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A Participatory Action Research Approach to Develop Bone Stress Injury Prevention Strategies in Classical Ballet.

Louise Drysdale1, Liam Toohey1, Kate Pumpa1,2

  • 1University of Canberra Research Institute for Sport and Exercise, ACT, Australia.

Journal of Dance Medicine & Science : Official Publication of the International Association for Dance Medicine & Science
|March 19, 2026
PubMed
Summary

Ballet dancers face recurrent bone stress injuries (BSI). Co-creating prevention strategies with company stakeholders identified key priorities for both professional and community settings, focusing on health literacy and improved access to care.

Keywords:
artisticdancinghealth literacysociological factorsstress fracture

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Area of Science:

  • Sports Medicine
  • Dance Science
  • Injury Prevention

Background:

  • Bone stress injuries (BSI) significantly impact ballet dancers, leading to prolonged rehabilitation and career disruption.
  • Recurrence rates for BSI in dancers are high, affecting long-term participation and career prospects.
  • A proactive approach involving stakeholders is crucial for developing effective BSI prevention strategies in ballet.

Purpose of the Study:

  • To co-create bone stress injury (BSI) prevention strategies with stakeholders from a classical ballet company.
  • To identify barriers and priorities for BSI prevention in both professional and community dance settings.
  • To develop a collaborative proposal for implementing BSI prevention initiatives within a ballet organization.

Main Methods:

  • Participatory action research (PAR) involving 17 stakeholder-researchers from diverse roles within a ballet company.
  • Four sequential focus group meetings were conducted, recorded, transcribed, and thematically coded.
  • Stakeholders collaboratively drafted a comprehensive BSI prevention proposal for the organization.

Main Results:

  • Improving health literacy among recreational dancers is essential to prevent the 'onflow' of poor health behaviors.
  • Professional setting priorities include enhanced onsite health services, annual evaluations, refined safeguarding, and wearable technology.
  • Community priorities focus on targeted BSI education for dancers, teachers, and families.
  • Barriers include artistic process demands, poor nutrition, stress, inadequate load monitoring, injury glorification, funding, and access to dance-informed practitioners.
  • Dancers' artistic identity can hinder utilization of 'athlete' health services.

Conclusions:

  • Collaborative PAR successfully identified and prioritized BSI prevention strategies for ballet dancers.
  • Recommendations include implementing health literacy surveys and systematic injury surveillance to monitor intervention effectiveness.
  • Addressing systemic and individual barriers is key to reducing BSI incidence and recurrence in the dance community.