Prevalence of Achilles Tendinopathy in Bharatanatyam Dancers

Overuse injuries such as Achilles tendinopathy (AT) are common in dancers due to repetitive loading and biomechanical stress. Although ballet has been studied extensively, very little research exists on Indian classical dance forms. This exploratory study aimed to assess the prevalence and severity of Achilles tendinopathy (AT) among Bharatanatyam dancers in Karnataka, India, using the VISA-A questionnaire, and to explore potential associated risk factors.

A cross-sectional observational study was conducted among 106 Bharatanatyam dancers aged 18 to 45 years, recruited through social media and peer networks. Participants were proficient in English and actively engaged in dance practice. Those with a history of lower limb injury, surgery, or insufficient physical activity were excluded. Data collection included the International Physical Activity Questionnaire - Short Form (IPAQ-SF), a survey of known risk factors, and the VISA-A questionnaire. Associations between VISA-A scores and potential risk factors were analyzed.

Of the 106 dancers (102 females, 4 males), 68.9% demonstrated signs of AT. All male participants presented with mild symptoms, while females reported AT with greater symptom variability. No significant correlation was found between VISA-A scores and years of dance or sports participation (P > .05). No significant associations were identified between the examined demographic and training-related variables and either VISA-A scores or Achilles tendon symptom status in the multivariable regression analyses.

These findings provide preliminary evidence of a substantial burden of Achilles tendinopathy among Bharatanatyam dancers, although confirmation in adequately powered studies is required. This study suggests that commonly assumed risk factors, such as years of dance practice and sports involvement, did not show a significant correlation with VISA-A scores. These findings emphasize the need for early identification and management of AT in dancers to prevent long-term impairments and improve their performance.