Injury Patterns in the Circus Arts

Injury Patterns in the Circus Art

The performing arts often entail a staggering display of acrobatic expertise which can place the musculoskeletal system under an intense amount of physical stress and increase the risk of injury.

It is essential to consider an individual’s level of experience and skill in acrosport and gymnastics before determining their ability to successfully perform complex maneuvers involving aerial stunts, diving and martial arts.

The execution of these acrobatic acts involves a significant amount of risk in terms of failed attempts leading to the individual falling or colliding during performance and sustaining serious injuries of the lower extremity.

While investigating injury patterns and rates among Cirque du Soleil artists over a period of 5 years, Shrier et al. noted that lower limb injuries were evenly distributed among performers, with the ankle and knee having the highest frequency of occurrence.

Ankle injuries were also found to be common in musicians, presumably from running on stage as part of an act or backstage during the show. These findings necessitate the formulation of preventative and rehabilitative strategies targeting the ankle and knee in order to protect the artist and reduce the overall number of incidences.

In an observational study conducted by David Munro, the Head Physiotherapist at the National Institute of Circus Arts (NICA) in Prahran, data was collected for 63 students who had visited the physiotherapy staff at the Institute for injuries sustained either during training or a show.

The most common mechanism of initial injury was observed to be acrobatics/tumbling which forms a large part of the general training programme provided by NICA to all students enrolled at the Institute.

The ankle was established as the most commonly injured body area, with the author noting that injuries to the ankle joint could easily occur during both high-impact acrobatic stunts and less high-impact activities such as falling off a high crash mat.

The extreme physical demands placed on the spinal structure during training and performance were reflected in the high proportion of spinal injuries, particularly lumbar spine injuries, reported by the students at the Institute.

As mentioned by Wanke et al. in their study on acute injuries in student circus artists, injury preventative programmes should provide for several aspects of an act since majority of the injuries incurred by these artists tend to be multifactorial in nature.

The authors elaborate the causes as being either endogenous in nature involving nutritional and training status, physical prerequisites and technical skills of the student or exogenous involving training plan, microclimatic conditions, lighting, partner and/or equipment.

Underlying foot postural disparities also need to be identified and treated in order to protect the individual from developing debilitating conditions of the foot or body that could potentially affect performance and limit movement.

In the event of an injury to the lower extremity, the use of MASS4D® customised foot orthotics would benefit the performance artist by providing an optimal level of support to the lower limbs in order to facilitate speedy recovery and promote pain-free ambulation during the rehabilitative phase.

The orthotics would also address any postural malalignments that could affect the functioning of the entire kinetic chain leading to reduced stress on the ankles, knees, hips and lower back – this helps in minimising the risk of injury and enforces normal functioning of these joints.

Related Links


  1. Munro, D. (2014) Injury Patterns and Rates Amongst Students at the National Institute of Circus Arts. Medical Problems of Performing Artists: December 2014, pp. 235-240
  2. Wanke, E. M., McCormack, M., Koch, F., Wanke, A., Groneberg, D. A. (2012) Acute Injuries in Student Circus Artists with Regard to Gender Specific Differences. Asian Journal of Sports Medicine: September 2012, Vol. 3, No. 3, pp. 153-160
  3. Shrier, I., Meeuwisse, W. H., Matheson, G. O., Wingfield, K., Steele, R. J., Prince, F., Hanley, J., Montanaro, M. (2009) Injury Patterns and Injury Rates in the Circus Arts. The American Journal of Sports Medicine: April 2009, Vol. 37, No. 6, pp. 1143-1149. DOI: 10.1177/0363546508331138 

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