Cumulative Psychological Trauma, Emotional Regulation, and Orthopedic Injury in a Sample of Pre-Professional and Professional Dancers and College Athletes

OBJECTIVE: Strong evidence identifies cumulative trauma exposure and a history of childhood adversity as predictive factors for physical and psychological disorders. In this study, dancers and athletes were examined to determine the relationship among childhood adversity, cumulative trauma exposure, stress responses, and injuries (including the need for orthopedic surgery). METHODS: In this cross-sectional study, 287 pre-professional and professional dancers (n=185) and college athletes (n=102) participated. Seven self-report measures were completed. Descriptive statistical analyses were calculated, followed by a 2 x 2 multivariate analysis (MAN-COVA, age and gender were covariates): 1) dancer and athlete groups, and 2) participants who had orthopedic surgery vs no surgery. Stepwise linear regression analyses were calculated to predict cumulative injuries in multiple body regions. RESULTS: The MANCOVA result indicated that dancers and athletes shared similar cumulative injuries to multiple regions of their bodies. Compared to athletes, dancers were exposed to more childhood trauma and experienced more anxiety and emotional difficulties. Participants who underwent orthopedic surgery also had more cumulative trauma and injuries as well as more difficulty with emotional regulation. In both dancers and athletes, increased exposure to childhood and adult traumatic events were significant predictive factors associated with injury. CONCLUSION: Both dancers and athletes frequently perform within a culture that is pressured and promotes behavior that ignores pain and injury. It is recommended that coaches, educators, and healthcare workers understand the influence of cumulative trauma on risk for orthopedic injury and incorporate trauma-informed care.