IADMS Conference: From Seattle to Basel

by Helen Laws, Manager, National Institute of Dance Medicine and Science

With this year’s International Association for Dance Medicine and Science (IADMS) conference fast approaching in October and taking place relatively locally in Basel, Switzerland, I thought I’d give you a little reminder of what these conferences are all about while there’s still time to book!

The IADMS annual meetings are invaluable to anyone interested in dancers’ health, wellbeing and performance. They are the place to find out about the latest research and best practice from dance medicine and science practitioners working with dancers worldwide. During several packed days, there are a wide range of professional development and networking opportunities, including clinical symposia, movement sessions, round table discussions and research presentations.

Helen Laws, Claire Hiller and Marijeanne Liederbach

Last year’s conference in Seattle opened with an honest and witty keynote address from Peter Boal, Artistic Director of Pacific Northwest Ballet. He spoke about the important role that healthcare practitioners had played during his dancing career, and gave a moving account of his depression when injured: “we are dancers and then suddenly we are nothing”.

It was inspiring to have someone speak so openly about their personal experiences and demonstrate a real understanding of the needs of dancers. Boal also acknowledged that his company had responded to dance science research showing the toll of a heavy schedule, by reducing the number of performances from eight to no more than seven per week.

James Garrick MD gave a fascinating insight into the history of injury prevention. We heard how rule changes and improvements in sports equipment and sports medicine followed large-scale studies. For example, when it was shown in American football that a particular type of boot caused significantly more injuries than another, the shoe was outlawed. Another study showed how bracing and taping significantly reduced repeat ankle sprains.

Listening to a number of such stories, some common themes emerged:

  • epidemiology is necessary to fully understand injury risk factors in any given environment and plan effective prevention strategies
  • where action was taken and necessary changes implemented, the injuries prompting this tended to have been extremely serious and/or numerous ie. with a high cost
  • for changes to be taken on board by athletes and coaches, they need to be implemented and enforced by governing bodies (and not left to individual choice)

This gave lots of food for thought for the dance world, which doesn’t have an overarching governing body and is reliant on voluntary compliance with best practice recommendations! Dr Garrick also made the point that although studies in dance have shown that comprehensive injury management programmes reduce recurrent injuries, there are as yet no studies demonstrating effective prevention of overuse injuries in any activity, and that large numbers of participants are needed to explore this effectively. The National Institute of Dance Medicine and Science is trying to change this and is currently fundraising to undertake large-scale epidemiological research with dance companies and colleges in the UK.

Later on Marijeanne Liederbach presented ‘Assessing and reporting dance capacities, risk factors and injuries: recommendations from the IADMS Standard Measures Consensus Initiative’. This was, in effect, a response to the ‘call to action’ implied by Dr Garrick. Recommendations for methods the dance world should use when collaborating on injury epidemiology research were given, and delegates had the opportunity to attend a subsequent extended round table session to explore the implications.

Fatigue is well known to be an injury risk factor so it was interesting to hear from researchers looking in detail at how dancers’ biomechanics are affected by it. Liederbach presented a very clear, well-designed biomechanical study,

‘A comparison of landing biomechanics between dancers and athletes: effect of fatigue’.

This showed that dancers took twice as long to reach a state of fatigue than athletes, but both groups’ landing biomechanics change similarly when fatigued, with worse alignment than in the non-fatigued state. The study suggests that there may be something to learn from how dancers train that enables them to jump efficiently for longer.

Dance UK’s Healthier Dancer Programme Manager, Niamh Morrin, presented ‘A kinetic and kinematic assessment of relevé in a non-fatigued and fatigued state’. Showing a lateral and posterior shift of pressure in the foot when fatigued, her research demonstrates how this can contribute to foot and ankle injury.

A large amount of dance research so far has been with ballet dancers, and to a lesser extent with contemporary and modern dancers. It was therefore great to see some presentations exploring ballroom and Latin dance.

Dr Patrizia Melchert suggested that dancers, trainers and medical professionals lack awareness of the risk of overuse injuries in dancesport genres. Her research showed that 58% of dancers suffered from painful foot conditions, with women experiencing higher levels of pain than men. Lesions of the metatarsophalangeal sesamoids were the most common causes, possibly as a result of wearing high-heeled shoes or having insufficient warm-up.

I know of quite a number of dancers that have needed hip surgery, particularly towards the end of or following their performing careers. I was therefore fascinated by Jason Brockwell’s presentation entitled ‘The dancer’s hip’.

IADMS delegates in a movement session. Photo: Jake Pett

He stressed that most important when dealing with hip pain is to establish whether it originates in the hip or elsewhere. For him, x-rays are the most useful investigative tool in diagnosing common dancer hip problems, namely Femero-Acetabular Impingement (FAI) and acetabular displasia. This was good to note as x-rays are less expensive than some other more routinely-used investigations. If in doubt about a diagnosis, Brockwell recommended trying a local anaesthetic hip joint injection to see if this causes pain to diminish. This can be used to establish whether pain originates in the hip or not.

Brockwell also talked about the treatment of FAI using arthroscopy and suggested that dancers could hope for five more years performing after this kind of surgery. If all dancers faced with hip problems sought, and were provided with, such a clear and thorough overview of potential causes, diagnosis, treatment and rehab options as given here, they would no doubt be much reassured.

Finally, one of the most significant benefits of attending the IADMS annual meeting comes as a result of the networking events and discussion forums, both formal and informal. Being part of the ‘standardisation’ round table in Seattle was particularly useful for me. After some healthy debate it became clearer where international colleagues agree on injury surveillance methods and what the next steps should be in order to build further partnerships.

Originally published in Dance UK  magazine, Issue 88 – Autumn 2014