Hip injuries in young dancers

Dancing is an increasingly popular sport amongst children with some kids starting as young as 2 years old and many participating in 4-5 different types of dance 5-7 days per week. Common dance types include ballet, jazz, hip hop, tap, acro, and Irish step dancing. This repetitiveness can become very taxing on the dancer’s body with certain dances requiring a lot of jumping, extreme hip or ankle ROM, and lots of muscle activity. Hips are of particular concern since these joints transmit all the energy and forces between the upper and lower body, generate most of the force to complete the dance, and often require extreme ranges of motion. Young dancers that participate in many different types of dance are less at risk of developing pain or injuries because the forces are constantly changing, however, those that choose to concentrate in 1 or 2 types of dance are at higher risk since the forces are constant and repetitive. There are a few common hip injuries that we see in dancers; Dancer’s Hip (Snapping Hip), Bursitis, Hip Impingement and Labral Tears.

Dancer’s hip, or snapping hip syndrome, is usually more annoying than debilitating but can cause performance issues. There are 3 main areas where a muscle or tendon rubs over a bony process which may cause the snapping sound or sensation. At the front of the hip, the iliopsoas may rub over the femoral head, or the iliopectineal eminence and is often called iliopsoas syndrome which is prevalent in 13% of female dancers under the age of 18. Also in the front of the hip, the hip flexor, or rectus femoris can also slip over the head of the femur causing a snapping. On the outside of the hip, the iliotibial band may rub, or snap over the bony prominence called the greater trochanter. All of these are caused as the hip bends and straightens at various positions. Because we have bursa surrounding these bony prominences to help protect the soft tissue, bursitis, or inflammation of the bursa may also develop. Dancer’s hip is usually more annoyance than anything, but if it becomes problematic, activity modification, rest, and ice may be of benefit. Physical therapists can also help the process and prevent reoccurrence by working on soft tissue restrictions, stretching, and strengthening exercises to address muscle imbalances, core strengthening, balance and stability, and technique.

Hip impingement can occur in youth as their bones are developing. Research shows that our bones can change a little bit from the norm with repetitive forces that are constantly the same, or from forcefully trying to achieve and maintain extreme ranges of motion such as with “turn out”. While less common, this can lead to hip impingement and labral tears. Hip impingement occurs when your upper leg bone hits into your hip socket, pinching your labrum. Your labrum “seals” your hip joint and helps to provide stability. Some of the symptoms associated with these issues include feeling a “pinch” in your hip, particularly with squatting activities, clicking, and grinding. If the labrum is torn, your hip can feel “out of place” or “too loose.” Impingement is usually more debilitating than Dancer’s hip, but can still be addressed conservatively with activity modification, rest, ice, and physical therapy. Physical therapists can educate the dancer and family on positions that should be avoided and can work to further strengthen the core and legs to help provide stability, improve alignment, and prevent further impingement.

Are you getting enough physical activity?

According to the 2018 Physical Activity Guidelines, only 26 percent of men, 19 percent of women, and 20 percent of adolescents report sufficient activity to meet the current minimum guidelines for both aerobic and muscle-strengthening activity.  The benefits of physical activity are well researched and have been found to take effect immediately. 

Regular physical activity benefits include:

  • Improved mood (decreased depression and anxiety)
  • Increased energy
  • Improved function for daily activities
  • Decreased risk of chronic diseases
  • Improved sleep
  • Decreased fall risk for older adults
  • Improved cognitive function for youth ages 6-13
  • Improved bone health and weight status for children ages 3-5
  • Reduced cancer risk

Minimum guidelines have been established for various age groups including young children, adolescents, adults, and older adults. 

Pre-school Aged Children (ages 3-5)

  • Be physically active throughout the day to enhance growth and development
  • 3 hours a day including varying levels of intensity
  • Encourage active play – throwing games, bicycle and tricycle riding, jumping, hopping, skipping, tumbling

School-Aged and Adolescent Children (ages 6-17)

  • 60 minutes (1 hour) or more of moderate to vigorous-intensity activity
  • Most of the 60 minutes should be aerobic in nature at least 3 days/week
    • Biking, hiking, running, organized sports, martial arts, swimming, yard work
  • Include muscle and bone-strengthening exercises 3 days/week
    • These can include jumping, hopping and skipping, running and also more structured bodyweight and resistance exercises for major muscle groups
  • Encourage age-appropriate and enjoyable activities to promote lifelong habits


  • 150 mins to 300 mins of moderate-intensity activity per week or 75 minutes of vigorous activity a week (aerobic activity spread out through the week at least 3 days a week)
  • Muscle-strengthening exercises 2 days a week hitting major muscle groups

Older Adults (65 and older)

  • Healthy older adults should follow the same guidelines as adults above
  • Strive to move more and sit less throughout the day
  • Incorporate balance activities
  • Determine your level of physical effort relative to your fitness level
  • Understand how chronic conditions may impact your activity and ability to perform the activity safely (seek guidance from a healthcare professional)

Below is a chart with some examples of both moderate and vigorous-intensity activities.

Moderate Intensity Activity

Vigorous Intensity Activity

Walking briskly (2.5-4.0 mph)

Jogging, running

Doubles tennis

Carrying heavy groceries upstairs

Raking the yard

Shoveling snow

Water aerobics

High-Intensity Interval training

Active forms of Yoga

Jumping rope

General yard work and home repair

Biking >10 mph

Ballroom or Line dancing

Swimming laps


If you need help determining your current fitness level or have chronic conditions that may be preventing you from being physically active, contact our office to schedule an appointment with a physical therapist.   We can help you develop a comprehensive program to keep you physically active and healthy for life.


Jen Buono, PT, DPT


References: Physical Activity Guidelines for Americans 2nd Edition. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf

Get PT First During the COVID-19 Pandemic

Because of the closures of physician's offices, stoppages of elective surgeries, and social distancing guidelines resulting from COVID-19, many people with pain or joint issues have had appointments or surgeries delayed. If you're one of them and you haven't seen your PT yet, you should. Here are some reasons why:

Early PT leads to better outcomes

Studies have shown that people who receive PT sooner have better outcomes, lower costs, are less likely to have surgery, use opioids or have unnecessary testing. Because back pain is so common, there is a lot of outcome data from people with back pain.  A study of 150,000 insurance claims published in Health Services Research, found that those who saw a physical therapist at the first point of care had an 89 percent lower probability of receiving an opioid prescription, a 28 percent lower probability of having advanced imaging services, and a 15 percent lower probability of an emergency department visit. Unfortunately, only 2% of people with back pain start with PT, and only 7% get to PT within 90 days.

Early PT saves money

The rising cost of healthcare is well known and early PT is something that has been shown to reduce costs without reducing the effectiveness of treatment. A study published in the Journal of Orthopaedic and Sports Physical Therapy showed that patients who obtained physical therapy via direct access had significantly lower medical costs—an average of $1,543 less per patient than those who chose referral from a physician. They also had significantly fewer visits and spent significantly fewer days in care.

Surgery may not be as effective as you think

Many patients look to surgery as the fix for their pain, but surgeries aren't always as effective as patients believe. A large study looking at worker’s comp patients with back pain found that people who have surgery have a 1 in 4 chance of having a repeat surgery, a 1 in 3 chance of a major complication, and a 1 in 3 chance of never returning to work again. Recent large studies of arthroscopic surgeries for meniscal tears have shown no difference in outcomes between people who have surgery and those who don't. Other procedures with questionable effectiveness include kyphoplasty, vertebroplasty, and injections for nonspecific back pain.

So, if you were planning on seeing your PCP or a specialist for an orthopedic condition or pain and you haven't seen a PT yet, you should consider making PT your first stop. You could end up getting better faster for less money and you might avoid riskier treatments like opioids or surgery.

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