The abundance of adolescence: How puberty increases teenage dancers risk of injury
by Brittany Cohen, CPT, HMS, EdM & BFA in Dance
Of all the injuries being experienced by dancers, 80% are happening to those between the ages of 11-18 [Roberts, 2013]. That's a lot of young dancers with a lot to manage while they are working towards their dance goals. On top of that, more than HALF of the injuries experienced are happening in the lower portion of the body, in the hips, knees, and ankles [Roberts, 2013]. In many of the genres of dance young dancers are exposed to, the lower body is the foundation for being able to build and support technique development. Why are we consistently finding such high numbers of injuries in this population?
The high rate of injuries happening through the dance experience of adolescents may not be a surprise to you. Considering this data, it is highly likely that you are one of the following: A) a dancer who has experienced an injury within the ages mentioned above, B) a parent who is managing or has managed care for a dancer in this age range with an injury, or C) you are a dance teacher or another dance professional who is seeing these issues arise in your dance population. I myself have been one of these statistics and work with a decent portion of the population. You've seen this data play out in real life. The show goes on. Why does it matter?
Being able to track the occurrence of injury is great, but what is considerably more important is understanding why this age sets the stage so well for injuries to make an appearance AND the role dance training has in their occurrence. Even more so, understanding that the dance injury experience isn't fixed. There is something we can do about reducing the likelihood of these numbers.
I work specifically in the realms of addressing the injury rates in this population of dancers. When I started my work, I was managing a handful of injuries sustained in my youth and working to piece together all the understanding of the body I developed to help other dancers prevent the many instances with injuries I experienced. I want to offer some of the pieces in the adolescent body and arrange them for you to get a BIG picture of how physical changes through puberty can align perfectly for injuries to occur while training in dance.
Let's take a female dancer, age 14, and start to place some of her pieces. Physically, she is undergoing MAJOR changes in the body as she experiences puberty. During this time her body will be experiencing the most rapid growth of its life, averaging about 4 inches per year. Once the bones begin to lengthen, the body starts to take on rapid weight gain. Even more changes and influence comes for young girls who experience menarche, including an increase in percent of body fat. The female body experiences a lengthy list of changes during adolescence which can make it susceptible to injury, as all of these changes take place long before the soft tissues and muscles are able to fully adapt. Muscles often spend a few years following growth playing "catch up" while dancers continue to work on technique and skill development. Bring on a clear opportunity for injury. I am an all too perfect example of this, as I experienced injuries in my ankles, knees, hips, and low back all during this time. The more easily observable changes to the body aren’t the only changes that can influence injury.
As bones grow, dancers have to take on moving what feels like a WHOLE NEW BODY! To their disadvantage, muscles are pulled and left to lift bones that can become up to 2x heavier than prior to puberty. As if this isn't a difficult task alone, the body is also working to regain understanding of balance and coordination while trying to apply the skills to already developed dance techniques. This means that skills that were once easily attainable can now be challenging to perform.
The strength required to stabilize the body and to control movements is greatly diminished. This is exactly why I highly encourage dancers to engage in strength training programs as they grow through adolescence. Plus, it's great to support healthy bone development, which can be a concern for the female dancer due to a phenomenon known as the female athlete triad.
With strength being limited, flexibility decreases as muscles are pulled along the growing bony structures. This results in stiffness within joints and can lead to posture that isn't supportive for safe movement. With soft tissues doing so much work, desperate to hold everything together, it is understandable that a majority of the injuries we see in this population result from overuse.
Let's put all of these changed pieces of the body together. Inside the young female body the following is happening in a short period of time during puberty: growth in height, change in posture, gain in weight, loss in strength, increased stiffness, and muscle tension. Now let's throw this dancer into the studio and see what happens. They are adding hours of training in dance to a movement system that is already overwhelmed.
This is a crucial moment, when dance technique can influence how the body can respond to the changes of puberty. If outside of highly demanding activity, the body is able to self-correct any of the potential issues in motor skill that can result from puberty. When in a highly demanding environment, the body will adapt to meet those demands. Say hello to compensation! Many of the injuries dancers experience in their adolescent years can be associated with faults in their technique. Specifically, to places where dancers can be seen compensating and manipulating the alignment of their boney structure to replicate an ideal image in the dance style they train in.
This is where a dancer's individual awareness of all the pieces to their puzzle can help dancers to move successfully and safely through their years of change. This is also when I encourage dancers to have their dance technique assessed by a specialist who can help them build strength and awareness while building safe training mechanics and habits in their dance technique.
If you support an adolescent dancer, here are some wonderful resources for you to find support to help them move safely towards their dance goals throughout puberty: https://www.bcartistry.dance/services , www.doctorsfordancers.com, www.thebridgedanceproject.com.