Muscle strains represent more than a third of all injuries in both dancers and athletes. Although often overlooked, anatomic variations play an important role in the etiology of these injuries, as does strength imbalance between agonists and antagonists. The incidence of spondylolysis is unusually high in ballet dancers and certain athletic groups, such as gymnasts, javelin throwers, and weight-lifters. Mechanical factors play a major role and can be exacerbated by congenital abnormalities. Various permanent adaptive musculoskeletal changes have been described both in dancers and athletes, especially those that start at a very young age. Task-related adaptive changes can also be seen in isokinetic strength measurements of various muscle groups, such as the spine muscles of Flamenco dancers. Shoes and floor surfaces can be directly responsible in part or in whole for many sports and dance injuries. "Vibration-pressure" diagrams are suggested as an objective way to document their effect on biomechanical behavior.