Overhead Pressing and Lumbar Injuries in Male Ballet Dancers
There is no area of dance that calls for a strength and conditioning approach to performance enhancement and injury prevention more than the repetitive and potentially injurious overhead pressing movement male ballet dancers are called upon to execute. Progressively overloaded, properly executed overhead lifts serve both the purpose of allowing male dances to lift more load more often (performance) and also prevent injury to the lumbar spine by cueing solid alignment and safe lifting technique (injury prevention).
A 2006 10-year study on ballet injuries indicated that “The most common locations of injury were foot and ankle and the lumbar spine, with the three most common diagnoses making up greater than a third (37%) of the total.” Male dancers, furthermore, “are at a higher risk of lower back injuries, given the amount of lifting they perform,” according to the same study.
A separate 2009 study attempted to evaluate risk factors for low back injuries in male ballet dancers and found “The distance between the male dancer and ballerina at the beginning of the lift appears to be a highly sensitive predictor of [peak lumbar anterior shear force],” or PLASF. PLASF is known to be a “predictor” of lower back injuries, according to the same study.
Taken together, these studies make a forceful argument for building stronger male ballet dancers who know how to lift overhead well. There are two parts to lifting overhead properly. First, an athlete must be physically strong enough to lift a load overhead. I’ve watched regional dance companies employ male dancers obviously not strong enough to be executing overhead lifts, which not only puts the male dancer himself at risk for low back injury but also his female dance partner. Second, athletes must be taught how to lift overhead properly without borrowing range of motion from the lumbar spine.
Athletes in any sport must be coached through all of these movements well, because loading a dysfunctional movement pattern eventually could be as injurious as lack of strength. One of the more interesting details in the 2009 study is the connection between moment arm length and injury potential. In physics, the moment arm represents the distance between the “line of action of the force to the fulcrum,” according to the Essentials of Strength Training and Conditioning. Think about it this way, if you’re trying to pick up a heavy box, it’s a lot easier (and safer for your back) to pick it up if it’s closer to you than if it’s farther away. We understand this intuitively, but we don’t often consider that this is because of the relationship between the fulcrum and the moment arm.
So how can male ballet dancers learn to lift well while keeping his female partner as close to his body as possible? By lifting an external load like a dumbbell, kettlebell, or barbell. Strength training allows him to pattern this overhead movement in a controlled, progressively overloaded setting. Once he steps into the rehearsal season, his shoulders, back, hips, and arms are ready for the rigors of difficult choreography.
Early in a male ballet dancer’s off-season, it might be wise to avoid strict overhead pressing in order to give the athlete a break from the rigors of performance. Pressing alternatives like landmine presses are great for maintaining deltoid and tricep strength, patterning good serratus anterior recruitment, and grooving healthy movement of the scapula on the ribcage.
As the off-season progresses and the dancer has healed from the performance season, strict overhead pressing movements like half-kneeling dumbbell overhead presses, strict barbell presses, and strict dumbbell overhead presses can be introduced. Once solid realignment and strength foundations have been developed, male ballet dancers should progress on to power movements like barbell push presses and kettlebell clean and push presses. The kettlebell clean and push press is a great tool for combining the movements of hip flexion and extension with overhead pressing in a controlled environment.
Male ballet dancers aren’t much different than other athletes who must lift heavy things above their heads. They need to be strong enough to do what they do and well-coached enough to do what they do safely. Strength training offers an invaluable tool for achieving both goals simultaneously.