"The Show Must go on" : The Experience of Injuries Among Dancers: Fears, Thoughts, and Beliefs. A Qualitative Study

Overview

This qualitative, cross-sectional study aims at describing the experience of Italian dancers with injury. Dancers face a high risk of sustaining one or more injuries during their career (87-94%), which may lead to physical, psychological, and socioeconomic consequences affecting dancer's lives and careers both short and long-term. Dancers report fearing injury and its consequences and believing in the existence of a stigma around injury and injured colleagues; many of them also try to self-manage pain and delay reporting injuries to healthcare professionals, possibly making its outcomes worse. This study will collect data from dancers via focus groups and individual interviews, investigating dancers' experiences, thoughts, and beliefs about injury. Records from the interviews will be transcribed ad verbatim and analyzed using the framework method to synthetize the data and highlight the most meaningful content. Understanding dancers' thoughts and behaviors regarding past or possible future injuries may be beneficial in improving treatment efficacy and designing adequate education and prevention strategies. It may also help raise awareness of dancers' complex and unique needs, and the importance of having accessible, specialized professionals around dance companies and schools.

The dance world is a complex setting characterized by high injury risk, high competitivity, high prevalence of risk-taking behaviors, low socio-economic support and a cultural exaltation of sacrifice and pushing through pain and injury to go dancing. With the rapid development of dance medicine and science in the last few decades, it has been highlithed that dancers face a high risk of sustaining one or more injuries during their career, which often come with harsh physical, psychological and economic consequences. Recent studies show that a great number of dancers are afraid of injury and believe in the existence of a "stigma" surrounding injury and injured colleagues; those who stop dancing report feelings of isolation, insecurity and low confidence in full recovery. In addition to this, dancers often delay seeking medical attention and treatment when they suspect an injury and try to keep dancing through pain (ignoring symptoms, modifying their activity and/or using painkillers) or relay on non-medical specialist, possibly worsening the outcomes of said injury. There seems to be a negative halo surrounding injury, and also a mismatch between the high medical needs of the dance population and their healthcare-seeking behaviors. Research shows trends are slowly getting better in context where dance medicine is well developed and easily available to dancers, especially in larger dance companies, but there is still much to be done. This research aims to describe the experience of dancers with injury to understand the reasons behind their thoughts and behaviors. Untangling the complex dancer-injury-context relationship will help in in improving care delivery efficacy and designing adequate and specific education and prevention strategies. Collecting data from questionaires and semi-structured interviews, this study will investigate: * What is perceived as "injury" by dancers and what will mean for them to sustain an injury * How dancers cope with pain and behave when suspecting an injury * What dancers think of a colleague who has to stop dancing because of an injury, and what role their specific context (teachers, choreographers, caregivers) play in this * What dancers think will help in reducing injury risk and bargain, if they believe it possible * The functional status of dancers taking part in the interview, past or present history of injury, Dance Functional Outcome Score (DFOS) This research will employ qualitative methods to collect and analyze data, allowing in-depht exploration of dancers' opinions and experiences. Volounteer participants will be recruited from dance schools and companies in different locations around Italy. Focus group interviews will be arranged within small groups of dancers (4-8 at a time), accommodating participants in individual interviews if logistical or personal challenges arise. Anagraphic data and the DFOS will be collected by questionnaires prior to the interviews. The interviews will be sistematically recorded and transcribed ad verbatim to undergo the process of qualitative analysis using the framework method, allowing to extract the most recurrent themes and highlight meaningful insights. Results from this research may help in improving care delivery efficacy and designing adequate and specific education and prevention strategies, promoting dancers' physical and psychological well-being.