Background: Achilles tendinopathy is a common and debilitating condition among female ballet dancers due to the large repetitive loading forces placed on their Achilles tendons during rehearsals and performances. Tendon health problems in females are exacerbated by a lack of understanding about how energy availability influences tendons. Ballet dancers, as aesthetic athletes, are vulnerable to low energy availability and can enter a spectrum disorder, relative energy deficiency in sport, that consists of low energy availability (with or without disordered eating), menstrual cycle dysfunction, and low bone mineral density (BMD). Aims: 1) To investigate the relationship between insufficient caloric intake and Achilles tendon health in pre-professional ballet dancers. 2) To evaluate if symptoms of relative energy deficiency in sport such as low BMD and menstrual irregularity can be matched with Achilles tendon structural damage in pre-professional ballet dancers. 3) To analyze if there is a relationship between BMD and nutrition in pre-professional ballet dancers. Methods: 30 pre-professional ballet dancers were recruited. Over the course of a 16-week training and performance period, the dancers underwent four ultrasound imaging sessions and two MRI sessions investigating their Achilles tendons. They also underwent one full body DXA scan and completed four ASA24 dietary recall surveys. The dancers additionally filled out questionnaires describing their menstrual history and current Achilles tendon health. At the end of the study, dancers were organized into calorie sufficiency groups (sufficient or insufficient). Results: Within both calorie groups, the Achilles tendon was significantly thicker at the end of the study as compared to the start of the study (p=.046). Within both calorie groups, echogenicity was significantly higher at the first two ultrasound imaging sessions than it was at the last two (p<.05). Additionally, the calorie sufficient group's tendons had a significantly higher echogenicity than the calorie insufficient group at the first two ultrasound imaging sessions (p<.05). There were significantly more dancers in the calorie insufficient group that experienced changes to their menstrual cycle (p=.007). Conclusion: Participants in the calorie sufficient group had significantly more hyperechoic tendons than those in the calorie insufficient group at the start of the study, and all participants saw a significant drop in tendon echogenicity halfway through the study. The results of this study suggest that a better understanding of how average caloric intake affects tendon health in dancers is necessary in order to help treat and prevent AT injuries in this dance population.
| Identifer | oai:union.ndltd.org:BGMYU2/oai:scholarsarchive.byu.edu:etd-11392 |
| Date | 22 April 2024 |
| Creators | Smedley, Annie G. |
| Publisher | BYU ScholarsArchive |
| Source Sets | Brigham Young University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Theses and Dissertations |
| Rights | https://lib.byu.edu/about/copyright/ |
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