Dear Jenn: How Do I Get A Nice Arch?

Dear Jenn,
I feel like every ballet dancer I see has a beautiful arch and instep. I have a low arch and instep, making for a foot that does not good terribly good when pointed. I've been using a Thera-Band and it's strengthening my feet, but I'm not noticing a difference. Is there anyway to make them look better?

Ahh, another thing I can commisserate on. I have pretty flat feet and I can point my feet all day, use a Thera-Band, and hope and dream, but nothing happens. Unfortunately, there is nothing you can do to change the bone structure in your feet that will create a more beautiful arch and instep.

Kendra Mitchell, a ballet dancer at Ballet Arizona says "I always wanted great feet growing up, and it used to get me down. But I eventually figured out how to work with them." Working with a Thera-Band will help strengthen your feet and I would recommend to continue your exercises. Mitchell recommends doing this exercise: Keep your heel on the floor and pick up a marble with your toes. Move your foot to the right and place the marble back on the floor. Repeat to the left.
If possible, wear a deshanked pointe shoe during barre to help articulate your foot and toe articulation. This will also help strengthen your demi-pointe. Mitchell used to practice walking and running in her shoes, and continues to work on maintaining good turn-out. Remember that when you are turned out your heel is up and forward and therefore your arch is less visible. Look at how pretty Melissa Hough's back foot looks- it's completely turned-out.
When you reach an advanced stage in your training, you can cut your shanks where your arch bends the most so it will flatter your foot the best. You can also sew the sides of your shoes down to create the illusion of a bigger arch or purchase shoes with a lower vamp.
I have several dancers in my class who have beautiful feet, but often times they have sway-back knees, which makes it difficult for them to fully stretch on pointe. Remember that it is the technique and quality of your dancnig that matters the most and is what professional companies are looking for, not your arch. Concentrate on another part of your body which you feel is your best. Do you have lovely arms or back? Concentrate on an amazing port-a-bras instead.

Send your questions to jenn@centralctfootcare.com.

Dancingly,
Jenn
jenn@centralctfootcare.com
Dr. Tina Boucher, DPM, Dance Podiatrist

Painful Feet After Ballet

Sometimes toes can hurt even more once you take your pointe shoes off. That's because lactic acid builds up in the feet after hours of being constricted. Feet have no extra space, so swelling tends to linger. To decrease inflammation and soreness, follow these five steps:

1. After you take off your pointe shoes, roll your arch over a tennis or pinkie ball to loosen up the foot muscles before putting on street shoes. This will help push lactic acid out of the ligaments and joints and keep the muscles from getting tight.

2. If your feet are extremely stiff, wrap them in an Ace Bandage or put on a compression sleeve to push out swelling.

3. Once you're home, stick your feet in an ice bath for three to five minutes.

4. Put your feet up above the level of your heart to let gravity decrease inflammation.

5. Increase your ankle stability to alleviate the amount of pressure that wearing pointe shoes places on your feet. Use a Theraband, working against the resistance in all four directions: up (flexing), down (pointing), in (sickling), and out (winging).

Dancingly,
Jenn
jenn@centralctfootcare.com
Dr Tina Boucher, Dance Podiatrist

Dear Jenn: Bunions from Dancing

Dear Jenn,
I'm getting bunions! I feel like I pad my feet well, but they are still developing. What can I do to prevent them?

This is a popular question we hear a lot and get asked often by dancers. I would first take a look at your pointe shoes. Are they too narrow? Because if they are, then that could be part of your problem. It would be worthwhile to take a look at your street shoes too because too narrow everyday shoes will exacerbate the problem as well.
Unfortunately, many people are simply predisposed to them. Does your mom have a bunion? Grandmother? Roughly 60% of people have the foot type with a long big toe, which makes you bunion prone.
What kind of padding are you using? One of the best things you can do is wear spacers in between your big toe and second toe. This will ease some of the pressure your big toe joint is experiencing and redistribute it to the rest of your foot. You should wear these spacers when you are not dancing as well. We sell in our office bunion sleeves which will help align your foot and again relieve pressure.
If you already have a pronounced bunion, your pointe shoe box should be square and wider to accomodate the bone. However, if the box is too wide, your big toe slips down and jams at the platform. It is best to work with a professional fitter to get the best fit for your foot.
Your street shoes should not be taper-toed or high heels. Round-toe shoes are best with a little bit of a heel. Flats offer no support for arches and should be avoided, along with flip-flops, UGGS, and other low-support shoes. Your podiatrist may prescribe custom-made orthotics to help with the bunion pain. People who tend to pronate in tend to have bunions, so orthotics would help with both issues.
Send your questions to: jenn@centralctfootcare.com
Dancingly,
Jenn
jenn@centralctfootcare.com
Dr. Tina Boucher Dance Podiatrist

Ballet Shoes for Children

April is Foot Health Awareness month and the American Podiatric Medical Association has teamed up with First Lady Michelle Obama's "Let's Move" campaign to shine the spotlight on childhood obesity and the importance of keeping children healthy and active. This new campaign launched by APMA is called "Today's Podiatrist Keeps America Moving". Ballet is an excellent way for children to exercise but choosing the right ballet shoe is important.

Children have developing and growing feet, and a properly fitting ballet slipper is vital to keeping feet safe. Certain ballet positions can put excessive strain on the feet, so check with your podiatrist if your child complains of foot pain related to dancing.
A ballet slipper should:
*Have a slightly snup fit to prevent balance issues. The slipper should not be loose or overly snug.
*Have a sturdy heel area, and feature a flexible sole.

Dancingly,
Jenn
jenn@centralctfootcare.com
Dr. Tina Boucher, Dance Podiatrist

Dear Jenn: Bruised toenails

Dear Jenn,
I take advanced ballet class several times a week for several hours at a time. I'm getting a lot of bruised toenails, which are hindering my performance in class. What can I do to prevent this from happening in the future?

I've gotten this in the past and it is definitely painful and not pleasant to look at! Your pointe shoes are probably to blame for the bruising. Are you still wearing the same size shoe you were wearing a year ago? Our feet change over our lifetimes and what may have fit us last year may not fit us this year. Feet get flatter or wider. Take a look at your shoes. Are they too short or too narrow for your foot? This will add unnecessary pressure on your toes. If the shoes are too wide, your toes will shift every time you go on releve. You should probably go back to your pointe shoe supplier and get a professional fit.

Keeping good care of your toenails is important as well. Your toenails should be trimmed short and along its natural curve. If you are unsure how to do this, make an appointment with your podiatrist today so they can show you the proper method. If you are not wearing any toe pads, I highly recommend you wear them (no pointe [har har] in suffering!). There are many different options out there for you to try, including lambswool, the new green bamboo padding I posted yesterday, gel pads, and others. I would also try adding individual toe caps to the nails that are affected the most. You can also apply anesthetic like Neosporin to the toenail to help it heal. If the nail is raised or continues to look bloody, then a podiatrist may have to drain the blood from the nail.
Send your foot and ankle dance questions to: jenn@centralctfootcare.com.
Dancingly,
Jenn
Dr. Tina A. Boucher, Dance Podiatrist

Be A Green Ballerina!

I came across this product in an old issue of Pointe Magazine. If you are currently padding your pointe shoes with lambswool, try using instead Green Ballerina Bamboo Pointe Shoe Padding. Made from bamboo fiber, it's a 100% renewable resource that is also 100% recyclable. This material is soft (looks and feels like lambswool!), naturally wicks away moistures and has antibacterial properties. Find it online at places like: http://www.balletboutique.com/pointe-accessories/123-green-ballerina-bamboo-pointe-shoe-padding.html.

Dancingly,
Jenn
jenn@centralctfootcare.com
Dr. Tina Boucher, Dance Podiatrist CT

Blisters from Pointe Shoes

 Pointe shoes are shoes. Just like we get blisters from regular shoes, you can get blisters from pointe shoes as well. When I first started taking pointe, I frequently got blisters on the backs of my heels. Now that my skin has hardened in that area, I rarely get a blister from pointe shoes.
Blisters, while not always painful, are certainly irksome. You may have blisters that are large or small or even in clusters, depending on where your pointe shoes are irritating the skin. Common places of irritation are on the backs of the heels, on the toes, and on the toe joints.

Blisters are caused by increase rubbing of the skins against an object. If the skin rubs hard and often enough against that object, trauma will occur. The epidermis and dermis separate (gross, I know) and fluids seep into this gap. The fluid acts as a layer of protection for the skin underneath and remains as a cushioning agent until the skin has fully healed. Once healed, the fluid will be reabsorbed into the body and a scab will form and peel away to reveal the new skin.
The area surrounding the blister may become red and swollen, depending on how severe the blister is. The fluid within the blister is typically clear. If the fluid appears to be bloody, it is likely a sudden force caused the blister. Also, if the fluid is greenish or yellowish, the blister is probably infected. You may experience a fever as your body fights this infection.
It is best the leave blisters alone so they may heal properly. Apply an antibiotic on them and cover it with a soft bandage. To prevent blisters from occuring again, put petroleum jelly or talcum powder on the spots in your pointe shoes that are irritating you. If you do not wear toe pads and frequently get blisters on your toes or toe joints, it would be best to add these to your shoes. Applying bandaids or medical tape to the affected areas before class will also help prevent blisters. Moleskin is also used for treatment of blisters. Cut the moleskin to the appropriate size with a hole for the blister and place it on your skin and cover with a bandage.
Most blisters if they are small should be left alone and not popped. If a blister does pop then leave the flap of skin that was left behind. Large blisters should be drained. If you are uncertain of doing it yourself, make an appointment with a podiatrist so they can properly do it for you. Doing it at home requires a sterilzed needle soaked with alcohol. Using the needle, pop the blister and make the hole wide enough so it will not reseal. Apply antibiotic and put a bandaid on it.
If you are experiencing recurring blisters, visit a podiatrist. Your feet should be dry at all times, so it is important before and after you take your pointe shoes off to towel dry your feet, as blisters commonly occur on wet, moist skin.
Dancingly,
Jenn
jenn@centralctfootcare.com
Dr. Tina Boucher, Dance Podiatrist, Meriden CT