Preventing dance injuries to the foot and ankle
DR. MONIQUE MITCHELL
Published: May 28, 2013
We have all watched a ballerina perform, and applauded at the end of the performance. But how many of us have paused to consider the demands placed on their feet and possible injuries they may develop during a performance or long hours of practice.
Dancing is an excellent exercise, for the whole body. If you love dancing for exercise, from ballet, hip hop, salsa, Calypso, Zumba or any other forms of aerobic dance, you must know dancing places more physical demands on the feet and ankle and increases your risk of injury. In addition, the type of footwear or lack of correct footwear used during the dance can also put the feet at risk for injury. The various positions and steps performed during the dance routine put pressure on different parts of the foot and cause injuries to these parts of the feet. For example, ballet dancers have added risk of foot and ankle injury because of specific positions such as "on pointe" and "demi-pointe," which can add stress to the toes and ball of the feet.
The most common injuries seen in dancers may include:
• Dancer's fracture or fifth metatarsal fracture, which is often the result of landing awkwardly on the outer side of the foot or twisting of the ankle.
• Lateral ankle sprain, which is a common injury among all athletes. This may happen from landing awkwardly after a jump or twisting the ankle especially on uneven surfaces.
• Bunions (Hallux Valgus), do not usually develop because of dancing, but may be made worse by wearing tight fitting shoes and irritation to the big toe joint.
• Stress fractures may result from too much dancing or dancing for too long which causes stress and weakens the bones. This most commonly happens in the second metatarsal and may cause pain and swelling.
• Ankle impingement syndrome is pain to the front or back of the ankle related to bone pinching the soft tissue when the ankle is pointed in one direction or the other. Over time this can progress to arthritis to the ankle joint.
• Trigger toe or tenosynovitis results when a tendon cannot glide within its canal, causing it to “jam” or get stuck. This prevents the big toe from being able to move freely up and down and sometimes getting stuck in one position.
• Sesamoiditis, Hallux Rigidus, Plantar Fasciitis and Achilles Tendonitis are also common injuries to the foot seen with overuse and repetitive trauma that occur while dancing.
All forms of dance place unique stresses on the foot and ankle. While the level of participation varies from recreational to professional, dance remains one of the most physically demanding activities on the musculoskeletal system and especially the feet. The hours of practice in dance may improve strength, flexibility, and balance. But sometimes overuse or chronic injury can occur.
Tips to prevent dance injuries
• Don't be extreme: Start your dance routine slowly and gradually increase the frequency, intensity and the duration of your exercise to avoid dance-related injuries and to safely and effectively partake in dance fitness. You may need to take a beginner's class before heading to the advanced class as well as taking one or two classes a week first instead of taking a class every day.
• Take the time to warm up: Always stretch gently and warm up for a few minutes before a dance class by doing light exercise. This will allow your muscles to loosen and warm-up and be better prepared for the workout. You can also get to the gym a few minutes early and do some cardio like walking on the treadmill, the elliptical or ride the stationary bike to get your body ready to boogie down.
• Cool down too: It is just as important to cool down after a workout as it is to warm up before. Your muscles will recover faster, reduce your risk of injury and you will feel better. This will prevent lactic acid build-up and any unnecessary injuries that might occur from tight muscles, if you just walk out of the class and head on with the rest of your day.
• Focus on proper technique: Proper technique is a vital ingredient in preventing dance-related injuries. Turning your body the wrong direction or holding a position incorrectly can instantly lead to injuries — pulled muscles, strains, sprains and even fractures. It is important to listen to your body. If something doesn't feel right or if you have pain don't do it. Pay attention to your dance instructor to learn proper dance moves as well as ask questions about how to do the moves can be a big help.
• Wear proper footwear: Before you start a dance-fitness class, ask the dance instructor for footwear recommendations. You might be able to get away with using your regular running shoes for a while, but if you plan on dancing often, it is best to invest in the correct footwear to prevent injuries.
• Cross train: Most dance routines will give you a full-body workout, but doing only one type of workout puts you at risk for overuse injury. Many injuries can be prevented with improved posture, flexibility and strength. Instead of doing only dance classes every week, add a strength training class, a Pilates class or another type of cardiovascular workout to exercise the muscles you don’t use regularly with dance and allow the dance muscles to rest in between workouts. Not only will you reduce your risk of injury, you will also get fit faster and avoid burn out.
Tips for the injured
If you do get a dance-related injury, it is important to take a rest from dance class and start on the road to recovery. It is best to follow the PRICE (Protect the injured area. Rest from activity and dance. Ice. Compression bandage or wrap. And Elevate an injury to decrease swelling). If pain and swelling persists, it may be time to see the podiatrist for an evaluation and treatment of any injury that is present. Early diagnosis and treatment of injuries helps to prevent long term complications and allows a safe return to your dance routine. Specific stretching and strengthening exercises or physical therapy may also be recommended.
• For more information visit www.apma.org or www.foothealth.org or email us at firstname.lastname@example.org. To see a podiatrist visit Bahamas Foot Centre Rosetta Street or call 325-2996 for an appointment or visit Bahamas Surgical Associates Center on Albury Lane off Shirley Street or call 394-5820 for an appointment.