Injury Profile of Hip-Hop Dancers
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Injury Profile of Hip-Hop Dancers Olga Tjukov, MA, Tobias Engeroff, PhD, Lutz Vogt, PhD, Winfried Banzer, PhD, MD, and Daniel Niederer, PhD Abstract dancers only involved the lower extremi- Hip-hop is characterized by moves This study assessed the injury incidence, ties. In house, the lower extremities were such as bouncing the body, bending mechanisms, and associated potential risk affected most frequently, followed by the the knees, jumping, turning, twisting, factors for hip-hop, popping, locking, trunk. A total of 65.3% of the dancers isolated extremity movements, and an house, and breaking dance styles. Data experienced time loss, with a duration of extreme involvement of the torso. The were collected from June to November 12.7 ± 21.3 weeks. Breakers experience significantly more injuries than dancers of characteristics of popping are short 2015. The retrospective cohort study and fast muscle contractions, which included 146 dancers (female: N = 67; the other styles. Injury risk among dancers of all the styles studied can be considered are performed with different body age = 20 ± 4.2 years; males: N = 79; age parts to the rhythms of the music. The = 22.9 ± 5.8 years) who completed a low compared to soccer players, swim- mers, and long-distance runners. dancer looks robotic and can incorpo- questionnaire that collected data concern- 6 ing training hours, injuries, self-reported rate wave and illusion techniques. In the dance style locking, many basic injury causes, treatment, and recovery ompetitive dancing has been movements are executed with the time over the last 5 years. For the last 5 associated with a high risk arms and wrists, which are “locked” years, 52% (N = 76) of the dancers re- of injury.1 While injuries in ported 159 injuries and, in the year prior or paused to point. Furthermore, Cballet, breaking (breakdance), and to the survey, 31.5% (N = 46) reported a dancers go into the squat position, modern and contemporary dance total of 75 injuries. Overall, 0.61 injuries pull up their knees, perform artistic have already been investigated quite (5 years) and 1.156 injuries (1 year) per jumps into half splits, and drop with thoroughly,2 there are popular con- 1,000 hours exposure time occurred. For their knees on the ground (“knee temporary dance styles that are largely breaking, 1.286 injuries (5 years) and drops”). House has its focus on the 2.456 injuries (1 year) per 1,000 hours neglected in this context, such as feet, which are almost constantly mov- exposure time were calculated, while the hip-hop. The term “hip-hop” is used ing to a rhythm of 120 to 130 beats other dance styles accumulatively reached both to differentiate a specific dance per minute,6 while the arms are usu- 0.151 injuries (5 years) and 0.318 injuries style and as an umbrella term for a ally just taken along. Finally, breaking (1 year) per 1,000 hours of exposure time. subculture that includes such styles as consists of fast footwork and acrobatic Breakers reported most injuries at the popping, locking, house, and hip-hop upper extremities, followed by the lower movements. The dancers spend most itself. Thus, although all dance styles extremities, trunk, and head and neck re- of the dancing time on the ground that are investigated in this study be- gion. Most injuries in hip-hop occurred at in positions where the hands have long to the hip-hop subculture, they the lower extremities, mainly affecting the contact with the floor and carry part differ significantly in their movement knees, followed by groin and ankle. Inju- of the body’s weight. patterns and physical demands.3-5 ries experienced by popping and locking Currently there is only one study that reports overall injury incidence for a compilation of hip-hop dance Olga Tjukov, MA, Tobias Engeroff, PhD, Lutz Vogt, PhD, Winfried Banzer, PhD, 5 MD, and Daniel Niederer, PhD, Goethe University Frankfurt, Department of styles. Ojofeitimi et al. performed Sports Medicine, Frankfurt am Main, Germany. research on injuries in popping and locking and a category that the au- Correspondence: Olga Tjukov, MA, Department of Sports Medicine, Goethe- thors refer to as “new school” (includ- University Frankfurt, Ginnheimer Landstraße 39, 60487 Frankfurt am Main, ing house, street jazz, krumping, and Germany; [email protected]. Harlem shake). From the 312 dancers Copyright © 2020 J. Michael Ryan Publishing, Inc. 66 https://doi.org/10.12678/1089-313X.24.2.66 Journal of Dance Medicine & Science • Volume 24, Number 2, 2020 67 included in that study, 232 reported good clinical practice in the conduct residence. The second part consisted a total of 738 injuries. The most and reporting of survey research.7 All of dance-related questions. The par- frequently reported injures for pop- participants gave written informed ticipants were asked what dance ping and locking affected the lower consent and all data were treated styles they practiced, for how long extremities (62%), upper extremities anonymously. they had been practicing each style, (25%), and trunk (8%). “New school- and how many hours per week they ers” were most frequently affected at Study Population were currently practicing each style. the lower extremities (69%), upper Participants (21.6 ± 5.2 years of age) Participants were also asked whether extremities (12%), and trunk (8%).5 in the survey were German residents, they participate in dance competitions The grouping of the dance styles, how- females (N = 67) and males (N = 79), and performances and, if so, how ever, does not allow for differentiating who practice at least one of the dance often per year, whether they worked injury locations and mechanisms for styles considered in this study for a as dance teachers, choreographers, or any one dance style in particular. minimum of 1 year and for at least both, and whether dance was their Therefore, despite the high-quality re- 1.5 hours per week. Potential subjects main source of income. Then there search design of this study, the subsets were identified at dance practices, were questions about their warm up lack detailed information such as 1. dance battles, and dance jam sessions habits, use of protective equipment, overall hip-hop injury rates, 2. simi- and came from 46 different cities in and participation in other types of larities and differences in movement Germany. All dancers who met the sport. The last question asked whether patterns, and 3. hip-hop as a unique inclusion criteria could participate in the dancer had experienced acute inju- dance style in its own right. the survey. ries or overuse damage from dancing. Accurately categorized informa- Those who answered affirmatively to tion concerning injury risk in the Data Collection this last question completed a third dance styles that constitute hip-hop Data were collected from June to part of the questionnaire. This third is of interest to dancers, coaches, and November 2015 by means of a ret- part asked for detailed information health care professionals. Based on rospective questionnaire with a recall regarding their dance-related injury or an increasingly profound knowledge period of 5 years. After a thorough multiple injuries: when did the injury of injury types and causes, effective literature review and in accordance occur (date); where did the injury prevention strategies for dance-related with the authors’ practical experience, take place (training, battle, jam, per- injuries may be developed. Moreover, an initial version of the questionnaire formance) and at what point in time insight into recovery times after inju- was generated. The pilot version of the during the dance activity (beginning, ries could be used to optimize current questionnaire was tested on 10 danc- middle, end); where was the injury rehabilitation programs. Therefore, ers involved in hip-hop dance styles. located, descriptive and indicated on this study systematically analyzes in- In accordance with the responses, all a diagram of a human body ventral, jury incidences, types, and causes, as unclear questions were rephrased. The dorsal, and lateral (left, right); did the well as injury recovery times, therapy revised questionnaire was then tested dancer seek medical help; what was regimens, and prevention for the on 10 different dancers and the fol- the diagnosis and therapy that the different hip-hop dance styles (hip- low-up procedure was repeated. The dancer received; in cases of overuse in- hop, popping, locking, house, and final questionnaire was distributed jury, how did the injury develop; and breaking), all as influenced by such to dancers who participated at dance what, in the dancer’s opinion, were potential contributors as age, sex, and practices, dance battles, and dance jam the causes of the injury. Subsequently, financial considerations. sessions in different cities in Germany. the dance style being practiced when Participants self-administered the the incident happened, the type of Materials and Methods questionnaire and handed it back to floor being used, and whether other Study Design and Ethical the investigator (OT). The investi- hobbies or activities could have led Standards gator was always close by to clarify to the overuse injury were assessed. This research project was designed as a potential questions and immediately The last questions concentrated on retrospective cohort study. A six-page checked each questionnaire after it consequences and time loss following questionnaire (available from the au- was returned for missing and unclear the injury. Injuries could be attributed thors on request) was used to survey data. In cases of missing information to a specific dance style in cases of dancers of the five different hip-hop or unclear descriptions, the researcher acute injury or when participants only styles about their dance habits and asked for the missing details to prevent practiced one dance style.