Ballet dancer's turnout and its relationship to self-reported injury

Study Design: Retrospective cohort study. Objectives: To compare the relationship between the degrees of turnout, passive hip external rotation range of motion, and self-reported history of low back and lower extremity injury in ballet dancers. Background: Ballet dancers are encouraged to externally rotate their lower extremities (turnout) as far as possible. This may cause stress on the dancers' low back and lower extremities, putting them at risk for injury. Methods and Measures: Thirty college-level ballet dancers and instructors were evaluated. Each participant completed an injury questionnaire that placed the participant either in a group with a self-reported history of low back and lower extremity injury or in a group without a self-reported history of low back and lower extremity injury. Each dancer's first-position turnout and passive external rotation range of motion for both hips were measured. The comparison between each dancer's first-position turnout and the measured hip external rotation range of motion was called "compensated turnout." A 2-sample t test was used to determine if the average compensated turnout was significantly different in the injured and noninjured groups. Results: The mean (+/-SD) compensated turnout values for the injured and noninjured groups were 25.4degrees (+/-21.3degrees) and 4.7degrees (+/-16.3degrees), respectively. This difference was significant at P = 0.006. Conclusion: Based on a self-reported history of low back and lower extremity injuries, ballet dancers have a greater risk of injury if they reach a turnout position that is greater than their available bilateral passive hip external rotation range of motion.