Dance Medicine: Scoliosis, Male Dancers & Artistic Athletes
By: Embodia Team ∙ Estimated reading time: 8 minutes

What’s the backstage scoop?

Dance medicine is an emerging field with a surge of research in the past decade.  This is exciting, as dance is a highly popular physical activity around the world and dancers have a high incidence of injury.  These facts combine to inform clinicians that the care they can provide has come a long way from the days when a dancer was handed a generic lumbar protocol and sent on their way. But even as the field matures, gaps persist in how we screen, how we assess, and who we consider when we talk about dancer health at all.

This post draws from the curriculum of Assessing & Treating Dancers and Artistic Athletes – Level 2, an 8-week advanced course developed by Dinah Hampson, BA, BScPT, FCAMPT, RISPT, of Pivot Dancer. Let’s look at two of the course's topics so you can see just how interesting and applicable this course is for today’s outpatient clinician. The additional topics are introduced briefly — not because they matter less, but because a blog post has limits and the course doesn't!

Scoliosis in dancers

Adolescent idiopathic scoliosis (AIS) presents most commonly between ages 11 and 18, affecting roughly 1–4% of the general population.

What many clinicians might not know is that the incidence in dancers is significantly higher. The literature cites an incidence of 12% in male dancers and 20–24% in female dancers — making scoliosis a condition you should be actively screening for in this population, not waiting to encounter incidentally (Lambert B et al, 2025).

The reasons for this elevated incidence are still being unpacked, but the contributing factors include low BMI, delayed bone maturation, relative energy deficiency, hormonal influences, and biomechanical loading before skeletal maturity. That last point is particularly relevant in dance, where high training volumes begin early and the spine is subjected to repetitive asymmetric loading well before growth plates close.

Low back pain complicates the picture further. Research by Swain et al. (2017, 2019) found that LBP is the third or fourth most commonly reported pain site in dancers, with 49% of female dancers and 59% of male dancers reporting it. The prevalence in dancers is higher than in the general population and higher than in most other athletic populations. When you layer scoliosis onto that, the injury risk compounds: dancers with AIS have been shown to have overall injury rates of 59.6%, compared to 37.5% in non-scoliotic peers, and are approximately three times more likely to sustain injuries to the upper back, lower back, ankle, knee, and toe (Wong A et al, 2021).

In the final course session the evidence highlights artistic athletes in figure skating, artistic swimming, gymnastics, and diving. Up to 100% of divers report experiencing low back pain and you will see the overlap of population risk factors and training principles throughout the artistic world.

Scoliosis is not just a spinal issue. It's a whole-athlete issue.

What assessment looks like in practice

Early detection is the intervention that matters most. The Adams forward bending test remains the most practical screening tool for dance settings, with 94% sensitivity and 99% specificity for detecting AIS (Dunn J et al, 2018). It takes less than two minutes and can be built into routine pre-participation screening.

Beyond screening, managing scoliosis in a dancer requires understanding the interaction between the curve, the demands of the art form, and the individual's stage of skeletal development. Treatment approaches range from observation and monitoring, to scoliosis-specific strength training, to bracing. Surgery is indicated in fewer than 10% of AIS cases.

On the strength training front, an RCT by Monticone et al. (2014) found that scoliosis-specific strength training produced a 5-degree curve reduction in the intervention group, versus a 3-degree increase in controls. The program emphasized symmetry, strength through range of motion, and muscle balance, with specific attention to incorporating internal hip rotation ROM.

Bracing compliance remains one of the most challenging aspects of management in this population. The evidence supports a regimen of more than 18 hours per day prior to skeletal maturity to reduce curve progression and the likelihood of surgical intervention (Asada T et al, 2024). Patient satisfaction before bracing begins, is one of the strongest predictors of compliance — which means the clinician's role in counselling and coaching is as important as the brace itself.

What a professional dancer's experience can teach clinicians

Jordan-Elizabeth Long, Principal Soloist at Miami City Ballet, was diagnosed with scoliosis at age 12, braced at 13, and has had a celebrated professional career with a 41-degree spinal curve. Her experience — the challenges she navigated and the factors that enabled her success — illustrates something the literature can't fully capture: the interaction between structural differences, technical adaptation, and psychological resilience. A diagnosis of scoliosis doesn't foreclose a performance career. But it does require clinicians who understand the population well enough to support both the health and the artistry.

The male dancer and the application of performance testing to adjust training needs

Dance medicine has historically focused on female dancers. The research base, the clinical frameworks, and even the assumptions baked into injury screening tools reflect this. Male dancers have distinct injury profiles, distinct psychosocial stressors, and distinct performance demands — and they deserve clinicians who have actually thought about those differences.

Lifting mechanics and low back injury

One of the most defining physical demands for male dancers is partnering — specifically, lifting. The biomechanics of ballet lifts place substantial load on the lumbar spine, and the research is specific enough to be clinically useful.

Full press lifts generate significantly higher lumbar compressive forces than arabesque lifts, with mean compressive forces at peak shear exceeding 4700N — well above the NIH's recommended 3400N back compressive design limit (Alderson J et al, 2009). The most important modifiable variable is not the body mass of either dancer, but the horizontal distance between the male dancer and his partner at the moment of lift. A difference of less than 0.1 metres significantly increases peak lumbar anterior shear force. That makes lift technique, not just strength, a primary target for injury prevention work.

Performance testing and the data it reveals

One of the most significant advances in dance medicine is the availability of objective performance testing tools, particularly force plate technology. VALD ForceDecks is one provider of in-clinic technology that allows clinicians to assess countermovement jump performance, single-leg jump symmetry, landing mechanics, and reactive strength — all of which have direct relevance to dancer health and injury risk.

Research by MacSweeney et al. (2024), conducted on 255 pre-professional ballet students at the Royal Ballet School in London, found that high asymmetry in countermovement jump phases and single-leg jump height was associated with up to 69% higher injury risk over the following nine months. For male dancers specifically, left-leg dominant asymmetries were significantly associated with increased injury risk. Jump landing asymmetry is a modifiable risk factor and being armed with data makes a clinician’s job easier in communicating the value of training shifts with the performer. No force desks in your clinic? No problem, single-leg jump height can be assessed without force plates, making it accessible in most clinical settings.

The course walks through real sequential VALD testing data from a pre-professional male ballet dancer, demonstrating what a clinically meaningful pattern looks like in practice: a case where global strength improved over time but jump performance declined, pointing to a force-to-power transfer problem rather than a capacity problem. That kind of nuanced picture is only visible with objective data. Hear from the dancer directly how objective testing is helping him change his training.

What else the course covers

The two topics above represent two of the eight sessions. Here's what the rest of the curriculum addresses:

• Foundations & Advanced Assessment opens the course with hot topics in dance science, a live virtual assessment with a senior dancer, and a pointe shoe breakdown with professional fitter Kristin Ruggieri. It's a practical reset for clinicians who want to sharpen their eye before diving into the clinical content.
  
  
• Pelvic Health & Menopause in Performers is one of the most underserved topics in performing arts medicine. Brooke Winder, PT, DPT, OCS, Associate Professor of Dance at California State University Long Beach, leads the session alongside Heather Ogden, Principal Dancer with Canada's National Ballet, who provides a dancer's perspective on menstruation, pelvic health, RED-S, and hormonal transitions across a career.
  
  
• Foot Fractures in Dancers covers stress fractures, Jones fractures, Lisfranc injuries, and avulsion fractures through real case presentations from dancers who have lived them — including professional artists from the Indianapolis Ballet and the National Ballet of Canada. The focus is on return-to-dance decision-making, not just the acute management most clinicians already know.
  
  
• Mental Performance & Resilience brings in Lauren Ostrander McArdle, who holds a Master's in Sport and Performance Psychology and is a former soloist with the Sarasota Ballet. The session covers performance anxiety, perfectionism, fear of reinjury, and burnout — and gives clinicians practical tools they can integrate into rehabilitation immediately.
  
  
• Nutrition, Supplements & Recovery addresses what dancers actually need to fuel performance, with registered dietitian Sarah Power covering RED-D, supplementation, and injury prevention nutrition. Lindy Mesmer, artist with the Joffrey Ballet, contributes a dancer's perspective on the realities of fuelling a professional career.

Session 8: the panel that brings it all together

The final session of the course is worth highlighting on its own. As mentioned, week 8 expands the clinical lens beyond ballet and contemporary dance to address the full breadth of artistic athletic populations: figure skating, artistic swimming, gymnastics, and diving.

The athlete panel includes Journie Kalous Indianapolis Ballet and former American figure skater, Jacqline Simoneau, World Champion and three-time Olympian in artistic swimming; William Emard, Olympian in men's gymnastics; and Katelyn Fung of the Canadian National Diving team. The clinician panel features Emily Scherb PT, DPT — known internationally as "The Circus Doc" — Meghan Buttle, sport physiotherapist with Olympic Team Canada Figure Skating, and Katie Smith, sport physiotherapist with Olympic Team Canada Artistic Swimming.

The breadth of that room — athletes and clinicians across disciplines, at the highest levels of their fields — is what makes this session different from any single-discipline continuing education course. The recurring themes across artistic populations, and the places where each discipline diverges, are exactly the kind of clinical pattern recognition that takes years to develop independently. This course compresses it for the learner and offers quite a unique peek into these worlds at once.

Why this matters for your practice

Whether you currently work with dancers regularly or are building confidence in this population, the clinical picture is more nuanced than most general training prepares you for. Scoliosis prevalence is four to five times higher in dancers than in the general population. Male dancers have injury profiles and biomechanical demands that require dedicated clinical thinking. Pelvic health, nutrition, and mental performance are not adjunct topics — they are central to career longevity in this population. And objective performance testing is now accessible enough that data should be informing rehabilitation decisions.

Dance medicine is a field where clinical expertise, performance science, and genuine understanding of the art form have to come together. The dancers who land in your practice deserve care that meets them where they are.

Assessing & Treating Dancers and Artistic Athletes – Level 2 is an 8-week advanced course on Embodia, developed by Dinah Hampson, BA, BScPT, FCAMPT, RISPT, of Pivot Dancer. Course recordings are available for self-paced access following the live series.

Explore the course on Embodia →