Note: This document was created to assist an amateur performance group of students at my studio.

Disclaimer: I am not a medical professional. I have attempted to combine my knowledge and over ten years experience in pole acrobatics with information I’ve learned from studying with physiotherapists. The intention of this post is to share some guidelines that have been helpful for me and my students. Do not use this guide to diagnose an injury. It is also not possible to prevent injuries, rather just reduce the chance of injury. If you suspect an injury or if you face unique challenges (possible due to a past injury or chronic illness, for example), you should consult an experienced medical professional about your participation in this sport.

Here are a few recommendations to reduce the chance of injury while training in pole dance and preparing for performance. Every body is different and has different needs, so this is just a starting point. Any student with past injuries or specific health concerns should work with a medical professional before participating in pole.

Warm-Ups

General

Always make sure to move all main joints through their full ranges of motion before training. CARS are a great starting point. Take the body through movements that mimic the pole positions that will be trained. Make sure to add in extra warm-up drills for any particularly specialized skills that will be trained. For example, if you’re including backbend tricks, add a warm-up for that. The guideline that has worked well for me is: if a trick requires an above-average range of flexibility or strength, then a warm-up specific to that should be added.

Shoulders

The most common injuries in pole are shoulder injuries. Students with a past shoulder injury or hypermobile shoulders must be extra mindful, as they are more susceptible to injury. Consider adding the following to your warm-up.

• Scapular CARS: These can be done with or without the block shown in the video. They can also be done in a tabletop or plank position. These take the shoulder blade through its full range of motion. The shoulder blade creates a moveable joint at the shoulder, which gives the shoulder the greatest mobility of any joint in the body. The shoulder blade must be able to upwardly rotate to allow for overhead arm positions.
• Rotator Cuff Exercises: The rotator cuff muscles keep the head of the humerus (the upper arm bone) in the shoulder joint. This is essential for shoulder stability. While recommended for everyone, these exercises are even more important for students with past shoulder dislocations and hypermobile shoulders. Also, when choosing the specific rotator cuff exercises that you want to use, think about what positions your shoulders will be in during your training. Pole requires the shoulders to stabilize in an overhead position much of the time, but there may be other positions that should be warmed up as well.
• Serratus Anterior Activation: The serratus anterior muscle assists in keeping the shoulder blade stabilized against the back, which is also essential for shoulder stability. The serratus anterior muscle is also responsible for shoulder blade protraction (spreading the shoulder blades wide on the back) and upward rotation of the shoulder blade (which is required for moving the arms overhead). Various plank-type exercises, when performed with correct technique and shoulder blades protracted, can work as serratus anterior warm-ups.
• Shoulder Flexibility: Since we hang by our arms with our arms overhead, it is important to be able to fully open the shoulders (create a 180 degree angle at the armpit) with the arms overhead and shoulders externally rotated (armpits wrapped). Students with this range of motion should include drills to improve this. Lacking the flexibility to achieve this overhead arm position can lead to unhealthy compensations such as internally rotating the shoulders in an overhead position, which is not as stable and puts the shoulder in a more vulnerable position.

Wrists

Wrist injuries are the second most common injury in pole. Warming up and strengthening the forearm muscles can reduce the chance of wrist injury. In many pole positions, the wrist is fairly close to neutral (such as in a chair spin position), and these positions can actually alleviate compression in the wrist. However, handstands, planks, and backbends require the wrist to be in extension and bear weight, and if these types of tricks will be trained, then the wrists need a bit more warm up.

• Wrist CARS: Recommended for all warm-ups. 
• Wrist Strengthening: Recommended for all warm-ups. Rubbing the hands together or explosive finger flicks performed for about one minute can be used for this.
• Wrist Extension Strengthening: Recommend before training handstands and similar tricks. Also for students working on tricks similar to ayeshas where the bottom wrist must extend and bear weight.

Hamstrings

Very little research has been done on pole dancers, but one recent study showed that hamstring injuries were the third most common injury in pole. This is likely due to training shapes like splits. Here are some suggestions to reduce the chance of a hamstring strain:

• Active Hamstring Flexibility Drills & End-Range Hamstring Strengthening: Consider including at least one of these in all warm-ups (hamstrings need to be lengthening to achieve positions like a straddle in an invert), and include both types of exercises if preparing for more extreme flexibility poses like splits. Do these before passive stretching.
• Hip Mobilizations & Hip Flexor Stretching: Have students work on increasing their hip back leg mobility in splits so they are not overly relying on their hamstrings in splits.
• Sensation-Based Training: Sensation-based training uses sensations (what do feel, how intense is it, does it feel productive or not) to guide training versus aesthetics (how do my splits look? Am I as flat in my splits as last time?). Our flexibility is impacted by many things, including neurodynamics. Stress can have a huge effect, for example. It’s generally safer to listen to your body instead of pushing yourself to always achieve the same things in every training session. Students with diminished awareness of their bodies (which is more common in hypermobile or neurodivergent people) can use tactile cues to learn how to feel their bodies in this way.
• Appreciate different shapes, styles, and bodies: Our bodies can’t all make the same shapes. That’s ok! Don’t force your body to look exactly like someone else’s if that doesn’t feel good or safe.

Proper Shoulder Position

Make sure that you’re using proper technique for all tricks, especially when it comes to your shoulders. When arms are overhead, the shoulders are most stable when elevated (shrugged to the ears) and externally rotated (armpits wrapped). Other shoulder positions will increase the chance of injury.

Photo: Arms overhead, shoulders shrugged and externally rotated.

However, when hanging from our arms, we need to resist the force of gravity (otherwise we’d be hanging off of our ligaments, which is not safe). Pull your shoulders down about one third to halfway to resist gravity. Don’t fully depress your shoulders though.

Photo: Back view, hanging by arms, shoulders externally rotated and mid-shrug

Photo: Front view, hanging by arms, shoulders externally rotated and mid-shrug

Increasing Training Load

There’s a rule in fitness (I’ve most often read about this applied to running, but some physical therapists and trainers use it more generally) that states that training load shouldn’t be increased more than 10% each week. Increasing the load could refer to an increase in training time or intensity. For example, if you want to increase your training time by two hours per week but you normally train 10 hours per week, then you should increase by just 1 hour the first week and if that feels ok you can increase up to the full two extra hours (for a total of 12 hours of training) by the second week. This is really very general and doesn’t apply to everyone. Since getting ready for a performance generally requires increased training time with rehearsals and so forth, take a look at how much you’re increasing your training time by. Consider replacing a current workout with rehearsal time or reducing the intensity of current workouts to let your body get used to the increase in load. This will likely best be managed by just checking in with your body before each workout. Do you feel exhausted from training the day before? If so, maybe it’s better to watch part of class/rehearsal and focus on gentle stabilizing exercises and mobility instead of overdoing it.

Cool-Downs, Rest & Recovery

• Cooling-Down: Every class and training session should include a cool down. Muscles that had to contract a lot during training (such as forearm muscles, lats, etc. in pole) should be gently stretched at mid-range. Muscles that had to remain in a lengthened position for a significant amount of time should be gently contracted (if backbending, for example, make sure to do some light front core exercises like dead bugs while cooling down) at mid-range.
• Rest: Just like how increasing the training load can vary quite a bit for each individual, so can the amount of rest needed. A general rule is to make sure to include one day of rest every week. For some pole dancers, this might be a day where you go on a run and do some flexibility training, but no upper body exercises. For others, this may be a day with no exercise or physical activity. Again, listen to your body. If you’re exhausted when you wake up, chances are that you won’t benefit from training through it and you may be more susceptible to injury if you do. Allowing your body to rest will likely result in you feeling stronger the next time you train.
• Recovery: A lot of pole dancers get knots or even muscle spasms in their upper backs, around the rib cage, armpit, and neck areas. If you have persistent knots (or if you want to reduce the chance of getting one), consider incorporating some soft tissue work such as using a peanut or foam roller. These types of tools improve one’s neurodynamics, and the nervous system issues are often the cause of things like knots. Nerve glides can be helpful too, depending on exactly what’s going on. Using heat or ice after a hard training session may be beneficial as well.

When to See a Medical Professional

If you experience any of the following symptoms, stop training and immediately see a medical professional. These may indicate that a more serious issue is going on and will not likely resolve on their own. Note that this is not a comprehensive list, but just a few things that require immediate medical attention.

• Weakness in legs or arms
• Shortness of breath and being unable to catch your breath without a reasonable cause (If you just ran through some choreo, it’s completely reasonable to be out of breath. If you just got up out of sitting in splits on the floor, it is not reasonable to be out of breath, for example).
• Feeling like you have to go to the bathroom without a full bladder

The following are also require follow-up with a medical professional (again, this is not a comprehensive list):

• Tingling or numbness in the hands or feet that persists
• Ringing in ears
• Seeing stars
• Dizziness or headache
• Pinching in shoulders, hips, or low back

References

1. Dr. Jen Crane (@cirquephysio). Flexipedia.
2. Dr. Jen Crane (@cirquephysio). Hypermobility course, Neurodynamics course, active splits course.
3. Dr. Theodore Dimon. The Body in Motion: Its Evolution and Design.
4. Dr. Susan Havens. Muscuskeletal Injury Prevalence and Profile in Pole Dancers. https://cdn.ymaws.com/www.ccapta.org/resource/resmgr/annual_conference_2020/researchposters/Havens_Poster_2020.pdf
5. McKenna, Shannon. Aerial Inversions for All.
6. McKenna, Shannon. One Arm Positions For Aerialists: A Practical Manual For Hanging Upside Down On One Arm.
7. Dr. Joanna Nicholas. The psychological, physiological, and injury-related characteristics of pole dancing as a recreational activity. https://research-repository.uwa.edu.au/en/publications/the-psychological-physiological-and-injury-related-characteristic
8. Dr. Emily Scherb (@thecircusdoc). Applied Anatomy of Aerial Arts: An Illustrated Guide to Strength, Flexibility, Training, and Injury Prevention.
9. Dr. Neola Wilby (@ptthepole). Strength and Conditioning for Pole.
10. Andrzej Szopa ¹, Małgorzata Domagalska-Szopa ², Aleksandra Urbańska ³, Monika Grygorowicz .Factors associated with injury and re-injury occurrence in female pole dancers. https://pubmed.ncbi.nlm.nih.gov/34997040/