Injury epidemiology in an elite ballet school: a seven-season cohort study of 2121 medical attention injuries and 1656 time-loss injuries.

Abstract

To describe the epidemiology of injuries in an elite vocational ballet school over 7 academic years. Injury records pertaining to 569 students (267 boys and 302 girls) were prospectively collected by chartered physiotherapists using a cloud-based athlete management system over 7 academic years (2016/2017 to 2022/2023) at an elite ballet school. 1548 student-academic-years, encompassing 266 468 student-days, were completed, during which 2121 medical attention injuries were prospectively recorded, 1656 of which resulted in time-loss. Injury incidence was comparable between sexes but was greater at the upper school (ages 16-19; 9.0 injuries per 1000 exposure days, 95% CI 8.4 to 9.7) than the lower school (ages 11-16; 6.5 injuries per 1000 exposure days, 95% CI 6.0 to 6.9). By severity scale, 282 injuries (13.3%) were classified as <i>mild</i> (1-7 days), 582 (27.4%) were classified as <i>moderate</i> (8-28 days) and 792 (37.3%) were classified as <i>severe</i> (>28 days). The injury burden was 236 and 416 days lost per 1000 exposure days at the lower school and the upper school, respectively. The most common injury mechanism was <i>repetitive-gradual onset</i> (54.8%), and 25% of injuries were recurrences. The most common movements associated with injury were <i>jumping and landing</i> (boys 30.8%; girls 21.4%) and <i>other</i> dancing movements (boys 23.2%; girls 27.9%); 16.4% of injuries affecting girls were associated with <i>pointe work</i>. During term time, the mean percentage of students fully available without injury was 78.8% at the lower school and 66.2% at the upper school. A large injury burden was observed across the 7 years in elite ballet students. Ballet schools must balance the training stimulus with appropriate recovery and ensure appropriate medical support is in place to manage injuries and implement prevention programmes.