Injury epidemiology in an elite ballet school: a seven-season cohort study of 2121 medical attention injuries and 1656 time-loss injuries

Objectives To describe the epidemiology of injuries in an elite vocational ballet school over 7 academic years. Methods Injury records pertaining to 569 students (267 boys and 302 girls) were prospectively collected by chartered physiotherapists using a cloud-based athlete management system over 7 academic years (2016/2017 to 2022/2023) at an elite ballet school. Results 1548 student-academic-years, encompassing 266 468 student-days, were completed, during which 2121 medical attention injuries were prospectively recorded, 1656 of which resulted in time-loss. Injury incidence was comparable between sexes but was greater at the upper school (ages 16–19; 9.0 injuries per 1000 exposure days, 95% CI 8.4 to 9.7) than the lower school (ages 11–16; 6.5 injuries per 1000 exposure days, 95% CI 6.0 to 6.9). By severity scale, 282 injuries (13.3%) were classified as mild (1–7 days), 582 (27.4%) were classified as moderate (8–28 days) and 792 (37.3%) were classified as severe (>28 days). The injury burden was 236 and 416 days lost per 1000 exposure days at the lower school and the upper school, respectively. The most common injury mechanism was repetitive—gradual onset (54.8%), and 25% of injuries were recurrences. The most common movements associated with injury were jumping and landing (boys 30.8%; girls 21.4%) and other dancing movements (boys 23.2%; girls 27.9%); 16.4% of injuries affecting girls were associated with pointe work. During term time, the mean percentage of students fully available without injury was 78.8% at the lower school and 66.2% at the upper school. Conclusion A large injury burden was observed across the 7 years in elite ballet students. Ballet schools must balance the training stimulus with appropriate recovery and ensure appropriate medical support is in place to manage injuries and implement prevention programmes.