Dance Injuries: Foot, Ankle, Hip, Back, Concussion and When to See a Pro

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It’s the third week of Nutcracker season. A teenage dancer rises onto pointe in the wings and feels it again: a pinch at the back of the ankle, sharp, the same spot as yesterday. She says nothing, because the show is in an hour and there’s no understudy. That moment, the pain you dance through because the show must go on, is where many dance injuries start. Dancers are athletes with an artist’s schedule. Every style loads the body differently, but research keeps pointing to the foot and ankle, hip, low back and knee. Here are the common dance injuries, what they feel like, what lowers the risk, and when to stop and see someone.

This page is general information, not medical advice. If you’re hurt, see a sports medicine doctor, a physical therapist (PT, ideally one who works with dancers) or a certified athletic trainer (AT). For the bigger picture, start at our dance hub.

How often dancers get hurt

A 2015 systematic review of ballet injury studies (more than 2,200 amateur and professional dancers) found about 1 injury per 1,000 hours of dancing for amateurs and 1.24 for professionals. Most were overuse injuries: 75% in amateur dancers. Lower-body injuries made up 66% to 91% of the total, and the foot and ankle alone 14% to 57%. In an international survey of 260 professional ballet and modern dancers, about half were injured at the moment they answered (54.8% of ballet and 46.3% of modern dancers), and more than 15% of injured dancers had not reported it. That last number matters most: dancers are trained to hide pain, and hidden injuries tend to grow.

Hip-hop styles look different. In a 2020 study of 146 hip-hop, popping, locking, house and breaking dancers, breakers had by far the most injuries (about 2.5 per 1,000 hours in the previous year, versus about 0.3 for the other styles combined), mostly to the arms and shoulders, then legs, trunk, and head and neck.

Foot and ankle

Posterior ankle impingement and os trigonum

Rising onto demi-pointe or full pointe takes the ankle into extreme plantar flexion (pointing the foot). In some dancers, a small extra bone behind the ankle, the os trigonum, or soft tissue in the same spot gets pinched at the back of the ankle. The typical complaint is pain at the back of the ankle when you relevé or point hard. In a study of 186 young trainee ballet dancers, 12 had posterior ankle pain and 6 of those had an os trigonum; 9 of the 12 did well without surgery. In two professional ballet companies followed over three seasons, ankle impingement and synovitis were the most common foot and ankle problems that sent dancers to the medical team, with pointe work and jumps the main causes in women. Pain behind the ankle can also come from the flexor hallucis longus (FHL) tendon, the “dancer’s tendon” that runs right next to it, so it needs a proper diagnosis.

Stress fractures

The American Academy of Orthopaedic Surgeons (AAOS) says the second and third metatarsals (the long bones in the middle of the foot) are the most common site of foot stress fractures and that ballet dancers are at particularly high risk. In pointe dancers, the base of the second metatarsal is a classic spot. The warning signs: pain that starts with activity and eases with rest at first, then comes sooner, plus tenderness in one spot or swelling on top of the foot. Stress fractures are also tied to fueling: the International Association for Dance Medicine & Science (IADMS) notes that dancers with low energy and low calcium intake have a relatively high rate of stress fractures. More on that on our dance nutrition page.

Ankle sprains, tendons and the big toe

Ankle sprains were the most common foot and ankle injury that actually kept professional ballet dancers out. IADMS lists FHL and tibialis posterior tendon irritation as common in dancers, along with Achilles tendon pain. For tendons, IADMS stresses load management rather than total rest: jumps and allegro are high load, barre and adagio low load, and the amount of each is adjusted while the tendon recovers.

Hip

Big extensions, développés and turnout ask a lot of the hip. AAOS says snapping hip comes mostly from tight muscles and tendons around the hip and that “dancers are especially vulnerable”, as are teens during growth spurts. In the ballet review, 58% of dancers in one study had a painful snapping hip. A review of hip problems in dancers, skaters and gymnasts found cartilage and labrum (the rim of the hip socket) damage and muscle injuries the most reported. A painless click is common; deep groin pain, catching or locking deserves a doctor’s look.

Low back

Low back pain is very common in ballet; one study in the 2015 review found 62% of dancers had lumbosacral pain. AAOS explains that young athletes in sports with repeated overstretching (hyperextension) of the lower back can develop spondylolysis, a stress fracture in a vertebra. Arabesques, cambrés, backbends and many acro tricks load the spine the same way. A teen dancer with low back pain that is worse when arching back, or that lasts more than a couple of weeks, should see a doctor rather than stretch through it.

Knee

In ballet, 29% of dancers in one study had pain around the kneecap (patellofemoral pain). A frequent cause is forcing turnout. IADMS explains that on average about 60% of turnout comes from the hip; dancers who force more turnout than their hips allow tend to roll in at the feet (“forcing the feet”), which stresses the inside of the knee and leg. ACL tears are less common but serious: in three Dutch dance companies, every ACL tear came from landing a jump on one leg in turnout with the knee collapsing inward.

Overuse in young dancers

IADMS describes the growth spurt (usually around ages 11 to 14, lasting 18 to 24 months) as a vulnerable time: bones grow before muscles catch up, so strength, flexibility, balance and turns can all get worse for a while, and growth plates near the knees and heels are easily irritated. Its advice to teachers is to cut back on jumps, center pointe work on one leg, hard lifts, kneeling and grand pliés during that period. Heel pain (Sever’s disease) and a sore bump below the knee (Osgood-Schlatter disease) are common in growing, active kids. For pointe, IADMS guidelines say not before age 12, and only for students with enough ankle range, strength, core control and at least two ballet classes a week. The American Academy of Pediatrics (AAP) recommends at least 1 to 2 days off a week from the main activity and 3 months off per year, in 1-month blocks. More on kids on our youth dance page.

Concussion in breaking, acro and partnering

Dancers do get concussions. A hospital case series of 11 dancers aged 12 to 20 found concussions from stunting, diving and flipping, drops during partnering, slips and falls, direct blows, and even repeated head whipping in choreography. Breaking, acro dance, cheer-style stunts and lifts are the obvious risks, but it can happen in any style. The CDC’s HEADS UP rule applies: if you think a dancer may have a concussion, remove them from dancing that day (“when in doubt, sit them out”) until a health care provider clears them.

Watch for (CDC): headache, dizziness, nausea, blurry vision, sensitivity to light or noise, feeling foggy, confusion, clumsiness, mood changes. Call 911 for the danger signs: one pupil larger than the other, a headache that gets worse, slurred speech, weakness or numbness, repeated vomiting, seizures, growing confusion, or loss of consciousness. The return is gradual, and the American Medical Society for Sports Medicine (AMSSM) says there’s no same-day return. Mats and trained spotters for tricks and lifts matter.

Prevention: what helps

• Strength outside class. IADMS says supplemental strength training can lead to better dancing and fewer injuries without hurting the dance aesthetic. See dance training.
• Respect your own turnout. Work from the hip, keep knees over toes, and don’t force the feet.
• Warm up properly, 15 to 20 minutes, with movement rather than long static stretches (IADMS).
• Manage load. Jumps and pointe add up. Big jumps in hours (performance weeks, intensives) are when tendons and bones complain.
• Eat enough. Low energy availability raises the risk of bone stress injuries.

Gear many dancers keep in the bag

None of these prevent injuries on their own, so ask your PT or teacher what fits you. But many dancers use gel toe protection like the Bloch Gel Toe Tube or Bloch Pointe Cushion against blisters and pressure in pointe shoes, a resistance band like the THERABAND Beginner Kit for foot and ankle strengthening, and a foam roller like the TriggerPoint GRID for warm-ups.

When to see a sports medicine doctor, PT or athletic trainer

• Right away (emergency): any concussion danger sign, a possible broken bone, a joint that looks out of place, or numbness and tingling.
• Within a day or two: you can’t bear weight or rise onto demi-pointe, a pop with swelling in the knee, a suspected concussion, or sudden sharp pain that stopped you dancing.
• Soon: pain in one spot on the foot or shin that’s getting worse, back pain when arching, hip pain with catching, pain at night or at rest, a limp in a child, or missed periods (a sign of low energy that also affects bones).

IADMS encourages teachers to offer modified class (no jumps, demi-pliés instead of grand pliés, floor barre) so injured dancers stay connected without delaying healing, and to aim for pain-free movement both during and after class. Recovery basics are on our dance recovery page; for how a team sport handles the same questions, see soccer injuries.

Dance injuries: FAQs

What is the most common injury in dance?

In ballet and most stage styles, overuse injuries of the foot and ankle lead, followed by the hip, low back and knee. A 2015 review found 66–91% of ballet injuries are in the lower body. Breakers are different: the wrist, shoulder and knee come up most.

What is os trigonum syndrome?

An os trigonum is a small extra bone behind the ankle that some people are born with. When a dancer points hard or rises onto pointe, it can get pinched, causing pain at the back of the ankle. Many dancers do well with non-surgical care; a doctor confirms it with an exam and imaging.

Can you dance with a stress fracture?

Not without a doctor’s plan. Continuing to jump and go on pointe on a stress fracture can turn it into a complete break. If you have pain in one spot on the foot or shin that’s getting worse, stop impact work and get checked; a doctor will also ask about eating and periods.

When can a young dancer start pointe?

IADMS guidelines say not before 12, and then only with enough ankle and foot range of motion, good alignment and core strength, at least two ballet classes a week, typically in the fourth year of training. Very flexible (hypermobile) feet often need extra strengthening first.

Do dancers get concussions?

Yes: from falls, dropped lifts, flips, collisions and even repeated head whipping. Treat it like any sport: remove the dancer, no return that day, and a health care provider clears the gradual return (CDC HEADS UP).

Is it OK to dance through pain?

Muscle soreness after a hard week is normal. Sharp pain, pain in one spot, pain that changes how you move, or pain that’s worse each day is not. IADMS suggests pain-free dancing as the guide, and more than 15% of injured professionals in one study hadn’t reported their injury. Tell your teacher and get it checked.