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.