Beyond Aesthetics: A Matched-Controlled Study of Static and Dynamic Foot Characteristics of 83 Professional Ballet Dancers.

BACKGROUND: Professional ballet dancers are exposed to substantial repetitive loading of the lower extremities particularly the feet. The aesthetic and technical demands of ballet may lead to morphological adaptations overtime. This study aimed to compare static and dynamic foot characteristics between professional dancers and active controls. METHODS: Eighty-three professional ballet dancers (44 female, 39 male) and sex-matched controls were assessed for static foot size (length and width) and arch parameters in sitting and standing using a caliper. Dynamic arch index, foot size, hallux angle, and foot progression angle were recorded with a pedobarography platform. Linear mixed models were computed separately by sex and condition (sitting, standing, and walking) with group (dancer vs. control) as fixed effect and controlled for age and BMI. The proportions of dancers versus controls with a hallux valgus angle exceeding 15° were analyzed with chi-square tests for both sexes, and the influence of age, group (dancer vs. control), and sex were analyzed using a binary logistic regression model. RESULTS: The dancers' static arch height index was higher, and their forefeet were wider than in the controls in both sitting and standing conditions (p < 0.001), whereas only female dancers showed a greater dynamic foot progression angle (p = 0.003) than the controls. Logistic regression revealed a nonsignificant, 2.8-fold higher likelihood of a hallux angle of 15° or greater in dancers. CONCLUSION: Ballet dancers demonstrate different static and dynamic foot characteristics compared to controls. The results underline the need for further longitudinal studies investigating how sex-specific loading patterns as well as ballet footwear affect the development of foot structure and function over time.