Injuries in pre-professional dancers: a performance psychological approach

Dance students are at a high risk for sustaining health problems due to the demanding physical, psychological and artistic aspects of dance training. Prevention is therefore essential. However, little is known about physical and mental health problems. Therefore, this thesis’ goal was to develop knowledge on incidence, characteristics, risk factors of and responses to injuries in contemporary dance students, as well as the incidence and characteristics of mental health problems. A longitudinal study including multiple cohorts, and a qualitative study were conducted to establish this knowledge. The findings indicated that contemporary dance students are at high risk for sustaining an injury and at moderate risk for mental health problems. Especially lower back and lower-extremity injuries were present, whereas anxiety, stress, and tiredness were the most common mental health problems. Factors associated with increased likelihood for injuries were limited coping skills, lower age and higher BMI. Besides, an association between stress levels and injuries was found. Furthermore, responses to injuries were influenced by dancers’ beliefs regarding the ‘hard’ culture of dance and its schooling system. Students perceived pressure, which influenced strategies to continue dancing while being substantially injured. In order to address the complexity of health problems, interventions aiming at different levels are proposed. At the individual level, stress reducing interventions and psychological guidance could be valuable. Whereas, managing workload and educating students and teachers about stress, coping skills, and the psychological impact of injuries could be beneficial at the social-cultural level. At the environmental level, a cultural change within dance is still needed, in which hard work and rest are balanced. To conclude, this thesis highlights that dance students are prone to health problems. This calls for a continuous process of learning and improving at multiple levels.