to assess the effects of a 12-week aerobic and muscular strength training program on selected dance performance and fitness-related parameters in modern dance students. The sample consisted of 32 men and women (age 19 +/- 2.2 years) who were randomly assigned into exercise (n = 19) and control (n = 13) groups. Anthropometric and flexibility assessments, treadmill ergometry, strength measurements, and- on a separate day-a dance technique test were conducted pre- and postexercise training in both groups. After the end of the program, the exercise group revealed significant increases in dance (p < 0.02), VO(2)max (p < 0.04), flexibility (p < 0.01), and leg strength (p < 0.001) tests compared to controls. It is concluded that in modern dance students (a) a 3-month aerobic and strength training program has positive effects on selected dance performance and fitness-related parameters, (b) aerobic capacity and leg strength improvements do not hinder dance performance as studied herein, and (c) the dance-only approach does not provide enough scope for physical fitness enhancements.

Twitchett, EA, Koutedakis, Y, and Wyon, MA. Physiologic fitness and professional classical ballet performance: a brief review. J Strength Cond Res 23(9): 2732-2740, 2009-Although classical ballet is an artistic expression through the use of the body, there is a real opportunity to improve and extend the dancer's career by simply applying sports science principles to dance training and performance. Dance training is a long process of physical, intellectual, and psychological preparation, through physical exercise, often beginning in childhood and continuing until retirement. Fitness programs, supplementary to traditional dance classes, have only recently been considered as a part of this process; it may be suggested that this cross-training has generally been avoided thus far because of tradition and a reluctance to follow principles associated with sport. Classical ballet training, rehearsal, and performance do not elicit significant stimulus to result in increased aerobic fitness levels. Therefore, dancers often demonstrate low levels of aerobic fitness even though a strong aerobic foundation is necessary to meet the required workload. Dancers have greater than average range of motion and strength at the hip joint but weaknesses in the upper body, torso, hamstrings, and quadriceps. In the past, dancers have been wary of strength training because they perceive this leads to aesthetically undesirable hypertrophy. Dancers also have low body weights and low percentage body fat. Given that training does not provide the opportunity to expend enough energy to maintain these aesthetic demands, this aesthetic demand may be met by caloric restriction, which may lead to subsequent increased injury risk. It has been hypothesized that a “fit for purpose” body can help improve performance, reduce the risk of injury, and ensure prolonged dance careers. This review aims to explore the extent to which physical fitness components relate to dance performance, in particular classical ballet.

Female ballet dancers require extreme ankle motion to attain the demi-plié (weight-bearing full dorsiflexion [DF]) and en pointe (weight-bearing full plantar flexion [PF]) positions of ballet. However, techniques for assessing this amount of motion have not yet received sufficient scientific scrutiny. Therefore, the purpose of this study was to examine possible differences between weight-bearing goniometric and radiographic ankle range of motion measurements in female ballet dancers. Ankle range of motion in 8 experienced female ballet dancers was assessed by goniometry and 2 radiographic measurement methods. The latter were performed on 3 mediolateral x-rays, in demi-plié, neutral, and en pointe positions; one of them used the same landmarks as goniometry. DF values were not significantly different among the methods, but PF values were (P < .05). Not only was PF of the talocrural joint significantly less than the other 2 measurements (P < .001), PF from the goniometric method applied to the x-rays was significantly less than PF obtained from clinical goniometry (P < .05). These data provide insight into the extreme ankle and foot motion, particularly PF, required in female ballet dancers and suggest that goniometry may not be ideal for assessing ankle range of motion in these individuals. Therefore, further research is needed to standardize how DF and PF are measured in ballet dancers. Level of Evidence: Diagnostic, Level I.

The physical demands placed on dancers make their physiology and fitness just as important as skill development. However, dancers’ muscular strength and bone and joint integrity seem to suffer as a result of the dance-only selection and training system. This partly reflects the unfounded view that exercise training that is not directly related to dance would diminish dancers’ aesthetic appearances and destroy muscle flexibility. Nevertheless, data on male and female dancers have demonstrated that supplemental strength training can lead to better dancing and reduced incidents of dance injuries without interfering with key artistic and aesthetic requirements. An awareness of these factors will assist dancers and their teachers in improving training techniques, employing more effective injury prevention program, and in determining better physical conditioning strategies.

Using electrocardiography and echocardiography, we screened elite men and women ballet dancers for abnormal cardiovascular conditions using an observation design with blinded clinical analysis of cardiac function tests. Fifty-eight (females n=33) elite professional ballet dancers (age: 26.0±5.7 years, body mass index: 19.9±2.2 kg/m2) with no past or present history of cardio vascular disease volunteered. Participants were assessed via a 12-lead electrocardiography and two-dimensional echocardiography for cardiac function. Electrocardiography revealed that 83% of our dancers demonstrated normal axis, while 31% had incomplete right bundle branch block and 17% had sinus bradycardia; none showed any abnormal findings. Findings from the echocardiography were also normal for all participants and comparable to their counterparts in other sports. Significant differences (p<0.05) were detected in almost all studied echocardiographic parameters between males and females. In conclusion, heart function and structure seem to be normal in elite ballet dancers, placing them at low risk for sudden cardiac death and performance-related cardiovascular complications. Larger samples are required to confirm these findings.

Female ballet dancers require extreme ankle motion, especially plantar flexion, but research about measuring such motion is lacking. The purposes of this study were to determine in a sample of ballet dancers whether non–weight-bearing ankle range of motion is significantly different from the weight-bearing equivalent and whether inclinometric plantar flexion measurement is a suitable substitute for standard plantar flexion goniometry. Fifteen female ballet dancers (5 university, 5 vocational, and 5 professional dancers; age 21 ± 3.0 years) volunteered. Subjects received 5 assessments on 1 ankle: non–weightbearing goniometry dorsiflexion (NDF) and plantar flexion (NPF), weightbearing goniometry in the ballet positions demi-plié (WDF) and en pointe (WPF), and non–weight-bearing plantar flexion inclinometry (IPF). Mean NDF was significantly lower than WDF (17° ± 1.3° vs 30° ± 1.8°, P < .001). NPF (77° ± 2.5°) was significantly lower than both WPF (83° ± 2.2°, P = .01) and IPF (89° ± 1.6°, P < .001), and WPF was significantly lower than IPF (P = .013). Dorsiflexion tended to decrease and plantar flexion tended to increase with increasing ballet proficiency. The authors conclude that assessment of extreme ankle motion in female ballet dancers is challenging, and goniometry and inclinometry appear to measure plantar flexion differently.

Dance is a high performance athletic activity that leads to great numbers of injuries, particularly in the ankle region. One reason for this is the extreme range of ankle motion required of dancers, especially females in classical ballet where the en pointe and demi-pointe positions are common. These positions of maximal plantar flexion produce excessive force on the posterior ankle and may result in impingement, pain, and disability. Os trigonum and protruding lateral talar process are two common and well-documented morphological variations associated with posterior ankle impingement in ballet dancers. Other less well-known conditions, of both bony and soft tissue origins, can also elicit symptoms. This article reviews the anatomical causes of posterior ankle impingement that commonly affect ballet dancers with a view to equipping healthcare professionals for improved effectiveness in diagnosing and treating this pathology in a unique type of athlete. Clin. Anat. 23:613-621, 2010. (c) 2010 Wiley-Liss, Inc.

The purpose of this study was to identify possible relationships between the sum of knee flexion and extension peak torques and the severity of lower-body injuries in professional dancers. Twenty male (age 26.6 (+/- 6.0) years) and 22 female (age 27.1 (+/- 5.4) years) ballet and contemporary dancers reported one or more low-back, pelvis, leg, knee and foot injuries. The severity of injuries was established by recording the days off dance activities. Subjects were then monitored on a Cybex II or a KIN-CON isokinetic dynamometer. Knee flexion and extension peak torques were obtained bilaterally during three normal contractions at the velocities of 1.04 and 4.19 rad/sec. No musculoskeletal injuries were reported at the time of data collection. At 1.04 rad/sec, results revealed significant correlation coefficients between relative thigh peak torques - expressed in Nm/kg fat free mass (FFM) - and prevalence of low extremity injuries. These findings suggest that the lower thethigh-power output, the greater the degree of injury. Female dancers demonstrated higher correlation coefficients (r = -0.70; p < 0.005) than their male counterparts (r = -0.61; p < 0.01). However, no such correlations were found at the angular velocity of 4.19 rad/sec, nor when low-back injuries and thigh-power outputs were considered at both velocities. The main conclusions are: a ) low thigh power outputs are likely to be associated with the severity of low extremity injuries, and b) such relationships are better identified at lower compared to higher isokinetic velocities

Background: Female ballet dancers require extreme ankle motion. The objective of this study was to quantify the relative contributions of the ankle and various foot joints to extreme plantarflexion (PF) and dorsiflexion (DF) in female ballet dancers using an X-ray superimposition technique and digital graphics software. Materials and Methods: One asymptomatic ankle was studied in each of seven experienced female ballet dancers. Three lateral weightbearing X-rays were taken of each ballet dancer's ankle: en pointe (maximum PF), in neutral position, and in demi-plié (maximum DF). Using graphics software, a subject's three X-ray images were superimposed and the tali were aligned. On each image the tibia, navicular, intermediate cuneiform, and first metatarsal were marked. Positional differences of a bone's line among the three images demonstrated angular movement of the bone in degrees. The neutral position was the reference from which both PF and DF of the bones were calculated. Results: The talocrural joint contributed the most motion of any pair of bones evaluated for both PF and DF, with mean movements of 57.6 ± 5.2 degrees en pointe and 24.6 ± 9.6 degrees in demi-plié. Approximately 70% of total PF and DF were attributable to the talocrural joint, with the remaining 30% coming from motion between adjacent pairs of the studied foot bones. Conclusion: Superimposed X-rays for assessing ankle and foot contributions to the extreme positions required of female ballet dancers offer insight into how these positions are attained that is not available via goniometry. Clinical Relevance: Functional information gained from this study may assist clinicians in assessessing ankle and foot pain in these individuals.