Movement Patterns During Ballet-Specific Tasks Predict Pain Severity in Pediatric Ballet Dancers Training En Pointe

INTRODUCTION: More than 95% of dancers report history of musculoskeletal pain, with ballet dancers experiencing injuries at higher rates. Lower extremity injuries are the most common, however it is unclear whether certain movement patterns contribute to these injuries. The purpose of this study was to analyze the association of pain with ballet specific movements in pediatric ballet dancers. METHODS: This cross-sectional study recruited pediatric female, pre-professional ballet dancers. Dancers completed the PROMIS Pediatric Numeric Rating Scale to establish presence and intensity of pain within the past 7 days, and a movement assessment, including anthropometrics and performance of ballet tasks. Inertial measurement units provided three-dimensional trunk, hip, knee and ankle joint angle range of motion while dancers performed first through fifth positions, développé à la seconde, arabesqué, and grand jeté tasks. Univariate analyses were conducted to identify relationships between kinematic variables and pain level. Lasso regression models were used to select predictors per task and across all tasks with α = .05. RESULTS: 34 ballet dancers reported pain ≥1. Greater passive hip extension was a significant associated variable of pain for several models, including the développé à la seconde, arabesqué and static positions. An increase in knee rotation motion during the développé à la seconde and reduced trunk flexion and greater trunk rotation for the grand jeté were associated with increased pain. Knee rotation in first position and hip abduction in third through fifth positions were found to be significant associated variables to pain. For the all-task model, rotational knee and hip differences during the développé à la seconde were able to predict reported pain level. CONCLUSION: The all-task model was successful in accounting for 45% of the variance in reported pain level, indicating pain can possibly be predicted based on movement patterns during specific ballet tasks.