Paratenonitis of the foot and ankle in young female dancers

Background: In their pursuit of excellence, dancers continually face the risk of injuries, such as paratenonitis. This attests to the strong need for preventive action, which is possible only if major risk factors are identified. The aim of the present descriptive study was to determine the association between risk factors and paratenonitis in young recreational female dancers. Methods: One thousand eighty-two non-professional female dancers, aged 8 to 16 years, were screened. The risk factors considered for paratenonitis were: joint range of motion (ROM), body structure, anatomic anomalies, dance technique, and dance discipline. All dancers were clinically examined for current ankle/foot paratenonitis. Results: Ninety-three dancers (8.6%) manifested a paratenonitis at the ankle or foot joints. ROM such as hyper ankle plantarflexion and hyper hip external rotation, false dance technique, and hours of practice per week were found to be associated with increased rate of injury. Regression analysis indicated that dancers with paratenonitis had greater hip external rotation ROM compared to dancers without paratenonitis. No association with injury was found with age of onset of menarche, body structure, and anatomic anomalies such as scoliosis. Conclusion: Precautionary steps, such as screening for joint ROM and dance technique, may reduce the risk of dance injury. Furthermore, our results led to a very significant justification of the dance maxim "don't force your natural joint ROM and especially your 'turnout' position,"as it could increase your chance to develop paratenonitis.