Low back pain in ballet, modern, and hip-hop dancers

Abstract

Low back pain (LBP) is a global medical issue that continues to rise in the general population. However, the consequences of low back pain in dance populations have been difficult to quantify, in part due to varying injury definitions. Low back pain is a multifaceted problem that is anecdotally common, but more research is needed to understand how low back pain impacts dancers’ lives and movements. The key aim of this thesis was to investigate low back pain in ballet, modern, and hip-hop dancers, and provide practical recommendations based on the findings. The aims of this thesis were to: (a) investigate the dancers’ perspectives on low back pain and what aspects of their lives and dancing it affects, including a determination of what movements dancers associate with exacerbating their low back pain, and (b) to further examine these movements, through archival and biomechanical research, to provide recommendations to the dance community. Study 1 assessed the dancers’ perspective on the impact and management of low back pain through an online questionnaire disseminated to primarily ballet, modern, and hip-hop dance populations. The results showed that low back pain negatively impacted dancers’ dance movements and non-dance activities, with spinal extension movements being most frequently reported as a movement that increased the dancers’ low back pain. Therefore, Study 2 utilized archival dance videos from YouTube.com to identify how often dancers were exposed to the movements that they reported in Study 1 as exacerbating their low back pain. Results showed that the dance movements that exacerbate low back pain were present in all the dance environments studied: ballet class and performance, modern dance class and performance, and hip-hop breaking, cyphers, and battles. Ballet performance environments had the highest number of total spinal extension movements (77±69.8), and hip-hop cypher environments had the highest frequency of spinal extension movements per minute (7±9.6). Recommendations for training focuses, based on the complete movement profile for each dance genre, are also presented. Study 3 used a case study to examine the biomechanics of three spinal extension movements: the ballet arabesque, the modern dance attitude with body roll, and the hip-hop dolphin dive. The influence of speed on the forces of the spine in dance had not been studied previously. Results suggest that thoracic and lumbar spine joint angles, angular velocity, and angular acceleration increase all three dance genres when performing movements from slow to fast speeds. Collectively, the results in this thesis verified that low back pain is an impactful condition with significant negative consequences for those dancers who are afflicted. The results also revealed dancers are frequently exposed to movements that they report can increase their low back pain. The results show increased angular displacements, angular velocity, angular acceleration in spinal extension movements performed at progressively increasing speeds. However, further research is needed to confirm if the forces at the low back increase as speed increases, and to clarify the role of asymmetry in movements that increase dancer LBP