Fatores de risco para lesões que acometem o complexo articular do tornozelo e pé em bailarinos

Abstract

Introduction: The demand imposed on the musculoskeletal system during the performance of classic ballet movements can be high and to require dancers to rave physical and physiological characteristics similar to professional athletes, in terms of aerobic and anaerobic capacity, muscles, flexibility and joint stability. This high demand associated with an inadequate capacity of the dancers can cause the diverse injuries ligaments, muscles, bones and joints. The majority of research has shown the ankle-foot complex (AFC) as the most commonly injured in dancers.The injuries in AFC are responsible for great part of the removals in dance.The inquiry of the risk factors related to the development of these injuries can be useful to and rehabilitation processes. Objective: To conduct a critical review of literature in order to the factors related to the development of the main pathologies of AFC in dancers: stress fracture of the metatarsal region, Aquiles tendinopathy, ankle sprain and posterior and anterior ankle impingement. Methodology: A literature researchwas performed with Pubmed, Scielo and Lilacs in the period of April to August of 2011. The keywords used were: dances (dança), classic ballet (bale clássico), injuries (lesões), foot (pé) and ankle (tornozelo). The research was carried out without data limit and in the Portuguese and Englishlanguages. Results and discussion: In accordance to the bibliographical survey, it was possible to perceive that the risk factors of the main injuries evidenced in dancers are several. The maintenance of the positions of pointe and demi-pointe, as well as of the position of maximum external rotation of the lower limb with extreme subtalar pronation can predispose de development of some injuries of the AFC. The performance of repetitive movements, in extremes of range of motion and at a reduced base of support are also factors that can generate some musculoskeletal skeletal. Moreover, some studies indicate that alterations in foot alignment, presence of inadequate flexibility and stiffnes of triceps surae, low body mass index and modified hormone levels of leptine are causes of some pathologies of the AFC. Finally, the waste of pointe shoes, the very rigid surfaces of training and the inadequate way to tie ribbons of pointe shoes are also considered risk factors. Conclusion: Environmental, anatomical, biomechanicals, nutritional, hormonale, technical and physical factors contribute to the occurrence of the main injuries in the AFC. The identification of these factors can assist the development of preventive programs in this population, which can make possible a bigger permanence of the dancers in the dance company.