Common foot problems in dancers?
Four frequent presentations?
Written by?Dr. Mathilde Konczynski
|Osteopath & Doctor
Body Spheres @ NatureWorks
The feet are essential structures in posture, gait and movement. In dancers, they are constantly put under pressure. Pointes, plies and jumps all rely on flexible, mobile and healthy feet.?Ideally, the many bones, ligaments and muscles work together to create a complex structure that acts like a spring, absorbing shocks and allowing recoil after stretching. So what happens if these structures are disturbed?Let?s look at a few common foot injuries in dancers and see what can be done.
1/ Hallux valgus and bunion
The big toe moves sideways towards the second toe and becomes painful, often over a developing bunion at its base.
The pain is usually worse when wearing tight footwear such as ballet shoes or high heels, or when putting excessive pressure through the affected area (demi-pointe, jumping).
As this is a progressive condition it is very important to identify it early and analyse the underlying mechanisms at play. The entire leg biomechanics are often involved and it is crucial to have a holistic approach to managing hallux valgus: reviewing the dancing technique,manual therapy, stretches and strengthening exercises to the feet, ankles, knees and hips, toe spacers and orthotics all play a role initially. If these conservative measures fail to stop the progression or to limit deformity, referral for surgical opinion is required.
2/ Hallux rigidus
This condition becomes apparent during full demi-pointe and is characterised by pain and reduced ability to achieve a 90 degree angle at the joint between the big toe and the rest of the foot.
Hallux rigidus is more common in dancers who start later in life. Forcing demi-pointes causes the joint surfaces to become irritated and bony spurs can develop as a result. These spurs can cause impingement and chronic pain develops over the dorsal aspect of the base of the big toe.?In those suffering from this condition, half demi-pointes should be encouraged as the forces through the affected structures are then reduced.
Cryotherapy (use of ice) over the irritated area, mobilisation and regular stretches can all help in reducing pain and inflammation. Taping the toe to protect it from excess dorsiflexion can also help relieve the symptoms. It is essential to review foot positions whilst dancing and modify the range of movement. Dancing should be pain-free.
3 /Plantar fasciitis
Plantar fasciitis is characterised by pain on the sole of the foot that is often a lot worse in the mornings or after a strenuous exercise session. It is caused by an irritation and inflammation of the fascial covering of the sole of the foot and, in dancers, it is often linked to dancing for long hours on hard floors.
Again, early detection is key in preventing chronic dysfunction. Rest, cryotherapy (ice applied locally), anti-inflammatories and manual therapy are all helpful tools in its initial management. Orthotics and splints can be used in chronic cases to help alleviate the symptoms.
This is characterised by pain over the ball of the foot. It is usually caused by years of overuse and overstretch of the ligaments of the toes. Altered weight-bearing dynamics put excessive pressure through the ball of the foot instead of diffusing it throughout the foot; the associated joints become too unstable to sustain body weight and pressure which leads to metatarsalgia. As with the other inflammatory conditions described above, rest and cryotherapy are recommended. Metatarsal pads can be used to relieve pain and pressure locally and strengthening exercises should be encouraged, especially those developing toe flexion.
These conditions affecting dancer?s feet are 4 of many. If you would like to have any further information on any of the conditions described above, if you would like to discuss any other problem or if you have an injury that you would like to investigate and manage, don?t hesitate to contact us; we?re always happy to help.