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Cirque du Soleil's "Mystere" was the focus of this epidemiological investigation into the nature and rate of injury occuffence in the members of the cast. Sixty-two athletes comprised the subject group involved inthe 12-month data collection period. Injury report forms and daily exposure sheets were used to collect data, and data was analyzed using the Microsoft Access relational database program. The rate of injury was found to be 531 injuries per 100 athletes, and 10 injuries per 1000 exposures. Females sustained a higher number of injuries (6.a) than the males (5.0) over the data collection period. The highest number of injuries per performner (6.2) was sustained in the trapeze act, while the lowest number of injuries per performer (2.4) was sustained in the Chinese poles act. Fifty-one percent of the injuries occurred during show performance, 9.7% were sustained during training, and 33 % occurred over a period of time (gradual onset). The act affected most by injury during show performance was the teeterboard act, followed by the trapeze act, while the act affected least by injury was the manipulation act. The body part affected most by acute injury was the ankle, followed by the low back, neck, shoulder, and the knee. The body part affected most by overuse injuries was the shoulder, followed by the low back, knee, lower leg and hip/buttock. The most common injury types were sprains, strains, tendinitis, and contusions respectively. The act that resulted in the highest number of injuries was the teeterboard act (101). Mechanism of injury was considered to be an important factor in analyzing the causes of injuries and suggesting preventative measures, despite the absence of a biomechanical analysis of the various aspects of the show. Insufficient warm-up, previous injury, and return to participation too soon following an injury were considered to be contributing factors associated with injury. Acute injuries were attributed to poor conditioning, poor biomechanical technique, lack of skill, fear of injury, lack of concentration while performing skills, equipment failure, poor communication between two performers, poor spotting, inadequate safety equipment, and interference from props or apparatus. Overuse injuries were attributed to increased training time, over-training, muscle imbalances, inflexibility, postural problems, poor skill biomechanics, previous injury, fatigue, effects from costumes, and effects from apparatus. Use of this database for ongoing tracking of injury and exposure data was determined to be helpful for injury projection/prediction, development of conditioning and rehabilitation programs that are activity specific, Establishment of the necessity of a full-time coaching staff, long term injury tracking, and screening athletes for potential employment. [author summary]

Trouvant leurs sources dans l’antiquité, les arts du cirque sont depuis 1974 en total renouvellement en France, tant au plan de la pratique artistique que de l’apprentissage.
Sensibilisé aux problèmes de santé de cette profession par son expérience d’artiste de haut niveau, l’auteur propose une approche historique et technique des principales spécialités pratiquées, et introduit les notions de performance artistique et de charge de travail physique au cirque.
Les spécificités de cette charge, ainsi que ses conséquences sur la santé et le statu social des artistes sont ensuite présentées, puis analysées au travers d’une étude personnelle appréciant le retentissement de l’apprentissage de haut niveau sur certains paramètres cardiovasculaires et la survenue de la pathologie chez 55 étudiants de l’École Supérieure des Arts du Cirque, pendant 12 mois. Il y est mis en évidence l’importance de la planification du travail et de l’entraînement ainsi que de la surveillance de l’adaptation de l’organisme à la charge physique spécifique au cirque.
Enfin, l’étude de la population des artistes, élèves et enseignants français et des structures médicales qui leur sont actuellement accessibles, met en évidence l’absence d’organisation spécifique des services de santé destinés aux artistes de cirque. Un projet d’organisation nationale de l’encadrement médical des arts du cirque en France est donc proposé, tentant de répondre aux questions soulevées par la préservation de l’intégrité physique chez les artistes, dont le corps est l’outil de travail et le moyen d’expression. [résumé de l'auteur]