Self-Reported Factors Associated With Bone Stress Injuries in Female Dancers: Results of a Survey

Background: Female dancers are at risk of bone stress injuries (BSIs). Few studies compare dancers with and without BSI, and most focus on ballet. Objectives: Compare risk factors between adult female dancers with and without BSI history and identify factors associated with BSI occurrence. Study Design: Case-control. Methods: An online survey focused on dancing style, physical impact, anatomical features, training hours, cross-training, injury history, medical/menstrual history, and medications. Respondents with BSI answered questions about location, number, and changes made. Data were compared between groups using χ2 tests/Fisher exact tests, Mann-Whitney U test, Wilcoxon signed rank tests, and multiple logistic regression models. Results: Data from 110 respondents were analyzed. The most common style was modern/contemporary (50%). Bone stress injuries (BSIs) were reported by 36.4%, with most common sites being the second metatarsal (17.5%) and fibula (17.5%). Forty-one percent with BSI reported more than 1. A higher incidence was found for dancing greater than 5 hours per day/20 hours per week, and for leg length discrepancy and anterior ankle impingement. Odds of a BSI were greater for White than for non-White dancers and for dancers who reported an anterior ankle impingement. Post-BSI, common changes were decreased dancing time, increased warm-up, strengthening/stretching, and diet and nutrition intake. Pain was the most common complication. Time away from dancing following BSI varied, with some dancers taking no time off. Conclusion: This study supports findings of other studies that primarily include ballet dancers. Increased screening for risks and education about safe return to dancing are needed.