Six weeks of intensive rehearsals for the Swan Lake ballet shows ultrasound tissue characterization changes of the Achilles tendons in dancers

Charlotte Anker-Petersen*, Birgit Juul-Kristensen, Jarrod Antflick, Henrik Aagaard, Christopher Myers, Anders Ploug Boesen, Eleanor Boyle, Per Hölmich, Kristian Thorborg

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

The objective was to investigate, first, whether six weeks of intensive ballet dance exposure is associated with structural and clinical changes in the Achilles tendon; second, the importance of demographics, self-reported Achilles pain, and generalized joint hypermobility (GJH). Data were collected at baseline and at six weeks’ follow-up, using Achilles tendon ultrasound tissue characteristics (UTC) as primary outcome (percentage distribution of echo-type I–IV: type I = intact and aligned bundles, type II = discontinuous/wavy bundles, type III = fibrillar, and type IV = amorphous cells/fluid). Secondary outcomes included clinical signs of Achilles tendinopathy, Achilles tendon pain during single-leg heel raise, self-reported symptoms (VISA-A questionnaire), and GJH. Sixty-three ballet dancers (aged 18–41) participated. From baseline to follow-up, UTC echo-type I decreased significantly (β = −3.6, p = 0.001; 95% CI: −5.8;−1.4), whereas echo-type II increased significantly (β = 3.2, p < 0.0001, 95% CI: 1.6;4.8). Furthermore, a significant effect of limb (left limb showed decreased echo-type I and increased echo-type III + IV) and sex (women showed decreased echo-type I and increased in type II) was found. No significant changes in the remaining secondary outcomes were found. Ballet dancers showed structural changes in UTC, corresponding to a decreased echo-type I distribution after six weeks of rehearsing for Swan Lake ballet. No changes in self-reported symptoms, clinical signs of Achilles tendinopathy, and single-leg heel raise test were seen from pre- to post-rehearsal. Thus, UTC changes in the Achilles tendon seem to appear earlier than clinical signs of tendinopathy.

Original languageEnglish
JournalScandinavian Journal of Medicine and Science in Sports
ISSN0905-7188
DOIs
Publication statusE-pub ahead of print - 18. Aug 2021

Bibliographical note

Publisher Copyright:
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Keywords

  • dance
  • diagnostic imaging
  • physical activity
  • tendinopathy

Fingerprint

Dive into the research topics of 'Six weeks of intensive rehearsals for the Swan Lake ballet shows ultrasound tissue characterization changes of the Achilles tendons in dancers'. Together they form a unique fingerprint.

Cite this