Adolescent maturation and injury risk in an elite ballet school: a 7- year cohort study of 506 students

Key Points

1. This study highlights a clear pattern of bone injury and growth-related injury and associations with growth rate and stage of maturation.

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BACKGROUND & OBJECTIVE

Early specialization is common in ballet, with talented dancers often entering pre-professional training from around 10 years old and undertaking up to 30 hours of practice each week. Such intensive training is associated with a well-documented injury risk, and while some students drop out due to injury, many carry significant injury histories into their professional careers, increasing future injury risk and reducing career longevity.

In football, apophyseal injury risk has been shown to follow maturation-related patterns, progressing from distal to proximal sites and peaking around peak height velocity. However, these relationships have not been explored within young ballet populations.

This study aimed to investigate how within elite-level ballet students’ growth and maturation-related factors are associated with growth and bone injury risk.

Early specialization is common in ballet, with talented dancers often entering pre-professional training from around 10 years old and undertaking up to 30 hours of practice each week.

Load management of high demand tasks like allegro in males and hip extension work in females becomes critical, with quadriceps strengthening and energy availability monitoring to support tissue adaptation during late maturation, without spending time looking into BMI.

METHODS

This was a cohort study design from the Royal Ballet School (UK), looking at training and injury data across seven academic years. The study examined associations between growth- and bone-related injuries and key growth indicators, including percentage of predicted adult

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