While incidence rate of injury in professional ballet can vary across company ranks and months, a majority of injuries that lead to time-loss are due to overuse, a new study finds.
A Large Percentage of Ballet Injuries Due to Overuse

Fifty percent of female dancers’ and 51% of male dancers’ time-loss injuries were classified as overuse. Traumatic injuries represented 40% of female dancers’ injuries and 41% of the male dancers’.
In the study, “Injury epidemiology in professional ballet: a five-season prospective study of 1596 medical attention injuries and 543 time-loss injuries,” published online in The British Journal of Sports Medicine on April 14, 2021, researchers analyzed the incidence rate, severity, burden and etiology of medical attention and time-loss injuries in professional ballet.
Data on medical attention injuries, time-loss injuries and dance exposure hours was collected on 123 professional ballet dances at one company for five consecutive seasons between the 2015/2016 and 2019/2020 seasons.
Overall, 66 women, age: 28.0±8.3 years and 57 men, age: 27.9±8.5 years) were included in the study.
The incidence rate per 1,000 hours of medical attention injury was 3.9 (95% CI 3.3 to 4.4) for women and 3.1 (95% CI 2.6 to 3.5) for men. The incidence rate per 1,000 hours of time-loss injury was 1.2 (95% CI 1.0 to 1.5) for women and 1.1 (95% CI 0.9 to 1.3) for men.
Ballet dancers that were first soloists and principals sustained between 2.0 and 2.2 additional medical attention injuries per 1,000 hours and 0.9-1.1 additional time-loss injuries per 1,000 hours compared with apprentices (p ≤0.025).
There were also intra-season differences in medical attention, but not in time-loss injuries. This highest incidence rates of medical attention injury were early in the season in August and September and late in the season in June.
The researchers also found that 35% of time-loss injuries led to over 28 days of modified dance training.
The researchers wrote, “This is the first study to report the incidence rate of medical attention and time-loss injuries in professional ballet dancers. Incidence rates differed across company ranks and months, which may inform targeted injury prevention strategies.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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