Elevated Prevalence Of Idiopathic Scoliosis In Elite Female Professional Ballet Performers

Musculoskeletal abnormalities have been previously reported among female professional ballet performers (PMID: 32079918, 35784521) and have been attributed to reduced energy availability, indices of disordered eating, and high training volumes. Factors such as low body mass (prevalent among female ballet performers) have also been attributed to adolescent idiopathic scoliosis (PMID: 24153169). PURPOSE: Characterize the prevalence of scoliosis (SCOLI) in a professional ballet company and to compare demographics, body composition, and bone mineral density (BMD) between those with and without criteria for SCOLI. METHODS: A retrospective analysis of total body Anterior-Posterior x-ray images taken by a licensed radiologist was performed on 49 elite professional female ballet performers (Age 16-38) from a single ballet company between 2016-2022. Body composition and BMD were assessed via DEXA. Criteria for SCOLI was defined via Cobb angle measurements >10 (Assessed in triplicate, Surgimap). Frequency of SCOLI was plotted against previously reported adolescent and adult general population norms. A t-test was used to compare demographics, body composition, and BMD between those with and without criteria for SCOLI (Significance set at p < 0.05). RESULTS (Figure): Ten of 49 performers (20.4%) were observed to have criteria for SCOLI (Cobb Major Curve: 29.1 ± 7.7 degrees | T4-T11 on average) which was observed to be 7-20% higher than published general population norms. Those with criteria for SCOLI were found to have reduced %body fat and fat mass compared to those without (p < 0.05).CONCLUSIONS: Female professional ballet performers demonstrate a heightened prevalence of SCOLI relative to the general population that may be attributable to factors such as reduced body fat commonly associated with reduced energy availability (known to impact) musculoskeletal health) in this, and other, elite female athlete populations.