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Dancing Facts & Injury Prevention

Dance Conditions & Injuries of the Foot and Ankle


Foot Trivia

  • 28 bones in each foot
  • 24 joints: 4 major and 20 minor
  • 11 extrinsic muscles outside the foot
  • 19 intrinsic muscles within the foot
  • 2 arches
  • 100’s of ligaments

Dancing Facts

  • Walking puts 2-3 x the body weight on each foot
  • Jumping puts 5-6 x the body weight for sports like basketball or volleyball
  • Jumping on pointe puts 12 x the body weight on each foot!!

Common Dermatology Conditions


Blisters and Corns

The Cause: High frequency friction causes blisters and low frequency friction causes a callus or corn.

Blisters: Typically have fluid inside the dome and there may be a blister underneath a longstanding callus, if there is extra irritation or new pressures.

Callus/Corns: These both are really the same thing, skin that is thickened due to unnatural pressure and friction. Anytime friction occurs and the boney prominence rubs against a shoe the skin gets thickened, “Helloma Molle” (soft corn) occurs between toes at the joints (knuckles).

Treament & Prevention

  1. Careful pumicing or shaving down the area.
  2. Applying creams or Vaseline (while not dancing) to keep area soft.
  3. Using sleeves, pads, lambs wool, or toe spacers.
  4. Shoe size or model changes if persistent.
  5. Soaking the foot and application of antibiotic creams.

Plantar's Warts

The Cause: A wart is a virus which shows up as a small round spot with a hard callus over it. It will have no skin lines within it and may have small black dots inside it as well. It may be painful to squeeze it side to side or directly.

Treament & Prevention

  1. Pumice or shaving it down.
  2. Don’t pick at it with your fingers as it can spread.
  3. Apply topical salicylic acid (15-20%) and tape over it nightly.
  4. Homeopathic remedy “Thuja Occidentalis” can be taken under the tongue 2/day for 3 weeks as well.

Athletes Foot/Fungal Nails

The Cause: Both are a fungal infection of either the skin and/or the nails. Typically the skin is infected first, then often, the nails get involved. The skin may have pinpoint red dots and blisters and “look” like dry skin. The nails may be thickened and yellow/brown.

“NOT” every thick nail is fungal “ESPECIALLY” in dancers and athletes.

Treament & Prevention

  1. Try athletes foot cream (prescription strength is stronger).
  2. Try non-cotton socks to reduce sweating.
  3. Try drying powder/sprays for shoes.
  4. Dr. prescribed topical or oral medication is available for nails.

Ingrown Toenails

The Cause: Some nail shapes are prone to growing inwards because of the natural shape of their nail (too wide or too curled under). Dancers are prone due to tightness of ballet and pointe shoes and many of the foot positions.

Treament & Prevention

  1. Careful trimming and cleaning of the borders.
  2. Cuticle creams.
  3. Toe padding to cover the nail.
  4. “Permanent” removal of the corner performed by the Podiatrist.
  5. Check length of shoes if persistent.

Overuse Foot & Ankle Injuries


What are overuse injuries: Any injury that starts slowly and progresses and if untreated can become a serious injury.

Examples

  • Tendonitis
  • Metatarsal pain
  • Shin pain
  • Stress Fractures
  • Plantar fascitis
  • Muscle strains
  • Leg/back muscular pains

Why do they occur?

  1. Inadequate strength or flexibility
  2. Biomechanical alignment (feet, turnout, scoliosis)
  3. Equipment, flooring issues or shoe fit
  4. Class or rehearsal schedules (too much)
  5. Hormonal imbalances (women-stress fractures)
  6. Nutritional status
  7. Old injuries not completely healed or rehabbed!
  8. Age (younger dancers more prone to some injury)
  9. Improper technique

Treament & Prevention

  1. Improve strength (strength training)
  2. Continue to improve flexibility (subtle differences)
  3. Continue cardiovascular workouts when hurt, etc.
  4. Watch shoe fit (especially street shoes)
  5. See a nutritionist (fatigue and performance)
  6. Discuss rehearsal or class schedules
  7. Have lower extremity biomechanics evaluated (for orthotics, inserts or shoe changes)

Foot & Leg Fatigue


The Cause:

  1. Overworked or weak muscles
  2. Tight shoes
  3. Pointe work after long layoff
  4. Collapsed arches (forcing turnout)
  5. Poor shoe support (street shoes too)

Foot Biomechanics


Foot Biomechanics can be the cause of low back and other lower extremity problems. Every movement that dancers make, requires having proper foot position, and lower extremity placement. Good technique is important for every athlete too. Improper foot alignment either from genetics (just having a flat or pronated foot structure) or from pushing improper turnout can allow many conditions to progress through time.

Examples

  1. Bunions
  2. Hammertoes
  3. Arthritis to mid foot joints
  4. Ligament injuries within the foot
  5. Chronic tendonitis conditions
  6. Knee issues
  7. Hip/Sacroiliac joint conditions
  8. Lower back strains.

What we do!


Dr. Schoene looks at the dancer's postural alignment! We evaluate for all dance conditions, causes, and prescribe many treatments to cure and prevent future injuries.

Our Evaluations Include Checking For:

  1. Scoliosis or leg length discrepancies
  2. Over turn-out technique
  3. Foot mechanic alignment
  4. Screen for bunions, hammertoes etc,
  5. X-ray evaluation for growth plates, and foot alignment
  6. En Pointe position X-ray evaluation with shoes on
  7. Dance specific strength and flexibility evaluation
  8. Dance shoe fit and modification suggestions
  9. Prescribe dance based exercise therapies

For Dance Companies or Studios Our Doctor Offers:

  1. Dance lectures to teachers or students
  2. Perform in studio dance screenings
  3. Back stage coverage for performances
  4. In-services during intensive programs that includes many types of handouts and instruction