Back to Ballet!

Some things just work out the way they are supposed to work out. I was offered more hours here at Central CT Foot Care Center, so I was able to quit my other job. With this new schedule, I can go back to ballet! For right now I'm in Pointe 1 on Thursday nights, but I am hoping to get into another class on Wednesday or take Zumba classes on Monday nights.

I was terribly concerned about the large amount of time off from June to December. Anyone who has taken rigorous ballet classes for several years knows how hard it can be to get back into the swing of things. Every part of your body aches after class.

Here is how it went: The rest of the class had taken summer classes and been working on Standard 7 in our Cecchetti method and was limber and technically more advanced, which is to be expected. Their pointe work had dramatically improved since June. They had worked the previous week on pirouettes at the bar, something which still terrifies me after all this time. The first week back I did not wear pointe shoes. It would have been ridiculous to even attempt it! It would have been like attempting a dive off the 10 meter platform when you haven't practiced in months.

I was able to keep up, which was completely surprising. I was tuckered after class though! I had sweated through my leotard and tights. I joked around with my husband when I got home that I could give him a really good hug... with lots of sweat. My feet were feeling ok, but having not pointed my feet for an hour at a time since June, my feet kept cramping up. I had tried to drink plenty of water before class to prevent this, but next time I'll try to work with a Pinky ball instead.

The next week, I was a brave soul and put my pointe shoes on. I was determined to keep up with everyone else and not show any pain. Which I did! I was so proud. I am determined to work hard to catch up with the work everyone else has put in. We did a lot of bourres at the end of class and I did better than some of the girls who had been taking class consistently.

My feet however, after, felt like needles had been poked in them. All of my joints were red and inflamed, but that was about it. Classes begin again next week and I will be anxious to see how my feet deal with more strenuous pointe work (and pirouettes on pointe! Any suggestions for getting over the fear of turning on pointe?)

Dancingly,
Jenn

Time Off From Ballet and What is that Zumba Craze?

Well, unfortunately, due to my schedule this year and the schedule at my dance studio, I cannot take my ballet and pointe classes. After dancing since January 2003, it has been quite awful to not be going to the studio two or three times a week. I miss the material, the movement, the exercise, the satisfaction after a particularly difficult class, and my teachers. After chasing a childhood dream, it is almost like the dream has ended before it has begun. I was never going to be a prima ballerina, or be the lead in the Nutcracker, but boy did I love the experience. I ran into the mother of one of my former classmates recently and she told me that even though I wasn't in class, I could still do stretching at home. Yeah, and I could finally work on those yoga and New York City Ballet fitness DVDs that's I've had for ages. We all know that going to a regularly scheduled class and paying for it is miles different than doing something at home where you are likely to be distracted from the task at hand.

I'm hoping that after my wedding in October that I can make plans to get involved with either yoga, pilates, or Zumba to keep in shape. My even bigger wish is that someone at my studio will take pity on me and teach me a private lesson once a week. Hint, hint.

I hadn't heard about Zumba until somewhat recently and have to say that I was baffled. What is Zumba and why are so many people going crazy for it? Is this the new "Sweating to the Oldies?" or Jazzercise? My future sister-in-law takes Zumba classes once a week, and from what she says, it seems like a lot of fun and right up my alley.

Zumba was created in the 1990's by celebrity fitness trainer, Beto Perez, who fused Latin-inspired aerobics with nontraditional music. He used tapes of merengue and salsa music that he had in his backpack. After success in his native Colombia, Beto brought Zumba to the United States in 1999. After Beto's two business partners scored a huge video deal, the demand for instructors in the US rose dramatically. In 2003, the Kellogg company signed Beto on to develop programming for Latin countries. Since then, Zumba fitness programs have been featured on Special K cereal boxes world-wide.

I'm hoping to get into a class soon. If any of you currently take class, let me know how you like it!

Dancingly,
Jenn

Alex Wong and Ruptured Tendons

I came home from work last night at 9:15, all ready to watch one of my favorite shows, So You Think You Can Dance. I saw the beginning of the Bollywood routine, which was supposed to be a duet between AdeChike and Alex Wong, my pick to win the competition. However, AdeChike had to perform the routine with the choreographer's assistant since Alex had possibly ruptured his Achilles tendon during rehearsal. The step that caused the injury was the repeated jump straddle splits. An MRI had been performed, but as of the Live show last night, the results were not known. Alex was placed in the bottom three because of his injury.

A ruptured tendon can be devastating for anyone, but especially more so for a dancer. The Achilles tendon is the band of tissue that runs from your calf muscle to your heel and is responsible for the "push-off" action when you walk and raise your heel. It is also known as the "heel cord". When you rupture your Achilles tendon you have created either a full or partial tear of the muscle. This is caused by stretching the tendon past its ability, forceful jumping (like Alex was doing) or pivoting. When Alex pushed off for his jump, he most likely pivoted and exerted too much force, and upon landing, collapsed on the floor.

Besides dancers, Achilles tendon ruptures can happen to serious athletes as well as what are known as "weekend warriors"- middle-age people who play sports on the weekend.

Those who experience Achilles tendon ruptures may show the following signs or symptoms:

1. A sudden, severe pain in the calf muscle or in the heel bone area. This pain is often so severe that people will collapse on the ground in obvious pain.

2. A popping or snapping sound or sensation.

3. Swelling in the area of occurrence, typically between the calf and the heel.

4. Problems walking or rising on the toes.

If you think you have a ruptured Achilles tendon you should seek medical attention from a podiatrist immediately. While you are waiting to see a medical professional, you perform R.I.C.E. (Rest, Ice, Compression, and Elevation) to reduce swelling and prevent any further damage.

During your appointment with a podiatrist, the doctor will ask how you injured yourself and if this injury has happened in the past. They will check the range of motion of the injured foot and compare it to the uninjured foot, as well as check the degree of the tear. Patients will exhibit a difficulty pushing down, like you would when pressing the gas pedal in a car. Some patients, like Alex, will require a MRI to determine the exact extent of the injury.

Unfortunately, it appears that Alex's injury will require surgery due to his dance background and his professional dance future. Those who qualify for non-surgical treatments are patients with minor ruptures, those who are less active and have conditions that would prevent them from having surgery. Treatments at this level include casts, walking boots or braces to limit the patient's movement. Surgery will be beneficial for Alex, since it will help him regain strength in his push-off, necessary for any dance allegro movement. He would be placed either in a cast or walking boot and be immobilized for several months while he recovers.

The results of the MRI should be back within the next couple of days. Hopefully it is less serious than we think and he can get back to competing!

Dancingly,

Jenn

jenn@centralctfootcare.com

Yuck! Icky dance toenails

Since I have started dancing, my toenails have taken a beating. I used to take pride in painting my nails a fiery red, or a bright pink just because I wanted to, but covering up my gross nails became a necessity, not a pleasure.

Ask yourself a couple of questions regarding your toenails:

1. Have your toenails become thicker, and harder to cut since you began dancing?

2. Do you have spots in your toenails, bruised or not, that result from an injury?

3. Have your toenails been stepped on or did your partner drop you on your pointe too aggressively?

Some of you may have any or all of these problems and they are problems that may last your entire dancing career if you do not take the time to have them treated.

First, you need to take care that you are cutting your nails properly. A proper toenail cut will be cut straight across on the edges and then close to the quick in the middle. Dancers who do not follow these instructions will find themselves suffering from painful, infected ingrown toenails, which require surgery to repair.

If you find that your nails have become increasingly difficult to cut because they are hard or brittle, you probably have toenail fungus. Take a look at your toenails. Do they appear yellowed, or have white striped running across them? You probably have toenail fungus, which is a common ailment for dancers, as they face nail injury on a daily basis. This is something that is treatable and you do not have to take a pill to rid yourself of painful, ugly fungal toenails. What works best for our patients is an oil-soluble product called Formula 3, which goes beneath the nail plate and hits the fungus at the root.

Bruised toenails are painful and difficult to put into pointe shoes. Everytime you go on pointe with a bruised toenail you feel like you are poking a needle into your nail. As soon as you notice that your toenail is bruised, you should make an appointment with a podiatrist to relieve some of the pressure behind the nail. What he or she may end up doing is drilling into the affected area so some blood may flow from it.

Dancers with ingrown toenails should also see a podiatrist immediately so the infection does not spread to other parts of the toe. Depending on the severity of the ingrown, your podiatrist will surgically remove the portions that are infectioned and ingrown . This may require you to be off your feet for a short while, but you will not be suffering from ingrowns or the infection.

Remember that the best thing you can do to prevent major toenail injuries from dancing is to cut your toenails properly and to be careful! Talk with your partner if he continues to drop you on your pointes too hard, or speak with another ballerina with consistently steps on your feet in a sequence. Never do bathroom surgeries at home as this will make the problem worse and you will have to spend more time away from your passion: dancing!

Dancingly,
Jenn
jenn@centralctfootcare.com

Ankle Sprains in Ballet Dancers

In class last Thursday we were attempting for the first time pirouettes on pointe from fifth position. A veteran of sorts of pointe, I did not see this as a potential problem. Well, I went to turn en de hors on my right foot, and my ankle went out after me. Fortunately, I did not come crashing down on my behind, but it was still embarrassing and made me even more cautious than I always am.

Ankle injuries, and sprains, are among the most common injuries a ballet dancer will face in their career. Doing the most simple thing, like releving onto pointe, can cause you to tworck your ankle and create an injury. When students graduate to pointe, they need to be especially careful because of the tiny bit of cardboard and fabric and glue they are standing on.

My teacher recommended thinking of two bricks on either side of your ankle, preventing you from wobbling on your pointes. A good suggestion, but not neccesarily something I am going to think of everytime I go on pointe. "Bricks! Bricks!"

Most dancers who experience an ankle sprain will describe the sensation as a "popping" sound that occurs when they either land from a jump, or from stepping on another dancer's foot. Other not dance ability causes may be from losing your concentration (like I did), losing your balance (again, like I did), or being at the limit of your strength at that particular moment in time. I was in Nutcracker rehearsals three seasons ago and from the other room heard the "pop". A male dancer, attempting to jump side split style over someone's shoulder's had landed incorrectly and went down. Still gives me the willies thinking about it.

After the injury occurs, dancers will notice significant swelling in their ankle and bruising in the next few days. You should seek the medical advice of a podiatrist immediately, as they are the only physicians who are exclusively trained in foot and ankle injuries.

What a podiatrist will recommend is RICE and perhaps a strapping to keep the ankle stable as it heals. Remember RICE is:

Rest. Especially important for ballet dancers in season who want to get right back up and return to rehearsal. Don't even think about it!

Ice. Twenty minutes on, then twenty minutes off. This can be done periodically throughout the day.

Compression. Bandaging or strapping to keep the ankle steady.

Elevation. Resting the affected ankle above your heart so no blood will pool in that area.

Dancingly,

Jenn

jenn@centralctfootcare.com

Breaking in New Pointe Shoes

A couple of months ago, the girls in my ballet class got their first pair of pointe shoes. Sigh. It is a momentous occasion in the life of a ballet dancer or student and a moment that should not be taken lightly.

Dancers who have the correct technique and have built up the strength in their legs, ankles, and feet should be allowed to go on pointe. In my old ballet school, girls were put on pointe much too early, without the proper technique or strength and suffered because of it. I was one such person and relearning pointe is proving to be a challenge. Bad habits are easy to learn but difficult to unlearn.

There seems to be a myth of sorts that all pointe shoes need to be broken in. In many cases that is the truth, but for dancers wearing the Cadillacs of pointe shoes, Gaynor Mindens (my pointe shoes- can't live without them!), there should be no "break-in" period. Gaynor Mindens come already broken in due to the elastomeric materials that they are made of. Traditional ballet shoes, like Blochs, Freeds, Russian Pointes, or Sanshas are made of a lot of cardboard and glue. No wooden blocks, I promise!

When purchasing your first pair of pointe shoes, it is essential to be fit by a professional. The daughter of the owner will not suffice. Each person's foot is different and not everyone is going to wear the same brand of pointe shoes. If you are fit with the wrong size, either your foot will swell in your too-small shoe, or your too-large shoe will come flying off your foot. Not a pretty picture either way.

If you chose to go with a traditional pointe shoe, know that they will take more time and effort to "break-in". There were a few girls in my class who opted for traditional pointe shoes, and going from flat foot to a true 3/4 pointe has been difficult for them.

What you can do to break-in your pointe shoes is walk around like you have Barbie shoes on. Barbie always wears high-heels, right? So go on 3/4 pointe and walk up and down your hallway. Novice pointe shoe wearers should never slam their shoes between doors to soften the shank, a trick often used by professionals. Instead, take your hairdryer on high heat and point it at your shanks. This will soften the shoe and make it more pliable to your foot. Do a lot of roll-throughs. Even when you think you're done with roll-throughs, do some more. Finally, your work at the barre in pointe shoes is essential. When you are ready, then you can take your first steps!

Dancingly,

Jenn

jenn@centralctfootcare.com

Evan Lysacek's Broken Toes

Evan Lysacek, gold medalist and Dancing with the Stars contestant, is dealing with several broken toes. Ouch! The judges keep reminding him that he needs work on his foot technique, especially pointing his toes, but that may be difficult when your toes are in extreme pain.

Lysacek broke his fifth toes, also known as "piggy" toes during rehearsal for the quick step, a fast-paced and fast-footwork routine for this past week. What began as a dull ache turning into a throbbing pain. Lysacek has visited three doctors, including the doctor on staff for Dancing with the Stars, but nothing can be done. Doctors have taped the toes so they will properly heal and the gold medalist in men's figure skating is taking painkillers to alleviate the pain.

If you are suffering from a dance-related broken toe injury, you should first visit a podiatrist who can treat you accordingly. Dancers should stay off the affected foot(feet) and practice RICE (rest, ice, compression, and elevation) for the duration.

Dancingly,
Jenn

jenn@centralctfootcare.com

Ballet Orthotics

As someone with collapsed arches and feet that are quickly deteriorating, I've tried every padding or tip known to the dance world. I use big tips for my big toes, little tips for my smaller toes and jel pads for covering all of the toes. I find that if I dance in pointe shoes without these necessities, I pay dearly the next day.

All of this padding however, only works for the toes and forefoot area. I've had heel bursitis since August 2007 and extended periods of allegro work, especially sautes, exacerbate the issue. So for people like me (and maybe you too!) who suffer from heel pain injuries, like bursitis and plantar fasciitis, if there any relief?

Allied OSI Labs from Indiana has developed a ballet orthotic called Braver Ballet, an insert which will fit right into your ballet slipper or pointe shoes. I have not ordered them yet, but I am curious to know if there is anyone out there who uses them and has had good results. From what Allied OSI Labs reports, these orthotics should alleviate pain from plantar fasciitis, shin splints, ankle instability, or stress fractures. Ballet orthotics are typically made from thin thermoplastic materials.

You should always visit your podiatrist first with any questions you have regarding if you are a candidate for ballet orthotics.

Dancingly,
Jenn

Are Bunions in Dancers Avoidable?

One of the things I have been most concerned about as a ballet dancer are bunions. It seems like so many dancers, across disciplines, get bunions and suffer greatly from them. Last year at my dance studio our best dancer had bunion surgery and she was only a senior in high school. Her podiatrist had to put pins in her big toe joint. She was off her feet for many weeks, in therapy, and cautious on her foot when she got back to class.


One of my ballet teachers talked to us last year about bunions and preventing them. She had us stand in arabesque sideways to the mirror and look at how our foot was shaped. Many had "curled" their big toe under and the majority of the weight of their foot was resting on their big toe joint. This is a sure sign of things to come.


Take a look at your own foot in the mirror in arabesque. Where is the weight resting? Now point your foot in tendu devant. Is your big toe joint sticking out? If so, then you might be going down the bunion road.


I mentioned in my previous blog about the perfect ballet foot. Gaining this perfect foot, or "winging" it can also lead to bunion problems. In order to create the perfect line some dancers will move their big toe joint instead of keeping it in line with the rest of your inner foot. When we "wing" our feet, it creates more pressure on the big toe joint, leading to inflammation. Dance students should focus on healthy alignment, while trying not to sickle the foot.


Heredity is a factor dancers cannot overcome. If a relative of yours has bunions then you may get them as well. However, dancers in particular need to recognize the need for proper footwear. Narrow toe boxes in not only your pointe shoes, but your street shoes as well should be avoided. Narrow toe boxes may look better, but in reality you are squishing your toes together and setting yourself up for disaster.


For those dancers who have bunions but the problem is not serious enough to warrant surgery, they may want to consider orthotics for your shoes. If there is a biomechanical problem with your feet, orthotics will help alleviate those issues. There are also semi-custom orthotics that are available for your ballet shoes. A podiatrist would have access to these items.

Shaping the Foot: An Impossibility

I wish I had beautiful feet. But alas, I do not. Relatively flat footed, with a long, narrow, and thin foot, there is little I can do to change the basic shape of my foot. There are some dancers in my class who astound me with how lovely their feet and arches are.



When I first started ballet, I sickled my foot, which means that I let the foot "collapse" inwards. In tendu the foot went in at an angle. I never noticed until my first teacher pointed it out to me. It was a rookie mistake.



Both of my ballet teachers have made shaping the foot a priority this year. We are at the level where we will be graduating from ballet slippers to pointe shoes, and making the foot appear as part of a long leg line is more crucial than ever. Having a "dead fish" at the end of our leg is something none of us want. They keep bringing in pictures from Dance magazine and Pointe magazine, telling us how it is possible to create a shape like they have. I had received my copy in the mail that same day and had walked up the driveway saying "How does she do that?"



If you notice in the picture above, from the top of her thighs to the point of her foot is a straight line (well, fairly straight; her leg does go in slightly at the knee). The foot is perfectly turned out so we see all of the heel and inside of her shoes. We tried this in class that day. Let me tell you, it is not as easy as it looks. Almost all of us got horrible foot cramps, but a select few came close to that picture.

For those of us who have to work extra hard to create that shape, we have a lot of painful work ahead. Some things to keep in mind are:

• When in tendu a la second, make sure that you have your heel turned out. By this I mean that from your toes to your heel should be a straight line. If you stand on a line with your foot in tendu, there should be an imaginary straight line.
• When in tendu devant, think of pushing your heel forward. This motion forces your toes back and creates the line desired.
• When in tendu derriere, your toes should be pointing upwards, like in the picture to the left.

To do this at home, try working with a Theraband to create strength. When you are sitting on the couch, stretch your legs out in a stretched releve and try to touch your toes to the couch.
It is important to remember however, that your foot has only a certain range of motion and it will only go so far. You can't break your foot doing these suggestions, but it will hurt.
Dancingly,
Jenn
Central CT Foot Care Center
Dr. Tina Boucher, DPM
www.centralctfootcare.com
jenn@centralctfootcare.com