Schrefl, A, Kolokythas, N, Erlacher, D, and Schärli, A. Association between single-leg heel rise performance and lower leg, ankle, and foot injuries in adolescent ballet dancers: a prospective cohort study. J Strength Cond Res XX(X): 000-000, 2026-Lower leg, ankle, and foot injuries are common in dancers, yet prospective evidence on performance-based risk factors is limited. The single-leg heel rise (SLHR) test is widely used to assess calf muscle endurance in dance screenings, but its predictive value for injuries remains unclear. At baseline, 70 vocational ballet students (45 females, 25 males) completed the SLHR test. Six movement-quality criteria and a muscular endurance threshold (30 repetitions) were assessed. Medical attention and time-loss injuries were prospectively recorded during a 36-week season. Random forest models identified key predictors, evaluated with logistic regression and receiver operating characteristic analyses. Low eccentric control and pronounced supination emerged as top movement-quality predictors (medical attention: area under the curve AUC = 0.75-0.76; time-loss: AUC = 0.80-0.84). Combined with the 30-repetition threshold, this model achieved AUC 0.73 (95% CI: 0.62-0.85), sensitivity 0.60, and specificity 0.80 for medical attention injuries, and AUC 0.69 (95% CI: 0.55-0.82), sensitivity 0.69, and specificity 0.70 for time-loss injuries. Low eccentric control was significantly associated with injury (OR = 4.49, p = 0.013), with nonsignificant trends for the 30-repetition threshold (OR = 2.71) and supination (OR = 1.56). Poor eccentric control, failure to complete 30 repetitions, and pronounced supination were the strongest performance-based indicators of lower leg, ankle, and foot injury risk in adolescent ballet dancers. Monitoring performance deficits in these areas may serve as a practical, low-cost approach to injury risk screening in dance populations. The level of significance was set at p ≤ 0.05.
Schrefl et al. (Thu,) studied this question.