Working conditions and musculoskeletal disorders in professional ballet dancers in Sweden

Ballet dancers have been shown to have frequent problems with the musculoskeletal system, but little is generally known about the prevalences of musculoskeletal disorders and about the working conditions of professional ballet dancers in Sweden.

The aims of the thesis were: to analyse the prevalence, location and recurrence of self-reported musculoskeletal disorders (pain) in professional ballet dancers and to study their association with background factors, amount of work, and the dancers' opinions about their psychosocial work environment. Additional aims were to investigate possible preventive strategies such as a new screening pain questionnaire, called the Self-Estimated Functional Inability because of Pain (SEFIP), and extra fitness training.

Of the 147 dancers in the three major ballet companies 128 participated (87%). Only 5% of the dancers reported no experience of musculoskeletal disorders in the preceding year. The low back, the feet and the neck were the three most common locations for pain, and there was a strong association between upper body disorders but not between low back and hips, or between hips and knees or knees and ankles/feet. Incapacitating pain the preceding year was reported by 65%. In a six-year follow-up no significant increase in neither total body disorders nor incapacitating pain from the whole body was seen. Faulty and too much training were the most commonly proposed reasons for both major injuries and increased musculoskeletal pain. While "satisfaction with work", "use of one's capacity" and "influence in the working situation" showed some association, "social support" seemed to be least important among the psychosocial factors examined.

The validation of the new pain questionnaire showed good sensitivity and specificity when compared with findings in a clinical examination developed especially for dancers. SEFIP can therefore be recommended as a screening instrument for professional dancers. With special training, the dancers' fitness increased regarding the maximum oxygen up-take and lactic acid in blood, but this did not affect the musculoskeletal pain significantly.