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Injury epidemiology in professional ballet: a five-season prospective study of 1596 medical attention injuries and 543 time-loss injuries
  1. Adam M Mattiussi1,2,
  2. Joseph W Shaw1,2,
  3. Sean Williams3,
  4. Phil DB Price1,
  5. Derrick D Brown4,
  6. Daniel D Cohen5,6,
  7. Richard Clark2,
  8. Shane Kelly2,
  9. Greg Retter7,
  10. Charles Pedlar1,8,
  11. Jamie Tallent1
  1. 1 Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, London, UK
  2. 2 Ballet Healthcare, Royal Opera House, London, UK
  3. 3 Department for Health, University of Bath, Bath, UK
  4. 4 Institute of Sport Science, Dance Science, University of Bern, Bern, Switzerland
  5. 5 Faculty of Life Sciences, University of Santander, Bucaramanga, Colombia
  6. 6 Sports Science Center, Mindeportes (Colombian Ministry of Sport), Bogotá, Colombia
  7. 7 Team GB, British Olympic Association, London, UK
  8. 8 Division of Surgery and Interventional Science, University College London, London, UK
  1. Correspondence to Adam M Mattiussi, Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, London, UK; Mattiussi.adam{at}


Objectives To describe the incidence rate, severity, burden and aetiology of medical attention and time-loss injuries across five consecutive seasons at a professional ballet company.

Methods Medical attention injuries, time-loss injuries and dance exposure hours of 123 professional ballet dancers (women: n=66, age: 28.0±8.3 years; men: n=57, age: 27.9±8.5 years) were prospectively recorded between the 2015/2016 and 2019/2020 seasons.

Results The incidence rate (per 1000 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 1000 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. First Soloists and Principals experienced between 2.0–2.2 additional medical attention injuries per 1000 hours and 0.9–1.1 additional time-loss injuries per 1000 hours compared with Apprentices (p≤0.025). Further, intraseason differences were observed in medical attention, but not time-loss, injury incidence rates with the highest incidence rates in early (August and September) and late (June) season months. Thirty-five per cent of time-loss injuries resulted in over 28 days of modified dance training. A greater percentage of time-loss injuries were classified as overuse (women: 50%; men: 51%) compared with traumatic (women: 40%; men: 41%).

Conclusion 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.

  • dance
  • injury prevention
  • sports and exercise medicine
  • surveillance

Data availability statement

No data are available.

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  • Twitter @adammattiussi, @JosephShaw_, @statman_sean, @ThePricep, @DDBrown__, @danielcohen1971, @Rich_Clark_, @shanekellypt, @pedlarcr, @jamietallent

  • Correction notice This article has been corrected since it published Online First. An additional affiliation has been added to Daniel Cohen.

  • Contributors GR implemented the electronic data management system. All authors contributed to the conception and design of the work. AM, JWS and SW completed the data analysis. AM wrote the first draft and prepared all revisions. All authors reviewed and edited drafts, and approved the final manuscript. CP and JT are joint last authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.