Five Important Facts about Injuries in Indian Classical Dance

by Pranamya Suri, MD (Resident physician at University of California, Irvine) 

In a survey of musculoskeletal disorders among Indian dancers, dancers reported pain and past injury in the back (42.5%) followed by the knee (28.3%) and ankle (18.6%) as the most common sites. Stress was the most commonly perceived cause of injury (34.4%), followed by overwork (24.7%), tiredness (17.2%), and falls (13.5%).  Although there is increased awareness of Indian classical dance, there is a dearth of research on injuries and injury prevention in Indian classical dancers. Given the current circumstances, dancers are actually practicing more and utilizing their time to create more work, exciting work. More dance can mean more injury. Here are five important facts about injuries in Indian classical dance. These will help you be more conscious of your body biomechanics during this quarantine period and prevent injury.

• Warm-up exercises are performed by only 43.30% of Indian Classical dancers, whereas only 20% stretch after practice. Many dancers also continue to dance when they have a pre-existing injury.
• Repetitive practice without warm-up or rest leads to decreased time for wound healing, resulting in scar tissue formation, worsening range of motion, and causing pain over time.
• There high incidence of patellar chondromalacia (a cause of knee pain) among ballet dancers. Clippinger-Roberson attributes this to the plie. Aramandi is literally a sustained demi-plie. Although this needs more investigation, this condition is likely an important causative factor for knee pain in Indian classical dancers.
• While in Mandalam, the knees are flexed and there is excessive external rotation of the tibia (shin bone). In the knee joint, there are also two cushion-like menisci, which act as “shock absorbers” and dissipate force. Mandalam puts increased stress on the medial meniscus. Additionally, several fundamental steps are performed in this position with a twisting motion, increasing the chances of a meniscal tear. More on this later.
• One of the hallmarks of Kuchipudi is dancing on the rims of a brass plate towards the ending of a lengthy piece. Dancing on a plate requires additional proprioception skills. Improper biomechanics or practicing on surfaces with increased friction leads to increased stress on the menisci.

References:

 Proske U, Morgan DL. Muscle damage from eccentric exercise: mechanism, mechanical signs, adaptation and clinical applications. J Physiol. 2001;537(Pt 2):333–345. doi:10.1111/j.1469-7793.2001.00333.x