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Mattiussi A. What goes up must come down: injury and jumping in professional ballet (PhD Academy Award). Br J Sports Med 2024:bjsports-2024-108238. [PMID: 38697622 DOI: 10.1136/bjsports-2024-108238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Adam Mattiussi
- Faculty of Sport, Allied Health and Performance Science, St Mary's University Twickenham, Twickenham, UK
- Ballet Healthcare, Royal Opera House, London, UK
- Performance Rehabilitation, UK Sports Institute, Bisham, UK
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Mattiussi AM, Shaw JW, Price P, Brown DD, Cohen DD, Lineham J, Pedlar CR, Tallent J, Atack A. The association of range of motion, lower limb strength, and load during jump landings in professional ballet dancers. J Biomech 2024; 168:112119. [PMID: 38669794 DOI: 10.1016/j.jbiomech.2024.112119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/09/2024] [Accepted: 04/22/2024] [Indexed: 04/28/2024]
Abstract
This study aimed to investigate the associations between peak plantarflexion ankle joint moments and vertical ground reaction forces (vGRF) during jump landings, and static ankle dorsiflexion range of motion (ROM), three-dimensional ankle excursions, and lower extremity strength in professional ballet dancers. Twenty-seven professional ballet dancers volunteered to participate (men = 14, women = 13). Participants attended one data collection session to measure dorsiflexion ROM and isometric lower extremity strength. Two further sessions were used to establish ankle mechanics and vGRFs during countermovement jump landings in seven foot positions, via a seven-camera motion capture system and piezoelectric force platform. Two linear mixed-effects models were used to investigate associations between the target variables and strength, dorsiflexion ROM, and ankle excursions. Dancer identification, sex, and foot position were entered as random effects. Model fit, when considered independent of random effects, was generally poor with the predictor variables explaining little of the variance of peak plantarflexion ankle joint moments (R2 = 0.02) or vGRF (R2 = 0.01). Model fit improved when random effects were considered (R2 = 0.65 & 0.34). Frontal plane ankle excursion was the only predictor variable with a significant negative association with peak plantarflexion ankle joint moments (p = .016), although coefficient estimates were small. Strength, static ankle dorsiflexion ROM, and three-dimensional ankle excursions are poor predictors of load experienced at a joint and system level in professional ballet dancers. Differences between individuals, sex, and foot position may be better indicators of the load experienced during jump landings.
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Affiliation(s)
- Adam M Mattiussi
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK; Ballet Healthcare, The Royal Ballet, Royal Opera House, London, UK; Performance Rehabilitation, Intensive Rehabilitation Unit, UK Sports Institute, UK. https://twitter.com/adammattiussi
| | - Joseph W Shaw
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK; Ballet Healthcare, The Royal Ballet, Royal Opera House, London, UK. https://twitter.com/josephshaw
| | - Phil Price
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK. https://twitter.com/thepricep
| | - Derrick D Brown
- Victorian College of the Arts, The University of Melbourne, Australia. https://twitter.com/ddbrown
| | - Daniel D Cohen
- Mindeporte (Colombian Ministry of Sport), Centre for Sports Science, Bogotá, Colombia; Department of Human Performance and Innovation, University of Limerick, Ireland. https://twitter.com/danielcohen1971
| | - Jack Lineham
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
| | - Charles R Pedlar
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK; Division of Surgery and Interventional Science, University College London, UK. https://twitter.com/pedlarcr
| | - Jamie Tallent
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK; Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia. https://twitter.com/jamietallent
| | - Alexandra Atack
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK. https://twitter.com/a_atack2
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Rice PE, Hill RD, Messier SP. Collegiate Dancers With Chronic Ankle Instability Possess Altered Strength and saut de chat Leap Landing Mechanics. J Dance Med Sci 2024; 28:4-13. [PMID: 37700594 DOI: 10.1177/1089313x231195249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Ankle sprains are among the most common injuries in dancers. Following one or more severe sprains, some individuals will experience residual mechanical and functional deficits, otherwise known as chronic ankle instability (CAI). Dancers who suffer from CAI may have weaker musculature surrounding the ankle and altered landing mechanics. The purpose of this study was to compare ankle strength and saut de chat landing mechanics between dancers with and without CAI. METHODS Dancers with and without CAI, defined by the Identification of Functional Ankle Instability (IdFAI), participated in the study (CAI n = 8; IdFAI = 18.75 ± 5.50 points; age = 20 ± 1.5 years; training = 15.5 ± 3.5 years) (Control n = 8; IdFAI = 7.13 ± 3.40 points; age = 19 ± 0.6 years; training = 15.9 ± 2.5 years). Strength and leap landing mechanics were measured on the affected ankle for the CAI group and on the preferred landing leg of a leap for the control group. Concentric and eccentric ankle plantar flexion, and subtalar inversion and eversion strength were determined with dynamometry set at an angular velocity of 60°•s-1. Force plates and motion capture cameras were used to calculate lower extremity kinematic and kinetic data as participants performed 3 saut de chat leaps. Independent t-tests were calculated to determine differences between groups. RESULTS Compared to dancers without CAI, dancers with CAI had lower eccentric plantar flexor strength, landed with higher vertical ground reaction forces, and absorbed greater power at the knee-joint during landing. CONCLUSION Whether dancers who are weaker are more prone to injury or ankle-joint injury leads to muscular weakness is unknown. Dancers with CAI appear to lack control during leap landing while concomitantly shifting loads proximally away from the ankle-joint. We encourage dancers with and without CAI to engage in additional training that enhances ankle strength.
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Affiliation(s)
- Paige E Rice
- JB Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Ryan D Hill
- JB Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Stephen P Messier
- JB Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
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Henn ED, Lanza S, Ambegaonkar JP, Smith T, Wyon M. Spinal Counts, Impact, and Partnering Movements in Ballet, Modern, and Hip Hop dance: A YouTube Video Analysis Study. J Dance Med Sci 2023; 27:203-221. [PMID: 37341101 DOI: 10.1177/1089313x231178083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
INTRODUCTION Dancers have self-reported a link between spinal extension movements and low back pain (LBP). Researchers have not reported the total number or frequency that spinal movements occur in ballet, modern, or hip-hop dance classes or performances. The purpose of this study was to report the number of spinal movements dancers are exposed to in different dance environments. MATERIALS AND METHODS We analyzed 65 dance videos on YouTube.com for dance movements within 7 dance environments: ballet class and performance, modern class and performance, and hip-hop breaking, ciphers (large groups), and battles ("1v1s"). Two reviewers recorded counts of spinal (spinal flexion, extension, lateral flexion, and rotation), impact (jumps, leaps, and falls), and partnering movements (lifts, catches, and leans). Data analyses were processed in Jamovi (the jamovi project, Sydney, Australia). We reported movement totals, percentages, frequency, ranges, means with standard deviations (SD), and medians with interquartile range (IQR). We calculated significant differences using Mann-Whitney U tests. RESULTS Video length ranged from 3 to 141 minutes (mean ± SD: 38.4 ± 38.3, range: 138). the average spinal extension movements ranged from 2 ± 0.8 to 7 ± 9.6 movements per minute across genres. Modern dance class had the most spinal flexion (89 ± 53.6), rotation (60 ± 40.8), and lateral flexion (74 ± 20.7) movements. Ballet performance had the most spinal extension movements (77 ± 69.8), jumps (74 ± 48), and leaps (19 ± 18.2). Hip-hop breaking had the highest number of falling movements (2 ± 2.3). Partnering movements were only present in ballet performance, modern dance performance, and hip-hop breaking environments. CONCLUSIONS Movements that increase LBP occur often in all 3 dance genres. Dancers can expect frequent exposure to spinal extension movements; therefore, we recommend strengthening back and core musculature for all dancers. We recommend that ballet dancers also strengthen their lower extremity muscles. For modern dancers, we recommend strengthening their obliques. For hip-hop dancers, we recommend increasing muscular power and muscular endurance.
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Affiliation(s)
- Erica D Henn
- Institute of Human Sciences, University of Wolverhampton, Wolverhampton, UK
| | - Samantha Lanza
- Institute of Human Sciences, University of Wolverhampton, Wolverhampton, UK
| | - Jatin P Ambegaonkar
- Sports Medicine Assessment, Research, and Testing Laboratory, George Mason University, Fairfax, VA, USA
| | - Tina Smith
- Institute of Human Sciences, University of Wolverhampton, Wolverhampton, UK
| | - Matthew Wyon
- Institute of Human Sciences, University of Wolverhampton, Wolverhampton, UK
- National Institute of Dance Medicine and Science, Birmingham, UK
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Shaw JW, Maloney B, Mattiussi AM, Brown DD, Springham M, Pedlar CR, Tallent J. The development and validation of an open-source accelerometery algorithm for measuring jump height and frequency in ballet. J Sports Sci 2023:1-7. [PMID: 37377013 DOI: 10.1080/02640414.2023.2223048] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/17/2023] [Indexed: 06/29/2023]
Abstract
The aim was to determine the validity of an open-source algorithm for measuring jump height and frequency in ballet using a wearable accelerometer. Nine professional ballet dancers completed a routine ballet class whilst wearing an accelerometer positioned at the waist. Two investigators independently conducted time-motion analysis to identify time-points at which jumps occurred. Accelerometer data were cross-referenced with time-motion data to determine classification accuracy. To determine the validity of the measurement of jump height, five participants completed nine jetés, nine sautés and three double tour en l'air from a force plate. The jump height predicted by the accelerometer algorithm was compared to the force plate jump height to determine agreement. Across 1440 jumps observed in time-motion analysis, 1371 true positives, 34 false positives and 69 false negatives were identified by the algorithm, resulting in a sensitivity of 0.98, a precision of 0.95 and a miss rate of 0.05. For all jump types, mean absolute error was 2.6 cm and the repeated measures correlation coefficient was 0.97. Bias was 1.2 cm and 95% limits of agreement were -4.9 to 7.2 cm. The algorithm may be used to manage jump load, implement periodization strategies, or plan return-to-jump pathways for rehabilitating athletes.
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Affiliation(s)
- Joseph W Shaw
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
- Ballet Healthcare, The Royal Ballet, London, UK
| | - Brian Maloney
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
- Ballet Healthcare, The Royal Ballet, London, UK
| | - Adam M Mattiussi
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
- Ballet Healthcare, The Royal Ballet, London, UK
| | - Derrick D Brown
- Institute of Sport Science, Dance Science, University of Bern, Bern, Switzerland
| | - Matthew Springham
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
- Ballet Healthcare, The Royal Ballet, London, UK
| | - Charles R Pedlar
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
- Institute of Sport, Exercise, and Health, Division of Surgery and Interventional Science, University College London, London, UK
| | - Jamie Tallent
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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Katakura M, Kedgley AE, Shaw JW, Mattiussi AM, Kelly S, Clark R, Allen N, Calder JDF. Epidemiological Characteristics of Foot and Ankle Injuries in 2 Professional Ballet Companies: A 3-Season Cohort Study of 588 Medical Attention Injuries and 255 Time-Loss Injuries. Orthop J Sports Med 2023; 11:23259671221134131. [PMID: 36874048 PMCID: PMC9978991 DOI: 10.1177/23259671221134131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/10/2022] [Indexed: 03/04/2023] Open
Abstract
Background The foot and ankle are often reported as the most common sites of injury in professional ballet dancers; however, epidemiological research focusing on foot and ankle injuries in isolation and investigating specific diagnoses is limited. Purpose To investigate the incidence rate, severity, burden, and mechanisms of foot and ankle injuries that (1) required visiting a medical team (medical attention foot and ankle injuries; MA-FAIs) and (2) prevented a dancer from fully participating in all dance-related activities for at least 24 hours after the injury (time-loss foot and ankle injuries; TL-FAIs) in 2 professional ballet companies. Study Design Descriptive epidemiological study. Methods Foot and ankle injury data across 3 seasons (2016-2017 to 2018-2019) were extracted from the medical databases of 2 professional ballet companies. Injury-incidence rate (per dancer-season), severity, and burden were calculated and reported with reference to the mechanism of injury. Results A total of 588 MA-FAIs and 255 TL-FAIs were observed across 455 dancer-seasons. The incidence rates of MA-FAIs and TL-FAIs were significantly higher in women (1.20 MA-FAIs and 0.55 TL-FAIs per dancer-season) than in men (0.83 MA-FAIs and 0.35 TL-FAIs per dancer-season) (MA-FAIs, P = .002; TL-FAIs, P = .008). The highest incidence rates for any specific injury pathology were ankle impingement syndrome and synovitis for MA-FAIs (women 0.27 and men 0.25 MA-FAIs per dancer-season) and ankle sprain for TL-FAIs (women 0.15 and men 0.08 TL-FAIs per dancer-season). Pointe work and jumping actions in women and jumping actions in men were the most common mechanisms of injury. The primary mechanism of injury of ankle sprains was jumping activities, but the primary mechanisms of ankle synovitis and impingement in women were related to dancing en pointe. Conclusion The results of this study highlight the importance of further investigation of injury prevention strategies targeting pointe work and jumping actions in ballet dancers. Further research for injury prevention and rehabilitation strategies targeting posterior ankle impingement syndromes and ankle sprains are warranted.
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Affiliation(s)
- Mai Katakura
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Bioengineering, Imperial College London, London, UK.,Fortius Clinic FIFA Centre of Excellence, London, UK
| | - Angela E Kedgley
- Department of Bioengineering, Imperial College London, London, UK
| | - Joseph W Shaw
- Ballet Healthcare, Royal Opera House, London, UK.,Faculty of Sport, Allied Health and Performance Science, St Mary's University, London, UK
| | - Adam M Mattiussi
- Ballet Healthcare, Royal Opera House, London, UK.,Faculty of Sport, Allied Health and Performance Science, St Mary's University, London, UK
| | - Shane Kelly
- Ballet Healthcare, Royal Opera House, London, UK
| | | | - Nick Allen
- Birmingham Royal Ballet, Birmingham, UK.,National Institute of Dance Medicine and Science, Birmingham, UK
| | - James D F Calder
- Department of Bioengineering, Imperial College London, London, UK.,Fortius Clinic FIFA Centre of Excellence, London, UK
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Escobar-álvarez JA, Jiménez-reyes P, Da Conceição FA, Fuentes-garcía JP. Effect of Supplementary Physical Training on Vertical Jump Height in Professional Ballet Dancers. Int J Sports Physiol Perform 2022. [DOI: 10.1123/ijspp.2021-0513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 11/18/2022]
Abstract
Dancers require many specific dance skills of a ballistic nature. The design of supplementary training to improve the strength of the lower limbs and jump height is a relevant area of research. The purpose of this study was (1) to compare the effect of plyometric training versus combined training on countermovement jump (CMJ), squat jump (SJ), and sauté in first position (sauté) height and (2) to observe whether changes in CMJ and SJ were associated with changes in sauté in female and male dancers. Eighty-one classical professional ballet dancers (41 women and 40 men, age = 22.9 [3.7] y, body mass = 59.7 [8.6] kg, height = 167.4 [7.3] cm) were divided into a control group and 2 experimental groups: plyometric training and combined training. All groups followed their common routine of training regarding classes and rehearsal practice, whereas the experimental groups added 2 sessions (1 h per session) for 9 weeks of supplementary training. Significant increases (medium to large effect size) in CMJ, SJ, and sauté height were found in the pretest versus posttest comparisons for both experimental groups. Significant, very large correlations were found between the magnitude of improvement in sauté and the magnitude of improvement in CMJ and SJ. Plyometric and combined training programs are effective ways to improve jumping ability in professional dancers. The improvement in CMJ and SJ has a good transference on sauté `performance. These findings support the use of traditional training methods to improve jump height in specific and nonspecific ballet jumping ability.
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