Updated 1/8/2025

In our work with youth artistic athletes, we’ve seen an uptick in concussion reported because dancers and families are recognizing that it is a medical concern.

Healing from and managing concussions are a different story than a muscle, ligament, or tendon injury. It’s often misunderstood and therefore not addressed in the best way it could be – it’s not going to “feel” like you’re injured, often the most significant symptoms don’t come on until later, and you might be feeling these symptoms for weeks.

Returning a dancer to a high level of training and performance is about communicating expectations, physical and mental load management, and listening to the body.

What is a Concussion?

• Due to traumatic impact, the brain tissue is stretched and impacted abnormally. Because of this sudden impact and high load, it can result in chemical imbalances that may take varied time to resolve. As a result, there is also a decrease in blood flow to the brain, which affects function and healing.
• It is possible to have a concussion *without* direct head impact or trauma.
• Whiplash injuries are also commonly seen. Not all whiplash injuries result in a concussion, but all concussion injuries will have a component of a whiplash injury.

Consideration for Families and Educators

• Concussion symptoms may present a few days later. Adrenaline and other flight or fight responses may mask initial concussion symptoms and dancer may feel “ok to dance” and report as such with minimal difficulty.
• “No two concussions are alike, and it is inappropriate to compare recovery times between concussed individuals. While many concussed late-adolescent dancers tend to become symptom-free and return to dance within two to three weeks after injury, many factors can influence recovery. 
• Some dancers may experience post-concussion syndrome – prolongation of symptoms past a usual anticipated time for recovery with often significant impairment in social interactions, ability to attend to school or work duties, and return to even basic levels of dance activity.

How Does It Happen in Dance?

• Many dance-related concussions are due to a recognized blow to the head as caused by a fall, contact with props or other dancers, or difficulties with partnering. 
• However, dance-related concussions may occur without a single particular head impact. Aggressive turning or head inversions and movements combined with high-speed chest or back impact with the floor or other dancers can lead to rotational or deceleration (whiplash) concussion injuries.
• Beyond dance, concussions/whiplash injuries can also occur with car accidents, accidental collisions,

What Might We See or Hear?

• Confusion
• Headache
• Vision disturbances (double or blurry vision)
• Dizziness or imbalance
• Nausea or vomiting
• Memory loss
• Ringing ears
• Difficulty concentrating
• Sensitivity to light
• Drowsiness
• Trouble falling asleep

May Need Visit to ER if:

• Severe or worsening headache
• Monitor the athlete for 2-3 hours without sleeping – if they are drowsy and cannot be awakened.
• Decreased level of consciousness >2 hours after injury
• Emotional, irritable, abnormal behavior
• Weakness or tingling in extremities
• Difficulty with balance and speech
• Nausea and vomiting
• Memory loss

How do we treat concussions at DANCE|PREHAB?

1. Calming down and reorienting muscle awareness
   • Concussions often present with whip-lash like symptoms. Often, shoulder muscles and necks muscles can overprotect, thus causing stiffness and other symptoms. In any rehabilitation involving the neck, we always look below to the shoulder blades and mid-spine.
2. Consistent monitoring
   • Is there consistent difficulty with balance and coordination? Symptoms may still present (up to 1 month).
   • Do they experience or complain of sensitivity to studio/stage lights and loud music in class or performance?
   • Even prolonged conversations or activities that require focus can seem tiring or taxing.
     
3. Communication, communication, communication.
   • Recovery times can differ based on age!
     • 7–10 days for college athletes
     • 14–21 days for high school athletes
     • 28–35 days for middle school athletes
   • EVERY CONCUSSION IS DIFFERENT.
     

the DANCE|PREHAB perspective.

Concussions are no joke and unfortunately many dancers do not get the help they need because its’ misunderstood. Because of this, many dancers also suffer additional neck, shoulder, and midback issues and pain which limit their ability to perform their best. As mentioned, concussions are the “invisible injury” because often, it doesn’t feel like a soft tissue (muscle, ligament, tendon) injury, and triggers may differ from dancer to dancer. If you or your dancer is suspected of having experience a concussion, please contact your health care provider to gain clarity to ensure a safe, informed, and proper return to dance process!

How can we help?

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Citations:

• Russell, J. A., McIntyre, L., Stewart, L., & Wang, T. (2021). Concussions in Dancers and Other Performing Artists. Physical medicine and rehabilitation clinics of North America, 32(1), 155–168.
• Robin L. Kish & Chris G. Koutures (2016) The Invisible Injury: Supporting the Recovery of Dancers with Concussions, Journal of Physical Education, Recreation & Dance, 87:8, 27-33
• Dance/USA Task Force on Dancer Health. Tips on concussion for dancers. Dance USA Informational Papers. 2019.
• Ojofeitimi, S., McIntyre, L., Barchi, E., Rae, S. S., Winnitoy, B., & Russell, J. A. (2024). Guidelines for returning to dance following concussion: Adaptations from sport concussion literature. International Journal of Clinical Practice. https://doi.org/10.1155/2024/1449433