Ask the Expert: Staying Injury Free in the Ballet World


Ballet is one of the most physically challenging performing arts. It requires years of daily training to prepare proper technique and a balance between flexibility and strength. Throughout training, remaining injury-free often requires thought and preparation. There are two types of injuries: acute and chronic. An acute injury occurs abruptly such as an ankle sprain. A chronic injury occurs gradually and may be related to technique and overuse. There are internal and external factors contributing to injuries such as inadequate flooring and fatigue, respectively. Below is a list of some of the most important routines that may prevent injury:

  • Maintain adequate hydration and nutrition. Losing only a small percentage of your body weight due to water can adversely affect your performance. Dehydration and hunger can also cause headaches, poor concentration and fatigue. Decreased mental acuity may contribute to carelessness during class and therefore faulty techniques. Try to have snacks with you during the day. Eat when you are hungry and try to prevent reaching a state of thirst by maintaining hydration throughout the day.
  • Find peace with your body’s natural facility. Given the pressures that exist in ballet to obtain perfect turnout and extensions, it is understandable that you may find yourself forcing and stretching in unhealthy ways. However, please try and remember that your body is the only one you have and it needs to last throughout what is hopefully a long career in dance.
  • Do not overly force your turnout. Not all of your turnout will come from your hips, however you should try not to force too much at your knees and ankles. Twisting of the lower leg joints can contribute to excessive pressure and injury to these areas. Try to work within your natural and pain-free degree of turnout. As a general rule, when in demi plié, make sure your knees are aiming for the middle toes in order to avoid torqueing in your lower leg joints. Also, avoid overstretching your hips. If you are uncertain how to stretch, ask a professional to guide you. This is a great topic to discuss with your teacher and even a physical therapist if available.
  • Do your shoes fit? As we age, our feet usually increase in size as the width expands. Pointe shoes need to be checked for proper size every few years. Also, feet come in different shapes and vary in toe length, uniformity of the toes, and arch height and range of motion. The point shoes’ vamp or toe box shape as well as the shank should be customized to allow your foot proper support and flexibility. Speak with a shoe expert at your dance store as well as your teacher to make sure your point shoes’ shape is appropriate.
  • What is your core? The core includes all the muscles of your trunk and pelvis, including your gluteal muscles. A strong core allows you to stabilize your movements while dancing, enabling you to balance while controlling speed, power, and flexibility. A strong core protects your lumbar spine and therefore your extremities from injury as it allows you to maintain proper alignment while moving. Core strength is also important for partnering and lifting. Ballet alone may not adequately strengthen your core musculature and cross training might be necessary. Speak with your physical therapist and teacher about other home exercises and training modalities that are core focused such as Pilates, gyrotonics, and some forms of yoga.

Pain is a sign not to be ignored. We all want to avoid injury and unnecessary treatment, but ignoring pain won’t always make it go away. Seek advice early if something is hurting so you can identify the cause and prevent it from developing into a more serious injury with a potentially longer recovery.

Dr. Elizabeth Manejias, Physiatrist

 Dr. Elizabeth Manejias is a physiatrist and acupuncturist at Hospital for Special Surgery. Professionally trained in ballet, Dr. Manejias is active in the performing arts community and provides educational lectures to dance programs on injuries and medical problems common in the female athlete. She treats dancers from Broadway to professional ballet.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

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