The perils facing ballet dancers may be news to the public but not to the dancers and those who train and care for them. Dancers – arguably – have the highest injury rate of any competitive “sport.” The most common are ligament tears, strains, tendinitis, sprains, lower back inflammation, dislocations and fractures (usually stress fractures). Some of these injuries end careers.
The physical aspects of ballet involve unnatural movements such as turnout of the hips, dancing on the toes in pointe shoes and twirling jumps, all of which put enormous strain on their bodies. One study showed that two-thirds of elite college dancers reported new injuries in the first semester. The British Medical Journal reported an even higher rate of injury. For decades, sports medicine experts have been fruitlessly searching for a way to reduce these injuries.
On top of the ever-present injury peril, ballet dancers must navigate a narrow passage between Scylla and Charybdis (two monsters Odysseus had to navigate between), that being between the slim beautiful persona of a dancer and the heavier nutritional needs of their bodies. Most dancers believe they must be thin to succeed, but they must eat to live. So, they navigate this passage by eating much less than their bodies need. Eating disorders are very common among dancers, but there is no satisfactory way to know how common it is as dancers often conceal it.
The hours competitive dancers practice are incredible. Professional ballet dancers usually practice with their coach in the studio every day for up to eight hours, often six days a week. They may practice more when they get home, stretch, go over choreographs, and often supplement their fitness regimen with cardio. On top of this, they can perform up to six times a week, each show lasting two to three hours. All this time, they are at risk for injuries, including career ending injuries.
Enter Professor Matthew Wyon, of the Institute of Sport and School of Performing Arts at the University of Wolverhampton in the UK. For ten years he has been shouting that there is something that will help dancers, but shout as he may, either no one is listening, or no one believes him. Several years ago, in a little noticed paper, he discovered ballet dancers have very low vitamin D levels, especially in the winter when injury rates double compared to summer. So what?
OK, so what, everyone is low. Wyon then conducted a randomized controlled trial (RCT) giving vitamin D to half the dancers and a placebo to the others. Incredibly, his research team found vitamin D significantly increased the dancer’s muscle power and jump height! In addition, he found the dancers who supplemented with vitamin D had only half the injuries of the dancers taking the sugar pill.
Last week, Wyon published larger study,, another RCT, which confirmed his earlier findings on injury but showed a greater protective effect against injuries. The dancers who took D had a 10% injury rate over four months compared to 30% in the sugar pill group.
Now this may surprise dance aficionados, but it came as no surprise to other sports medicine specialists. That’s because in 2009, a seminal paper in the flagship journal of American College of Sports Medicine presented the first evidence in the Western literature that vitamin D would both reduce sports injuries and modestly improve athletic performance. Why do you think the Russians and East Germans routinely irradiated their elite athletes using vitamin D producing sunbeds from the 1950s to the 1980s?
Since the 2009 paper, almost 200 publications have studied various aspects of vitamin D and sports with varying results. Perhaps most interesting were studies of NFL players that found players with higher vitamin D levels were significantly more likely to make the team. Last month, researchers reported the same thing for players trying out for the NBA and found the relationship was graded which suggests cause and effect. But most professional athletes were downing the vitamin D before these studies. The rumor is the Chicago Blackhawks began widespread D supplementation a year before their miraculous ascent from last place to winning the Stanley Cup.
So, it’s time to give something back to these incredible dancers who have given us so much pleasure. It’s true that future research may show D doesn’t help, but that is always true. But then again, future research may show it helps. The dipositive fact is that vitamin D is incredibly safe, so there is simply no down side to giving it to dancers. Let’s try to reduce dancer’s high injury rate now, not next decade.
John Cannell, MD. How vitamin D supplementation may benefit competitive dancers. The Vitamin D Council Blog & Newsletter, 2018.