Clinical Burden of Injuries in Students at a Professional Circus College: A 7.5-Year Longitudinal Study.

OBJECTIVE To characterize clinical burden of injuries incurred by circus students enrolled in a 3-year college training program. METHODS Student (n=334) injury data derived from an in situ clinic was examined over a 7.5-year time frame from August 2009 to December 2016. Injury incidence rate (per 1,000 training hours) was calculated and clinical incidence (injuries/year) was examined in relation to year in program, sex, age, and circus discipline. Weekly and monthly injury incidence were plotted with respect to milestones in the scholastic training year. Clinical burden (injury incidence and duration) was examined according to anatomic location and circus discipline. RESULTS The overall injury incidence rate was 1.89 injuries/1,000 training hours and 0.94 injuries/1,000 training hours for injuries with a duration longer than 4 weeks. Clinical incidence decreased with year in program (p<0.05) and there were no sex or age differences. Temporal analysis demonstrated elevated weekly injury incidence for the 3 weeks following return from both summer and winter vacation (p<0.01) and for the weeks leading up to technical exams (p<0.01). According to anatomical location, shoulder injuries accounted for the greatest clinic burden followed by ankles and according to discipline, ground acrobat flyers followed by ground acrobats with equipment accounted for the greatest clinic burden. CONCLUSION Overall injury incidence rate in the circus training program was within the range reported by other circus training programs and similar artistic and athletic training programs. Resources should be designated for enhanced rehabilitation efficacy and prevention of shoulder and ankle injuries and for ground acrobats with equipment and flyers. Preventative strategies to improve safety upon return-to-training after vacations should be examined.