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Dr. Jojo Lai -  Doctor

Dr. Jojo Lai -  Doctor

12 November 2020


Foot and ankle injuries are known to be the most injured body part in dancers, and they are more often to be chronic than acute. Ankle impingement or tendinitis (inflammation of tendons) and metatarsal stress fractures due to overuse are examples of chronic conditions, while ankle sprain remains the most common acute ankle injury. Persistent pain around the foot and ankle may be a red flag which prompts dancers to seek medical attention. However, can we predict which region of the foot and ankle will be the most prone to injury in different types of dancersis it possible to predict the site of injury based on the type of dance?

A recent research study has been performed to compare foot and ankle injuries among pre-professional Ballet, Contemporary and Chinese dancers in Hong Kong based on data of one academic year collected in the span of one academic year via online questionnaire.

Based on the results, as high as 96% of dancers experienced foot and ankle pain since the start of their career, with prevalence in 2018-2019 being 89% in Ballet; 79% in Chinese dance and 70% in Contemporary respectively. Different types of dancers indeed presented with different injury patterns in the foot and ankle region.


The Achilles tendon is the most injury-prone region in ballet dancers. Classical ballet dancers performing en pointe, demi point, or plie constantly exert force on their Achilles tendon, thus overusing it. Moreover, the dancers tie the shoe ribbons at the ankle, which will impair blood flow to the tendon. These factors increase the risk of attritional injuries.

It is stated that classical ballet dancers performing en pointe, demi point, or plie exert forces that, although normal in magnitude, are increased in frequency, thus overusing the Achilles tendon. The level where dancers tie their ribbons at the ankle is also shown to have impaired blood flow. This makes the Achilles tendon prone to attritional injuries.


The hindfoot/ankle region is most prone to injury in Contemporary dancers are more prone to hindfoot/ankle injury. This dance style particularly emphasizes on weightbearing on extreme ankle plantarflexion (e.g. toe rise). Such movement is shown to be associated with posterior ankle impingement.

Chinese dance

The midfoot is the most injury-prone region in Chinese dancers. Like gymnastics and acrobatics, landing from unsteady bases or heights (e.g. partners, props) are common in Chinese dance and these are shown to be associated with mid-foot injuries.

The above findings provided the framework in terms of developing genre-specific foot and ankle strengthening programmes in different dancers in the future.

More interestingly, although these foot and ankle injuries resulted in partial absence or suboptimal performances, only 1/3 of these dancers would go for formal medical consultation. “No pain no gain” seems to be the mindset of many dancers, but it is just as important to realize when to seek medical attention in a timely manner if these aches persist, such that we can avoid permanent damage and enjoy dance pain-free for as long as we can.

芭蕾舞 | 現代舞 | 中國舞:足踝傷患找不同

作者:黎海晴 - 醫生​

足踝傷患是最常見的舞蹈傷患, 而慢性勞損比急性創傷更為普遍。 長期傷患一般包括因過度重用同一組關節而引致的足踝筋腱發炎、壓力性骨折以及後踝夾擠症候群, 急性創傷則以踝部扭傷(拗柴)最為常見。 舞者往往因為持續足踝疼痛才去求醫診治。究竟我們可否推測在不同舞種的舞者中足踝哪個部位最常受傷?

近日有本地研究嘗試解答以上問題,並透過網上問卷訪問香港準專業舞者有關足踝傷患的情況。被訪舞者分別主修芭蕾舞,現代舞以及中國舞。研究結果顯示,高達 96% 的舞者有足踝疼痛的狀況。而過去一年此情況在芭蕾舞者中最常見(芭蕾舞 89%; 中國舞 79% ;現代舞 70%) 。當中並發現各舞種最常受傷的足踝部位確有不同。











  1. Ekegren CL, Quested R, Brodrick A. Injuries in pre-professional ballet dancers: Incidence, characteristics and consequences. J Sci Med Sports. 2014;271-275.

  2. Fernandez-Palazzi F, Rivas S; Mujica P. Achilles Tendinitis in Ballet Dancers. Clinical Orthop Relat Res. 1990; 257:257-261.

  3. Bronner S, Brownstein B. Profile of dance injuries in a broadway show: A discussion of issues in dance medicine epidemiology. J Orthop Sport Phys. 1997;26(2):87-94.

  4. Grossman G, Wilmerding V. Dance physical therapy for the leg and foot: Plantar fasciitis and achilles tendinopathy. J Dance Med Sci. 2000; 4(2):66-72.

  5. Russell JA, Kruse DW, Koutedakis Y, Mcewan IM, Wyon MA. Pathoanatomy of posterior ankle impingement in ballet dancers. Clin Anat. 2010; 23:613-621.

  6. Chilvers M, Donahue M, Nassar L, Manoli A. Foot and ankle injuries in elite female gymnasts. Foot Ankle Int. 2007;28(2):214-218

Disclaimer Statement:

This article was accomplished by the author in his/her personal capacity. The opinions expressed in this article do not reflect the view of the official statement of CUHK and HKADMS. It is intended for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with an appropriate professional for specific advice related to your situation.

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Primary Source:  DANCE Magazine