Influence of turnout on foot posture and its relationship to overuse musculoskeletal injury in professional contemporary dancers: A preliminary investigation

Background: The angle of turnout is thought to predispose professional dancers to overuse musculoskeletal injuries of the lower limb; yet, the influence of angle of turnout on foot posture is currently unknown. Methods: Twelve professional contemporary dancers (five women and seven men; mean age, 26.8 years) were recruited. The angle of gait and angle of turnout were measured using a quasi-static clinical tracing method. Foot posture was assessed in the base of gait and angle of turnout using the Foot Posture Index. Each dancer completed a dance history and injury questionnaire. Results: The results show a tendency toward a pronated foot posture (mean, 9°) in the angle of turnout position. A significant relationship was noted between the Foot Posture Index and angle of turnout (ρ = 0.933-0.968, P <.01) and between the number of reported injuries and change in foot posture in the angle of turnout (ρ = 0.789, P <.01) (right foot only). Twenty-eight injuries were reported; male dancers experienced a mean of 2.8 injuries and females a mean of 1.6 injuries. An inverse relationship was noted between age at training initiation and total reported injuries (r = -0.867, P <.01). All of the dancers reported a history of injury to the spine or lower limb, and 9 of the 12 reported an injury within the previous 12 months. Conclusions: Turnout is one of the most fundamental aspects of dance technique. This study suggests a trend toward pronation in angle of turnout and a link to lower-limb musculoskeletal injury.