Injury Prevention Tips for Adolescent Dancers

The following Injury Prevention Guidelines summarize findings from the article The Adolescent Dancer: Common Medical Conditions and Relevant Anticipatory Guidance by Kathleen Linzmeier, MD and Dr. Koutures which is published in Adolescent Medicine State of the Art Reviews, April 2015 and is copyright from the American Academy of Pediatrics.

1)      The American Academy of Pediatrics recommends a rest period from organized physical activity that includes a minimum of 1 full day off per week and 2 to 3 months off per year.

2)      Emerging evidence suggests that the risk of injury increases when the number of hours of organized sport/dance activity per week exceeds the age of the child in number of years (eg, a 14-year-old girl should not exceed 14 hours per week of organized dance activities).

3)       Single sport or activity specialization at young ages can increase the risk of physical and emotional overuse, frequently leading to burnout and complete cessation of activity. Particular warning signs may include decreased interest in dance activities, lower school grades and attendance, less social interaction, changes in appetite or sleep, and mood alterations such as irritability, anger, or lack of fun or new activities.

4)      Incorporating recommended weekly and annual rest intervals along with varying the types of organized activities can reduce the potential for burnout.

5)      Medical practitioners may be asked for their opinion on the readiness of young dancers to begin dancing en pointe, which is an advanced ballet skill that places extreme stress on the lower leg, ankle, and foot

6)     Readiness recommendations focus not on chronologic age but on the presence of adequate whole body strength and balance (especially of the foot and ankle), lack of current restricting injuries, sufficient “pre-pointe” dance class exposure (minimum 3-4 years), and the future goals of the dancer.

6)     Screening tests that can assess appropriate proximal strength, proprioception, and placement of extremities not only for pointe but for higher-level leaping

7)      Medical professionals should maintain an open dialogue about adequate intake of calories and essential vitamins and minerals, and maintenance of healthy weight to best support ongoing dance activities.

8)      Physicians should respect the anatomic and emotional changes that occur during puberty without hesitating to modify or change focus to more basic skills to allow compensation for changes in movement patterns and coordination.

An Intensive Effort to Reduce and Prevent Dance Injuries

Always a leader in cutting edge dance, Backhaus Dance is also front and center with promoting health dancer practices. Proud to be part of their Summer 2016 Intensive faculty and proud to share tips below with all dancers and dance educators.

Thrilled to have DR. CHRIS KOUTURES, MD, FAAP @dockoutures joining us! #healthy #dancers #BDSI2016 #faculty #support pic.twitter.com/30zipRd20w

— backhausdance (@backhausdance) July 12, 2016

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Video: Dr. Koutures Grand Rounds on Performing Arts Medical Care

August 20, 2014 - Grand Rounds - CHOC Children's Hospital

Click Here for Video: The Performing Arts Athlete: Anticipatory Guidance & Evaluation

Chris Koutures, MD, FAAP
Pediatric and Sports Medicine Specialist
Anaheim Hills, CA
Medical Team Physician, Cal State Fullerton and USA National Volleyball Teams

Outcomes - At the conclusion of this presentation, the physician leaner will be able to:
1. Provide anticipatory guidance to young dancers and performers about nutrition, rest, risk of overuse, and other key injury/illness concerns.
2. Appreciate the various forms of dance and recognize certain movements and positions that can lead to both acute and overuse injuries.

Maximizing Good Memories from Summer Sports Camps and Intensives

As the old song goes, "Summertime, and the living is easy."

No school, no homework, no classroom tests or projects to worry about.

However, many young athletes and performers find ways to test themselves over the summer months by attending high level sports camps, showcases or intensives. They often take goals of getting stronger, learning new skills, getting noticed by college coaches and recruiters, and making new friends. 

Unfortunately, I have seen too many unhappy campers return home with injury or illness souvenirs after trying to play or perform at the higher levels of skill and intensity required at specialty camps and intensives for several consecutive days/weeks without sufficient support

What particular tips can I share to better put yourself in the position of writing the upbeat "How I Spend my Summer" essay upon returning to school?

• Don't rush right from a spring school or club season, or from a tough summer program right into a intense specialty sport camp or dance intensive
  • Specialty camps often teach higher level skills with higher number of repetitions against more talented competition. Plan schedules head of time to include taking a week for preparatory rest can increase enjoyment and the overall learning process.
• By the same token, don't leave camp and step right into full Fall sport/dance activitity
  • Insufficient recovery after a high level camp increases the risk of overuse injury and doesn't often allow full ability to utilize newly acquired skills. A bit of time off before and after intensive camps is the best recipe for success.
• Don't stop rehab or prehab routines just because you are going to camp
  • Many athletes and performers have individualized stretching and strengthening programs which must be continued while away from home.
• Observe those days of rest
  • Camp doesn't have to be all work, in fact, recent recommendations emphasize taking a minimum of one day off per week from organized activities to reduce risk of overuse injuries. 
• Don't forget medications
  • Many exercise-related or chronic medical conditions, such as asthma, can worsen when exercising at higher levels in foreign environments. Visit with your regular physician or sports medicine specialist ahead of time to optimize illness control and ensure you have adequate supply of medications.
• Know what medical resources are available
  • Ideally, a high level camp or intensive will have high level medical support such as athletic trainers, physical therapists, and other sports medicine specialists. In the real world, formal on-field or on-floor coverage is often sorely lacking. Highly recommend identifying local off-site resources and even making advanced maintenance and evaluation appointments especially for prolonged camp activities. Definitely recommend using quality and availability of medical support as key criteria for camp selection.
• Remember fluids are your friend
  • Summer camps often take place in unfamiliar hot and humid environments that require early and often access to fluids and salt sources. Water is a sensible first choice, with fluids containing salt and sugar more recommended for exercise lasting over a hour. While sport beverages can fit this requirement, using infant electrolyte replacement fluids can actually be more effective in overly humid environments
• Food is Recovery
  • If exercising for several hours a day isn't enough of a challenge, then add in dealing with being away from home for the first time, unappealing  or repetitive cafeteria food, or even worse, living in an apartment without access to prepared food. This often inadequate nutrition cannot properly sustain high level performance. Planning head and focusing on the following items can help correct these deficiencies:
    • Post-exercise protein intake- good sources include chocolate milk, Greek yogurt, and peanut butter
    • Fruits and vegetables- especially berries and cherries which act as natural anti-inflammatory agents to reduce post-exercise muscle soreness
    • Meat, poultry, fish, beans, eggs, and leafy green vegetables for additional protein along with iron source

Do you have any other recommendations or concerns about summer camps and intensives?