Concussions in Dance

Recital 2018

So my three girls participate in dance at a local studio. This past weekend, June 9, they had their dance recital and all three of them did great. It was the 3.5 year old’s first time on stage like that and she did just great. My oldest is in the studio’s performing company which means she danced during all four recitals on Sunday on top of dancing with the other classes she was in. Perhaps you are familiar with this but for us dance recital day is a long day. While I was waiting in between recital times I decided to dig into what evidence exists on concussions in dance.

There are not nearly the same number of studies on the impact, recovery, or injury rate of concussions on girls or women as there are these studies on boys or men. The why is easy to understand because the focus on concussion has been on football, a overwhelmingly male sport. The focus outside of football has still largely been on male sports. One study out there found that women were at a 50% higher risk for concussion than men who play the same sport. This indicates that a woman playing college soccer has a 50% higher risk than a man playing college soccer. There is very little in terms of studies on women or women sports and there are almost no studies on concussions in dance despite the fact that dancers do get concussions.

I use a site called pubmed.gov to look up studies related to health or the human body. PubMed is maintained by the US National Library of Medicine which is a division of the National Institute of Health. Searching this site will bring up results of every peer-reviewed journal published today. When I search for concussions in football I get over 1000 results, when I searched for concussions in dance I got 5 results. This means that there is almost nothing in the peer-reviewed literature to give us any definitive direction on risk and recovery in dancers in regards to concussion.

I learned a few fascinating things from these studies but they really don’t come close to helping us understand this injury in dancers as the studies on football players do. From what I read in these studies dancers are not getting baseline exams done with any regularity. We know that baseline data is important because a concussion is an injury we cannot measure. There is no blood work or imaging study we can do to measure this injury. What we can do is compare a post injury test score to a baseline exam.  I also noted that dancers and parents of dancers know what a concussion is but they do not know what constituents as safe concussion behaviors such as when to report and seek care for a potential injury. Data from one study seems to indicate that dancers may have symptoms of greater severity than other concussed athletes.

Today it seems to me the biggest issue of dance related concussions is awareness. We don’t know what the injury rate is of concussions in dance but we know they happen so parents and dancers should be aware of what to do to protect against this injury and what to do in the event of an injury. The most significant issue with regards to concussion is not identifying the injury when it happens. Less than 10% of concussions occur with a loss of consciousness so you cannot rely on that as the main indication a concussion has occurred. It would be obvious to assume a concussion when a dancers head hits the floor but a concussion can also occur without any impact at all. In of the the studies a dancer suffered a concussion by repetitively whipping her head around in circles. Diagnosing a concussion is done by getting a comprehensive history of the injury and symptoms. There are no blood tests or imaging studies that can be done to confirm or rule out this injury. The best thing is to have a baseline exam to compare a post injury retest to. Having a score on the re-test that is worse than the baseline is a good indication a concussion occurred. It also gives us something to measure in determining when the athlete may return to their activity. Returning before the brain has healed can lengthen healing time and may result in significant issues in the athletes ability to perform in their sport or even perform at school. Adequate rest is critical after a concussion.

Concussion is a complex subject and what we understand about it is minuscule and what we understand about concussions in dance is even smaller. The best we can do is create awareness that concussions can occur in dancers and what the best course of action is to ensure a proper recovery. I attempted to touch on a few key items in this post but the issue is far too complex for a blog post. We offer a class on concussions called Concussion Roulette. In this class we go over the whole topic and provide solutions to ensure your athlete can compete safely. If you want to know more about concussions, or the class we offer contact me. I would be happy to discuss the topic of concussions. ph: 630-232-6616 email: brycejdc@stakerchiro.com

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Posted in Exercise and Fitness, Injury Prevention, Pediatrics

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