Pole Dance Research Recap:

A narrative review of pole dance physiology and injury research


Since the modernisation of pole dancing in the late 90’s/early 00’s, there has been a growing thirst for knowledge and information surrounding this art form. For many years there was a slow but steady drip of opinion pieces and research published on the sociological, psychological and cultural aspects of pole dancing (i.e feminism, sexuality and stigmas associated), but a significant lack of research published on the physiological demands of the sports and injuries that may occur.


Well, it’s time for the pole dancing nerds of the world to rejoice! Over the past 4-5 years there has been a scattering of articles published on this topic and my top-secret sources tell me there’s even more on its way!


So what we thought best to do is to round up what’s currently out there in the literature and talk through them all, with an aim to provide 6-12 monthly research updates along the way!


Disclaimer: Pole dance research is still very much so in its infancy. As such, each study has multiple limitations. To ensure we’re getting the full picture we’ve included them in our discussion below!


Let’s first break down the research that talks about the physiological demands of pole dance. Not going to lie, we’re about to get super nerdy, so stay with us here!


1. Pole dancing for fitness: The physiological & metabolic demand of a 60-minute class.

Lead author: Dr Joanna Nicholas (2018).


Before we dive into this article, we just want to take a moment to chat about the lead author of this article. The OG of pole researchers, Dr Joanna Nicholas, is not only the first ever researcher to complete her thesis in pole dancing psychology, physiology and injuries, but has legitimately led the way for so many more researchers to complete their studies. So for that, we salute you @drjoannanicholas! If you’re a science and pole nerd like us, make sure you’re following her on socials to stay up to date on all her upcoming pole research!


In this article, Dr Nicholas and her team were finally able to provide quantitative evidence to all those claims made over years about how beneficial pole dancing is. This was the first study to our knowledge that has measured physiological and metabolic demands of a 60-minute standardised pole class.


By assessing a range of physiological values (mean heart rate, rating of perceived exertion, energy cost, oxygen consumption, and blood lactate) of 14 advanced level biological female polers over 3 x 60-minute pole classes, Dr Nicholas and her team were able to classify pole dancing as a form of moderate-intensity cardiorespiratory endurance exercise per the American College of Sports Medicine Guidelines (required intensity of between 2.0-5.9 METs).


This might not seem like a big thing for some because we already know just how hard pole dancing is. But this was the first ever study that quantified exactly how hard pole is to the rest of the world! And it supports the argument that pole dance is a legitimate exercise form and when performed 5 days a week for greater than 30 minutes at a time we are likely meeting our required adult exercise needs to improve health and cardiorespiratory fitness.


Furthermore, this study confirmed classes with a greater dance/routine-based focus expend more energy than stand-alone trick classes. So for individuals seeking elevated intensity of training and energy expenditure, routine-based training is recommended.


Every study has limitations because it’s hard for research to mimic the exact demands of real-world situations. The main limitations to this study are:

  • Small sample size of 14 participants

  • The classes were run for an advanced level - results may differ considerably between different teachers, studios and levels.

  • Skills training and routine/dance training were completed consecutively in all classes. Classes which focus solely on tricks or dance may elicit a different overall result.

  • There may have been a learning effect over the three classes which could in theory reduce difficulty and intensity of the class for the participant.

  • This study focused on the short-term metabolic responses to the demand of a standardised 60-minute pole dance class. Randomised longitudinal research is required to confirm long-term health benefits


2. Biomechanics and physiology in top level pole dancers: A case study

Lead Author: Bruno Ruscello (2018)


This article is a smaller case study that aimed to look at the biomechanical and physiological demands of pole dancing in elite level dancers. We view case studies as the lower end of high-quality evidence in the medical/research world as they usually focus on a very select group of people and the results lack generalisability to the pole population. However, they are always a great starting point for research and can help us pinpoint areas in which future research needs to be undertaken.


This particular case study was the assessment of 3 elite level pole dancers (2 female, 1 male aged between 24-35) during a 3-minute and 30-second pole dance routine. They were required to remain on the pole for 3 of those minutes and assessment was undertaken via measurement of blood pressure, heart rate, blood lactate concentrations and postural stability.


In particular, this case study found the rate of acceleration and the magnitude of gravitational force placed on the body at all times highlighted the constant workload demand placed on the body. The highest amount of work occurred when the pole dancers ‘broke the body’ along the pole during controlled phases of falling or dropping down (i.e exiting into a drop). The pole dancers in this study experienced a breaking phase requiring almost 3 graviton during their drops.


They also noted the adaptation of the vestibular (balance) system on a spinning pole to allow efficient control and movement to allow for dance expression whilst involved in rotating movements on the pole of a magnitude of ~ 400o/s. All three dancers strongly relied on their sight as a balance strategy throughout their routine.


The final outcome of this study: pole is hard. Between the rotating forces, gravitational forces, friction forces and the demands placed on the cardiovascular, vestibular and musculoskeletal systems, our bodies have our work cut out for them. Pole dance is a highly skilled form of fitness that poses heavy requirements on the individual and on the authors’ words, it is a ‘discipline that needs a careful and skilled training methodology (and) specific coaching knowledge’ to allow the athlete to handle its demands.

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Ok break time! How we handling all this info so far?


If you’re not used to reading research it can definitely feel overwhelming, but hopefully you’re finding our summary is making it that little bit easier to understand. Trust me when I say we’ve sorted through the technical mumbo jumbo for you!


So now we’ve covered the physiology (yes, just 2 studies), we are going to deep dive into the injury surveillance studies that have been published. Now you’ll find that there’s a bit of discrepancy with the results of the studies. But remember, our research is still in its infancy and none of the designs of these studies are perfect so it’s hard to replicate exactly what’s happening in the pole world! But as a collective, they do give us a fairly good idea and snapshot.


Alrighty, let’s do it!


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1. Musculoskeletal injuries in pole dancers: A prospective


surveillance study.

Lead author: Dr Joanna Nicholas (awaiting publication in 2022)


Another study by superstar Dr Joanna Nicholas and her team, this study is a part of her thesis looking at injuries in the pole dance world.


This study collected injury data prospectively from 66 Australian pole dancers over a 12-month period. They looked at demographics and characteristics of pole dancers, activity exposure, injury incidence, and the most commonly injured anatomical sites, types and mechanisms of injury. Data from injuries that occurred during pole-specific and pole-related activities were recorded (i.e flexibility training etc).


So what did they find?


Over the 12 months 103 injuries occurred, with a total injury incidence rate of 8.52 per 1,000 activity hours. For those who don’t know, that’s a high number. For a quick comparison, gymnastics has an injury rate of only 5.2/1000 hours.


Out of these injuries, 59.2% were acute with 40.8% being overuse. The shoulder (20.4%) and hamstring (11.7%) were the most common site of injuries. The primary contributing factors of injury were loaded internal humeral rotation of the shoulder (twisted grip) and front splits for the hamstring.


Joanna and her team flagged the need for injury screening programs and targeted injury risk reduction (injury ‘prevention’) strategies in pole studios to address the areas of the body at highest risk of injury.


Additionally, we at The Pole Physio would like to add our personal opinion (since we’re already talking about it). We firmly believe that studios should look to address how these more challenging pole positions are taught to students with good instructor training (i.e. technique cues), but more importantly they should look at when they are taught in their syllabus (i.e true grip should be taught before twisted grip and handsprings should not be taught at the same time as an Ayesha!).


Limitations to this study are that the patient was diagnosed by their choice of physiotherapist which introduces bias of non-consistent diagnostic reporting (limited by the Physiotherapists’ knowledge and skillset) and in many cases participants self-diagnosed their injury (medical care was at the participant’s expense). In addition, there was a high drop-out rate of participants and a small sample size of injuries included, limiting our ability to extrapolate results to a large pole population.


This study flags the need for future research to understand the mechanical demands of pole tricks, with the aim to implement an injury prevention framework internationally to reduce the risk of injury.


2. Types of the locomotor system injuries and frequency of occurrence in women pole dancers –

Authors: Agnieszka Goluchowska & Marta Humka (2021)


This study via a retrospective survey examined the types and frequency of musculoskeletal injuries amongst 213 amateur (140) and professional (73) pole dancers.


58% of dancers involved reported an injury (slightly higher in professionals – 68 vs 52%). Across both groups, the shoulder joint was the most commonly injured site (44% in amateurs vs 50% in professionals). Other key areas of injury for amateurs were the forearm (22%), hamstrings (19%), ankle (19%) and wrist (18%). Whilst the professionals experienced injuries mainly in the hamstrings (34%), the wrist (22%), the spine (22%) and the ankle (18%).


These results echo that of Dr Nicholas’ PhD which showed shoulders and hamstrings were at highest risk of injury. The key areas to note between the groups were the considerable increase in spinal injuries in the professional group compared to the amateurs (22% vs 7%). On a personal note, this is something that we also see reflected in the patient numbers that we treat.


Also, recurrent injuries were more likely in the professional dancer (47% vs 27%). The areas at highest risk of re-injury in both groups were the shoulder and hamstrings. The wrist and spine also had a higher risk of re-injury in the professional population.


The biggest limitation of this study is that it is a self-reported survey. Patients often misreport due to a variety of factors, and evidence shows that questionnaires asking for memory recollection greater than 1 year increase the risk of bias incorrect self-reporting significantly. In the case of this study, athletes were required to report on injuries they sustained throughout their entire pole career.


Furthermore, patients often report the site of the pain, not the diagnosis – i.e bicep pain instead of a specific shoulder or neck injury causing their pain. This lack of accuracy in reporting can skew the results significantly of the data presented.


3. A small series of pole sport injuries

Lead author: Florian Dittrich (2020)


This particular article is a published series of case studies on the risks of acute injury from falls from a pole and was performed retrospectively on 4 biological female patients who sustained acute injuries between 2011-2017. Patients were contacted years post injuries and case files/radiology was retrieved to determine the severity of the injuries. All of the injuries sustained were traumatic.


The injuries sustained by these polers were:

  • Patient 1: clavicle fracture (surgically fixed)

  • Patient 2: L2-4 transverse process fractures and pelvis contusion

  • Patient 3: 2 separate incidences of concussion

  • Patient 4: ankle sprain


In all of these incidences a safety mat was not used. It’s unclear in the study as to whether the polers were amateur or professional polers, however this case study makes a strong argument that crash mats are important and are used in other sports such as gymnastics and circus. Regardless of level, we would encourage all polers to utilise a crash mat with training, particularly when first learning a new move. Over time when confidence has been established in a trick it may be appropriate to remove the safety mat.


4. Musculoskeletal Injury Prevalence and Profile in Pole Dancers

Lead author: Sue Havens (not published)


This study aimed to identify the prevalence of musculoskeletal injury, and associated risk factors, in 231 pole dancers through a retrospective survey. This study has not been published yet to our knowledge and as such is not peer-reviewed. Furthermore, despite attempts at reaching out to the authors, we were unable to gain full access to the article, so are unable to assess methodology and limitations of research.


This study determined an injury rate of 8.95 per 1000 hours of exposures, with the most commonly injured region being the shoulder (28.7%), followed by the wrist (14.7%), and hips/thighs (12.2%). 63% of injured participants had more than one musculoskeletal injury in the past year, with the upper extremity being the most likely involved.


Shoulder injury appeared to be more prevalent in the higher skilled polers and those who had been poling for greater than 2 years. And there was a slight association with those who had a higher training frequency to competition involvement.


The results of this study appear in line with the results of Dr Nicholas’ PhD and Goluchowska & Humka (2021).


5. Prevalence of Pole Dance Injuries From a Global Online Survey

Lead Author: J. Y. Lee (2020)


Similar to the previous study, the authors distributed a web-based survey to 158 polers of different skill levels, retrospectively assessing for pole injury characteristics across a spectrum of pole dance levels.


In this study the most commonly reported injuries were shoulder (54.5%), wrist (34.2%) and back (24.7%). 75.5% of injuries were acutely sustained.


77% of the subjects recovered in less than 3 months from their injuries. For recovery, about two-thirds of the subjects added rest to their training schedule to recover from their injury, 44% added stretching exercises, 35% added strengthening exercise, 33% added more pole dancing and 26% added yoga or Pilates...


But of great concern was that only 22% of those injured went to see a physiotherapist or other movement professional for rehabilitation! From experience treating this population, there tends to be a negative culture towards assessment as most polers report concern they will have to stop the activity completely and others report financial concern (despite continuing with paying the costs and associated secondary experiences of class!)


One of the most interesting findings from this study was that they found pole dancers over the age of 40 were 3.7 times more likely to need longer than 3 months to recover from injuries compared to those aged from 19 to 29 years. This was the first study that looked into age as a risk factor.


They also found participants with 3 to 6 years of pole sport experience were at 3.9 times higher risk for moderate/severe injuries compared to those with less than 3 years’ experience. After 7 years of poling there was no increased risk.


Wondering why this might be the case? Usually we find this is the time in a poler’s career that they are learning the heavily loaded tricks such as Ayeshas, handsprings and deadlifts. Our theory is that once the body has learnt to handle the demands of these tricks, their risk of injury naturally reduces. But whilst they are building up the capacity the risk will naturally be much higher.


6. Epidemiology of injuries in pole sports

Lead author: Vasileios Mitrousias (2017)


Whilst published, the full study has been unobtainable to date. Comments are in relation to information from the abstract. This article was a retrospective case series based on hospital records of 34 patients who presented to the hospital emergency department between December 2015 and July 2016.


It’s important to note that the injures documented in this study are only the ones that present to emergency department which may not be reflective of the usual range of injuries that occur in the pole community.


From the injuries documented, 29.4% were low back and hip pain, 17.7% were wrist injuries and 14.7% were ankle sprains. Concussion was present in 5.9% of presentations.


Interestingly, no shoulder injuries presented to hospital during this period despite all previous studies listing the shoulder as the most commonly injured area of the body. We theorise that most injuries in this study were likely traumatic injuries secondary to falls or similar. This was the first study that documented concussion rate in pole dancers. It is paramount that further research is undertaken to document the injury characteristics of concussion in pole dancers.


7. The risk of injuries and physiological benefits of pole dancing –

Lead author: Mariusz Naczk (2020)


This small size, controlled study looked to gather and compare information on injuries and physiology between 30 pole dancers and 30 non-pole dancers. They were tested for strength, flexibility and body composition and surveyed on lifestyle, diet, injuries sustained during everyday life and during pole dance, weight, menstruation and warm up.


It will come as no surprise that the pole dancing group had greater strength and flexibility compared to non-pole dancers, and less body fat and greater muscle mass compared to the control group. Interesting to note, pole dancers were more likely to have irregular periods and were less likely to seek appropriate care after an injury (this links in with the results of Lee’s study in 2020).


Of the participants, 40% had an acute injury and 80% reported an ongoing chronic injury. Most of the injuries sustained in this study were in the wrist and shoulders (similar to previous results). And interestingly, this was the first study that documented an association between injury risk and those participants who did not warm up. This is everything we know in other sport literature to date, but it’s great to see it documented in pole research too! Additionally, an increased injury risk was also found with those who were on a restricted calorie diet, again confirming what we already know in other sports and now nicely demonstrating how important nutrition is in the pole population. Good food for thought! (See what we did there….! )