Cracking Under Too Much Stress?

Calcaneus (heel bone) fracture X-ray (Photo credit: Wikipedia)

When tiny little cracks appear in a bone that carries an overload in a certain area, they are referred to as stress fractures. This is a common overuse injury in high impact repetitive sports such as jogging, basketball and soccer.  However, they are also frequently seen in performing artists, such as ballet dancers due to the jumping and toe work involved.  Risk factors that contribute to the likelihood of stress fractures include improper diet, in the quest to be thin and poor training habits that include grueling hours of rehearsal and performance. Sometimes the body cannot maintain its adaptive pace to keep up with the increased demands placed on it.

Even though a stress fracture can occur in any bone, it is most frequent in the shin and foot. This is because these areas support the weight of the body and no other area of the body is under that amount of load.  Healing time for a stress fracture is usually four to eight weeks and if sufficient time is not allowed, the injury is likely to recur and perhaps worsen. Even when the area is completely healed, stiffness and reduced mobility can be an issue. 

The best treatment for stress fractures is complete rest and avoidance of the aggravating activity. As long as there is not a chance that the stress fracture could become a complete fracture, or become displaced, rest is probably sufficient. Sometimes total weight bearing avoidance is necessary for healing. If it hurts, don’t do it, seems to be the treatment rule. Icing the injury can help with pain and swelling, as well as, over-the-counter pain medication and supportive footwear.

As was previously mentioned, dancers are not only athletes, but also performing artists.  They are very body conscious and need to be strong but appear waif-like. Nutrition can become a major concern when enough fat, calories and calcium are not consumed to keep the bones strong. Eating disorders, continual vigorous exercise and poor nutrition combine to reduce bone density. This can lead to increased probability of stress fractures.

Any suspected stress fracture needs to be checked out at once. Continued weight and stress can further complicate the issue. Please contact Dr. Boucher at (203) 238-3668 to set up an appointment. Her medical expertise and familiarity with the dancing community can definitely work in your favor. She is familiar with the rigors of the art and will work with you to resolve your foot and ankle concerns without compromising your best interests.

References:

http://www.granitemedical.com/health_education/health_tips/foot/stress-fractures.cfm
http://orthopedics.about.com/cs/otherfractures/a/stressfracture.htm
http://www.footdynamics.com/your-feet/articles/ballet-dancers/

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Don’t Let Heel Pain Prevent Your Next Plie’

(Photo credit: Wikipedia)

The most common cause of heel pain in dancers is plantar fasciitis. This occurs when the tough collagen fibers in the long flat ligament on the bottom of the foot get overused or strained and develops small tears, which cause it to become inflamed. The pain from plantar fasciitis is most noticeable with the first steps taken in the morning or after having sat for a long period of time. The pain ranges from dull to intense and increases over a period of months. If left untreated plantar fasciitis will worsen.

Risk factors for plantar fasciitis include the following:

• Foot arch problems either high or low
• Tight Achilles tendon
• Shoes with little or no arch support and soft sides
• Sudden weight gain or obesity

In order to diagnose plantar fasciitis, Dr. Boucher will perform a physical examination of your feet. This may reveal high or low arches, tenderness on the foot’s bottom, some swelling and stiffness in the arch. Occasionally the doctor will require x-rays just to rule other possible problems.

Thankfully, there are many steps that can be taken to alleviate the pain of plantar fasciitis and combinations are usually successful at reducing the pain, but it does take time. Combinations of the following may be used:

• Rest as much as possible for at least a week
• Wear shoes with good arch support and cushioning
• Do recommended heel stretching exercises
• Take over-the-counter pain relief as needed
• Apply ice twice daily during the first week for 10 to 15 minutes each time
• Use heel cups, felt pads or shoe inserts
• Use night splint to stretch the plantar fascia and allow it healing time

If pain relief is not achieved, Dr. Boucher may recommend a month in a boot cast, custom foot orthotics or steroid shots. Non-surgical attempts usually prove successful by decreasing pain level, but it can take up to two years to completely resolve. There are rare instances where surgery may be required, but there are risks involved with surgery. Dr. Boucher will discuss your personal situation with you. Call her at (203) 238-3668. Many options are available don’t forget to check out Our Doctor Store on our website.

References:
 
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004438/
http://www.dancevision.com/buyers-guide/resources/dance_tips/health_fitness/197/
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004438/

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