Behind the Scenes at the Circus
Circus performers have wow'ed audiences for years with flying trapeze artists, elephant tricks, lion tamers, and clown acts. But the circus has taken on a distinct difference in the last 25 years with the athletic gymnastics routines performed by modern circus artists without animals. Cirque du Soleil is a large circus company of this type entertaining audiences around the world.
But those amazing feats of flexibility don't come without some problems. This report from McGill University in Canada, Center for Sports Medicine in San Francisco, and Stanford University describes the kinds of injuries sustained by Cirque du Soleil artists. Injury pattern and injury rates during practices and performances were gathered over a two-year period of time.
Cirque du Soleil performers are really athletes of the highest caliber. They train in diving, juggling, swimming, martial art, dance, and Chinese acrobatic maneuvers. They perform hundreds of times every year -- not just in large theatres but at schools and festivals as well. The time they put into practice and performances adds up to 1000s of hours.
An internal electronic database was available for use in this study. Internal means the records were kept by the Cirque du Soleil organization. Physical therapists and athletic trainers working with Cirque du Soleil performers kept track of injuries (location, type), treatment and number of treatments for the injury, and number of practices/shows missed.
Separate analysis was done based on whether the performer was male, female, a musician vs. acrobat, and whether the injury occurred during practice or performance. They found men were twice as likely to be injured as women. Most injuries were relatively minor affecting only one area of the body. Musicians were more likely to injure the head/neck or arms. Acrobats were more likely to suffer injuries of the lower extremities (e.g., knee, ankle, foot).
Types of injuries included sprains, strains, fractures, and ligament or muscle tears. Running on and off the stage actually generated the largest proportion of injuries in both musicians and nonmusicians alike. The performers were back on their feet in one or two sessions and rarely missed a show due to injuries. Overall, the rate of circus-related injuries was far lower than for most men's and women's athletic events (e.g., soccer, field hockey, basketball, wrestling, football).
Given all that they found, the authors made a couple of suggestions to help prevent modern circus-related injuries. First, injury prevention programs should target the shoulder, knee, and ankle for all performers and the hip/groin for female artists. Prevention begins with purchasing the highest quality equipment designed for circus performers and then carefully maintaining that equipment.
Work schedules should be reviewed and managed for each artist to avoid excessive workload without adequate rest periods. All performers should be encouraged to report any and all injuries, no matter how minor. Quickly addressing the problem, providing appropriate rehab, and restoring strength and conditioning are key factors to successfully minimizing the impact of injuries.
This is the first report of its type detailing and analyzing circus-related injuries. Despite the fact that circus performers are extremely physically active, combining athleticism and acrobatics/gymnastics, the overall injury rate is much lower than for any other group of athletes.
These performers are called upon to perform multiple physical activities in a single show -- probably far more than the average sports performer. Perhaps they have something to offer athletes that might reduce injuries on the playing field or on the court. This was the first study of its type. More research is needed and planned to look at this type of data more carefully and in the near future.
Ian Shrier, MD, PhD, et al. Injury Patterns and Injury Rates in the Circus Arts. June 2009. Vol. 37. No. 6. Pp. 1143-1149.