{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T15:30:59Z","timestamp":1774279859489,"version":"3.50.1"},"reference-count":37,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2025,12,28]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the epidemiology of injuries in an elite vocational ballet school over 7 academic years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Injury records pertaining to 569 students (267 boys and 302 girls) were prospectively collected by chartered physiotherapists using a cloud-based athlete management system over 7 academic years (2016\/2017 to 2022\/2023) at an elite ballet school.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      1548 student-academic-years, encompassing 266 468 student-days, were completed, during which 2121 medical attention injuries were prospectively recorded, 1656 of which resulted in time-loss. Injury incidence was comparable between sexes but was greater at the upper school (ages 16\u201319; 9.0 injuries per 1000 exposure days, 95% CI 8.4 to 9.7) than the lower school (ages 11\u201316; 6.5 injuries per 1000 exposure days, 95% CI 6.0 to 6.9). By severity scale, 282 injuries (13.3%) were classified as\n                      <jats:italic>mild<\/jats:italic>\n                      (1\u20137 days), 582 (27.4%) were classified as\n                      <jats:italic>moderate<\/jats:italic>\n                      (8\u201328 days) and 792 (37.3%) were classified as\n                      <jats:italic>severe<\/jats:italic>\n                      (&gt;28 days). The injury burden was 236 and 416 days lost per 1000 exposure days at the lower school and the upper school, respectively. The most common injury mechanism was\n                      <jats:italic>repetitive\u2014gradual onset<\/jats:italic>\n                      (54.8%), and 25% of injuries were recurrences. The most common movements associated with injury were\n                      <jats:italic>jumping and landing<\/jats:italic>\n                      (boys 30.8%; girls 21.4%) and\n                      <jats:italic>other<\/jats:italic>\n                      dancing movements (boys 23.2%; girls 27.9%); 16.4% of injuries affecting girls were associated with\n                      <jats:italic>pointe work<\/jats:italic>\n                      . During term time, the mean percentage of students fully available without injury was 78.8% at the lower school and 66.2% at the upper school.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A large injury burden was observed across the 7 years in elite ballet students. Ballet schools must balance the training stimulus with appropriate recovery and ensure appropriate medical support is in place to manage injuries and implement prevention programmes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-109787","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T18:20:19Z","timestamp":1769797219000},"page":"514-524","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Injury epidemiology in an elite ballet school: a seven-season cohort study of 2121 medical attention injuries and 1656 time-loss injuries"],"prefix":"10.1136","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1538-9966","authenticated-orcid":false,"given":"Joseph W.","family":"Shaw","sequence":"first","affiliation":[{"name":"Faculty of Sport, Allied Health and Performance Science, St Mary\u2019s University Twickenham, London, UK"},{"name":"Ballet Healthcare, Royal Ballet and Opera, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2303-855X","authenticated-orcid":false,"given":"Niall","family":"MacSweeney","sequence":"additional","affiliation":[{"name":"Faculty of Sport, Allied Health and Performance Science, St Mary\u2019s University Twickenham, London, UK"},{"name":"The Royal Ballet School, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7707-2152","authenticated-orcid":false,"given":"Karen","family":"Sheriff","sequence":"additional","affiliation":[{"name":"The Royal Ballet School, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne","family":"Kitchener","sequence":"additional","affiliation":[{"name":"The Royal Ballet School, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3075-9101","authenticated-orcid":false,"given":"Charles R.","family":"Pedlar","sequence":"additional","affiliation":[{"name":"Faculty of Sport, Allied Health and Performance Science, St Mary\u2019s University Twickenham, London, UK"},{"name":"University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"2026032307450979000_60.7.514.1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-103817"},{"key":"2026032307450979000_60.7.514.2","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-199214020-00002"},{"key":"2026032307450979000_60.7.514.3","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-098418"},{"key":"2026032307450979000_60.7.514.4","doi-asserted-by":"crossref","first-page":"140","DOI":"10.12678\/1089-313X.19.4.140","article-title":"Epidemiological Review of Injury in Pre-Professional Ballet Dancers","volume":"19","author":"Caine","year":"2015","journal-title":"J Dance Med Sci"},{"key":"2026032307450979000_60.7.514.5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.ptsp.2022.10.001","article-title":"Injury epidemiology in pre-professional ballet dancers: A 5-year prospective cohort study","volume":"58","author":"Critchley","year":"2022","journal-title":"Phys Ther Sport"},{"key":"2026032307450979000_60.7.514.6","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-101969"},{"key":"2026032307450979000_60.7.514.7","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp265"},{"key":"2026032307450979000_60.7.514.8","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2023-107496"},{"key":"2026032307450979000_60.7.514.9","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102859"},{"key":"2026032307450979000_60.7.514.10","doi-asserted-by":"crossref","DOI":"10.1136\/bjsports-2016-096653","article-title":"The workload-injury aetiology model","volume":"51","author":"Windt","year":"2017","journal-title":"Br J Sports Med"},{"key":"2026032307450979000_60.7.514.11","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2024-108616"},{"key":"2026032307450979000_60.7.514.12","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2024-108233"},{"key":"2026032307450979000_60.7.514.13","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2015-095788"},{"key":"2026032307450979000_60.7.514.14","doi-asserted-by":"publisher","DOI":"10.1177\/146642409711700107"},{"key":"2026032307450979000_60.7.514.15","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-020-01411-8"},{"key":"2026032307450979000_60.7.514.16","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.jsams.2018.03.002","article-title":"The incidence, prevalence, severity, mechanism and body region of injury in elite junior Australian football players: A prospective cohort study over one season","volume":"21","author":"Lathlean","year":"2018","journal-title":"J Sci Med Sport"},{"key":"2026032307450979000_60.7.514.17","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1002\/tsm2.226","article-title":"In your shoes: A qualitative study on the perspectives of professional dancers and staff regarding dance injury and its prevention","volume":"4","author":"Bolling","year":"2021","journal-title":"Transl Sports Med"},{"key":"2026032307450979000_60.7.514.18","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.3893"},{"key":"2026032307450979000_60.7.514.19","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1089313X231174684","article-title":"Rehearsal and Performance Volume in Professional Ballet: A Five-Season Cohort Study","volume":"27","author":"Shaw","year":"2023","journal-title":"J Dance Med Sci"},{"key":"2026032307450979000_60.7.514.20","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1080\/02640414.2022.2051380","article-title":"The influence of exposure, growth and maturation on injury risk in male academy football players","volume":"40","author":"Johnson","year":"2022","journal-title":"J Sports Sci"},{"key":"2026032307450979000_60.7.514.21","doi-asserted-by":"publisher","DOI":"10.1002\/erv.888"},{"key":"2026032307450979000_60.7.514.22","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2014.5334"},{"key":"2026032307450979000_60.7.514.23","doi-asserted-by":"crossref","unstructured":"Hoenig T , Ackerman KE , Beck BR , et al . n.d. Bone stress injuries. Nat Rev Dis Primers 8. doi:10.1038\/s41572-022-00352-y","DOI":"10.1038\/s41572-022-00352-y"},{"key":"2026032307450979000_60.7.514.24","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520971782"},{"key":"2026032307450979000_60.7.514.25","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-015-3440-3"},{"key":"2026032307450979000_60.7.514.26","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2340\/16501977941116","article-title":"Self-reported musculoskeletal pain and discomfort in professional ballet dancers in Sweden","volume":"26","author":"Ramel","year":"1994","journal-title":"Scand J Rehabil Med"},{"key":"2026032307450979000_60.7.514.27","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1515\/folmed-2017-0087","article-title":"An Epidemiological Study of Non-specific Low Back Pain in Non-professional Female Greek Classic Ballet Dancers","volume":"60","author":"Angoules","year":"2018","journal-title":"Folia Med (Plovdiv)"},{"key":"2026032307450979000_60.7.514.28","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1016\/j.jbmt.2024.10.062","article-title":"Coping strategies for combating chronic pain among professional ballet dancers in Cali, Colombia. Qualitative study","volume":"40","author":"Alb\u00e1n-Reyes","year":"2024","journal-title":"J Bodyw Mov Ther"},{"key":"2026032307450979000_60.7.514.29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13102-022-00474-6","article-title":"Effect of low back pain on clinical-functional factors and its associated potential risk of chronicity in adolescent dancers of classical ballet: cross-sectional study","volume":"14","author":"de Souza","year":"2022","journal-title":"BMC Sports Sci Med Rehabil"},{"key":"2026032307450979000_60.7.514.30","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.3928\/00904481-20151215-01","article-title":"Assessing Readiness for En Pointe in Young Ballet Dancers","volume":"45","author":"Lai","year":"2016","journal-title":"Pediatr Ann"},{"key":"2026032307450979000_60.7.514.31","doi-asserted-by":"crossref","DOI":"10.1111\/sms.14502","article-title":"Jumping demands during classical ballet class","volume":"34","author":"Maloney","year":"2024","journal-title":"Scand J Med Sci Sports"},{"key":"2026032307450979000_60.7.514.32","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1080\/02640414.2023.2223048","article-title":"The development and validation of an open-source accelerometery algorithm for measuring jump height and frequency in ballet","volume":"41","author":"Shaw","year":"2023","journal-title":"J Sports Sci"},{"key":"2026032307450979000_60.7.514.33","doi-asserted-by":"crossref","first-page":"S242","DOI":"10.1123\/ijspp.2016-0334","article-title":"Managing the Training Load in Adolescent Athletes","volume":"12","author":"Murray","year":"2017","journal-title":"Int J Sports Physiol Perform"},{"key":"2026032307450979000_60.7.514.34","doi-asserted-by":"crossref","first-page":"2290","DOI":"10.1249\/MSS.0000000000002725","article-title":"Dance Exposure, Individual Characteristics, and Injury Risk over Five Seasons in a Professional Ballet Company","volume":"53","author":"Shaw","year":"2021","journal-title":"Med Sci Sports Exerc"},{"key":"2026032307450979000_60.7.514.35","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1093\/ajcn\/51.5.779","article-title":"Nutrition and the incidence of stress fractures in ballet dancers","volume":"51","author":"Frusztajer","year":"1990","journal-title":"Am J Clin Nutr"},{"key":"2026032307450979000_60.7.514.36","doi-asserted-by":"crossref","unstructured":"Shaw JW , Mattiussi AM , Brown DD . The activity demands and physiological responses observed in professional ballet: A systematic review. JSES 2021;5. doi:10.36905\/jses.2021.04.04","DOI":"10.36905\/jses.2021.04.04"},{"key":"2026032307450979000_60.7.514.37","doi-asserted-by":"crossref","first-page":"185","DOI":"10.2519\/jospt.2018.7542","article-title":"The Influence of Injury Definition on Injury Burden in Preprofessional Ballet and Contemporary Dancers","volume":"48","author":"Kenny","year":"2018","journal-title":"J Orthop Sports Phys Ther"}],"container-title":["British Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjsports-2025-109787","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T14:45:35Z","timestamp":1774277135000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjsm.bmj.com\/lookup\/doi\/10.1136\/bjsports-2025-109787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":37,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,3,23]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bjsports-2025-109787"],"URL":"https:\/\/doi.org\/10.1136\/bjsports-2025-109787","relation":{},"ISSN":["0306-3674","1473-0480"],"issn-type":[{"value":"0306-3674","type":"print"},{"value":"1473-0480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]}}}