Musculoskeletal pain and injury in elite adult Irish dancers

Background: The popularity of Irish dancing (ID) has increased enormously since the success of “Riverdance, The Show”. The last two decades have seen the evolution of ID to professional status as well as the elongation and intensification of competitive careers. However, scant investigation of musculoskeletal pain and injury among this cohort has been undertaken. Aims: To establish the incidence, type and causes of musculoskeletal pain and injury among current and former elite adult Irish dancers. To investigate the impact of job-satisfaction on the health and well-being of professional Irish dancers. To prospectively identify factors predisposing elite adult Irish dancers to pain/injury, and to propose guidelines for an evidence-based screening program to attempt to minimise the impact of same. Methods: A systematic review was conducted to examine existing research in this area. An online questionnaire was used to establish retrospective rates and perceived causes of pain/injury, as well as job satisfaction in a cohort of 178 professional Irish dancers. A different cohort of 104 elite adult Irish dancers completed a questionnaire investigating diverse biopsychosocial factors and 84 of these subjects underwent an extensive physical screening. Eighty-four subjects were followed up at monthly intervals for one year using an online questionnaire. Data regarding injury, illness, general physical and psychological health were recorded. Results: The systematic review demonstrated that there is a lacuna of pre-existing research into pain and injury in Irish dancers. This thesis has identified that pain/injury rates in elite adult ID cohorts were high and comparable to rates in elite ballet and contemporary dance. Perceived contributory factors to pain/injury identified by subjects include accidents, fatigue/overwork, repetitive movements, and unsuitable stages/floors. Professional Irish dancers largely expressed job satisfaction in their career but reported physical and psychological challenges to dancer wellbeing. Foot and ankle pain/injury were most common among elite adult Irish dancers with a host of biopsychosocial factors associated with pain/injury to the foot and ankle specifically, and to the whole body generally. A history of more severe pain/injury at baseline, greater daily pain and pain when dancing, and a higher number of bodily pain sites, a higher number of general subjective and psychological health complaints, lower mood and insufficient sleep, appeared to predispose subjects to greater levels of future pain/injury. Conclusion: Pain and injury in ID are commonplace and comparable to rates in other elite genres. Lower limb injuries, particularly to the foot and ankle are highly prevalent with numerous interrelated biopsychosocial factors found to be significantly associated with subjects more at risk of pain/injury. While physical factors have been focus of many screening tools in other genres, in ID pain issues, general health and psychological factors appear to be more related to pain/injury. Screening protocols and interventions embodying these factors should be developed to identify Irish dancers at risk for pain/injury going forward.