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Dance induces physiological adaptations in children and adults, including bone remodelling, improved muscle strength and neuromuscular control, enhanced balance and flexibility, lower limb morphological adaptations and changes in body composition. However, it is also associated with a high incidence of musculoskeletal injuries, predominantly affecting the lower limbs, owing to overuse mechanisms such as sprains, muscle injuries, fractures, stress fractures and soft tissue damage. Growth periods, cumulative training load, technical constraints (eg, pointe shoes, specific footwear, hard surfaces) and individual factors such as joint hypermobility, low energy availability and low body mass index may increase injury risk, potentially affecting performance and quality of life. Acute injuries during professional performances are often recognised as work-related, whereas those sustained during training or rehearsals and chronic conditions related to prolonged practice lack occupational recognition. Emerging observations suggest that dance therapy may offer benefits for certain chronic musculoskeletal conditions, particularly fibromyalgia, although evidence remains limited. This narrative review synthesises the physiological adaptations to dance, the spectrum of dance-related musculoskeletal injuries, associated risk factors and the available data supporting dance as a non-pharmacological intervention. The findings reported herein should be interpreted in light of several limitations, including the narrative design, heterogeneity across studies, small observational samples, inconsistent definitions, potential publication bias and regional variability in practice conditions.<\/jats:p>","DOI":"10.1136\/rmdopen-2026-006937","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T07:30:11Z","timestamp":1782718211000},"page":"e006937","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Dance as a double-edged sword: physiological adaptations, injury risks and therapeutic potential"],"prefix":"10.1136","volume":"12","author":[{"given":"Andrea","family":"Hinojosa-Azaola","sequence":"first","affiliation":[{"name":"Department of Immunology and Rheumatology, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Renoult","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Bretagne Occidentale (Brest University), Department of Rheumatology and PHARES Unit (Pharmacy, Research, Epidemiology, Public Health, Occupational Health), CHU Brest, INSERM LBAI (U1227), LabEx IGO, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise","family":"Lam-Briand","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Bretagne Occidentale (Brest University), Department of Rheumatology and PHARES Unit (Pharmacy, Research, Epidemiology, Public Health, Occupational Health), CHU Brest, INSERM LBAI (U1227), LabEx IGO, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Pochart","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Bretagne Occidentale (Brest University), Department of Rheumatology and PHARES Unit (Pharmacy, Research, Epidemiology, Public Health, Occupational Health), CHU Brest, INSERM LBAI (U1227), LabEx IGO, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brice","family":"Lodde","sequence":"additional","affiliation":[{"name":"Occupational Diseases Center, pole PHARES (Pharmacie, recherche, \u00e9pid\u00e9miologie, sant\u00e9 au travail), CHU Brest, and ORPHY Laboratory, EA 4324, Brest University (UBO), Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8454-7067","authenticated-orcid":false,"given":"Alain","family":"Saraux","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Bretagne Occidentale (Brest University), Department of Rheumatology and PHARES Unit (Pharmacy, Research, Epidemiology, Public Health, Occupational Health), CHU Brest, INSERM LBAI (U1227), LabEx IGO, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,28]]},"reference":[{"key":"2026062900300702000_12.2.e006937.1","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1016\/j.ard.2025.07.012","article-title":"The shared debt of art and rheumatology","volume":"84","author":"Saraux","year":"2025","journal-title":"Ann Rheum Dis"},{"key":"2026062900300702000_12.2.e006937.2","doi-asserted-by":"crossref","unstructured":"Brandstetter G . 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