Background Cirque du Soleil (CDS) is an acrobatic circus company with 1500 acrobatic and non-acrobatic performers for its current 20 touring and resident shows. Although published data analysis revealed that injuries at CDS are generally minor (80% requiring seven treatments or less), injury prevention and rehabilitation have and continue to be a high priority. The company considers injury surveillance an essential tool in evaluating the effect of policy changes on artists' health.

Objective To describe an example of how CDS uses injury surveillance to improve injury prevention.

Design Pre-post study.

Setting and Participants Circus artists.

Intervention A new touring concept directed for a pilot change in performance schedule where there was a need for artists to travel between cities on ‘non-performance days’, and to perform in more than one city per week.

Main outcome measurements Injury rate and frequency of treatments.

Results The previously new and unknown performance concept increased CDS' usual injury rate 1.8-fold and the number of treatments increased 2.4-fold in the two months following the change in tour-schedule. Additional analyses ruled out other changes over time including changes in cast size, and changes in locations. Based on these analyses, CDS did not continue with the pilot policy changes in performance scheduling.

Conclusion Injury surveillance can be a useful tool to help sport and artistic businesses minimise injury rates and as such maximise the longevity of their athletes and artists.