Let’s Keep On Dancing

Dancer (Photo credit: Wikipedia)

There is nothing easy about a ballet dancer’s life. It is stressful with constant worries about winning a role, guarding their position, rehearsals, performances, money and competition. The calm look on the face of a dancer as she performs might be masking a world of pain. They are on their feet so many hours a day, and on top of it they probably have one or more foot conditions that they experience pain from. Common disorders that they must bear up under include bunions, ingrown toenails, blisters and corns which can easily become infected.

Today let’s learn a bit about bunions and treatment methods that may allow a dancer to keep on dancing. A bunion is a deformity at the base of the big toe, which is caused when the big toe becomes misaligned and extra bone growth appears at the joint. It mostly affects the inner side of the big toe. As the misalignment continues, the big toe slants toward the other toes and the joint becomes more enlarged. If allowed to grow untreated, a bunion can become very painful and make even walking nearly impossible. This is why it is necessary to begin treatment of a bunion early and be persistent.

Symptoms to look for include:

• Redness
• Swelling
• Protruding at the joint
• Pain
• Tenderness

It used to be generally believed that a bunion was caused by tight and ill-fitting shoes. This may be somewhat true, but now it is also believed that genetics plays a part because of bone structure.

Different treatment methods for bunions include:

• Rest
• Anti-inflammatory medication such as Ibuprofen
• Exercises and stretching that encourage correct positioning of the big toe
• A nighttime bunion splint
• Bunion sleeve
• Cortisone injections
• Surgery
• Shoes with a roomier toe box

In order to allow a dancer to continue performing, with bunions present, Dr. Boucher may suggest rest as much as possible and take over-the-counter medication for pain. An elastic sleeve can be pulled on over the foot to maintain correct position or gently reposition the big toe.

If you are a dancer and suffer the constant discomfort of bunions, as many do, contact Dr. Boucher at (203)238-3668. Dr. Boucher was a dancer also, understands your needs and how important it is for you to keep dancing.

References:

http://www.guardian.co.uk/stage/2006/sep/05/dance

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A Ballet Dancer’s Feet

The "box" of a pointe shoe resides within the front end of the shoe. The box itself cannot be seen, but its shape is exposed by the tightly stretched outer fabric of the shoe. (Photo credit: Wikipedia)

Have you ever been to a live ballet performance? It is beautiful and a sight to behold, but the serene look on the faces of the performers may be hiding a world of pain and agony. They struggle so to keep their spots, win roles and perform without complaint. What is it that makes them return to their dressing rooms in tears? Pain! It’s a very common ailment suffered by ballet dancers, but also poses a serious risk of infection - CORNS.

Corns, like hair and nails is a skin secretion made up of keratin. They form at points on the body that are sensitive to pressure. They tend to be somewhat pointed, and as the build-up of keratin continues, they can become very painful. In some instances the build-up is so significant and the pressure so great that the corn can actually puncture into the skin and lead to an infection. If you are a dancer you must be particularly aware of the location between the third and fourth toe.  Many dancers experience frequent pinched nerve damage and very little sensation in this area. If a corn becomes infected there, you should seek immediate medical attention. An infected corn may appear similar to an infected pimple, but because of lack of sensation it will not hurt.  Any corn that appears to be infected should be treated by Dr. Boucher. 

You may not develop infected corns, but if it is a condition that is repeatedly bothersome to you, as a dancer, check the fit of your point shoes. Remember your feet can grow as you age and your shoes may be too small. If the wear on the soles of your shoe extend one inch or more beyond the shank, chances are the shoes are too small. Your comfort zone may lie in a pair of shoes one-half size larger.

At home treatment for corns may include:

• Regular foot soaks
• Using a pumice stone to reduce corns and calluses
• Over-the-counter non-medicated corn pads

If you have corns in areas that are difficult to treat, or if they are large and bothersome, contact Dr. Boucher’s office at (203) 238-3668. She has a treatment option for you that will remove the corn and allow you to continue on your way with little or no pain.
 
References:

http://www.centralctfootcare.com/Central-Connecticut-Footcare-Center-LLC.html
http://findarticles.com/p/articles/mi_m1083/is_n4_v68/ai_14986740/

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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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The Athlete In The Performing Artist

Maria Menounos (Photo credit: Wikipedia)

Many of us have been glued to the television for season 14 of Dancing with the Stars (DWTS) and seen the injuries. There is a little bit of dancer in the athlete, and a lot of athleticism in the dancer. For the purpose of this discussion, they are one and the same. The injuries remain the same. Whether it’s a running back dancing his way downfield, maneuvering his footwork to avoid oncoming tacklers. Or the ballet dancer leaping across the stage, delighting and wowing the audience. They are both prone to injuries that can alter or stop their careers.

Last month there were a couple of injuries worth noting. William Levy sustained an injury to his right ankle during rehearsal.  The results of an MRI done the following day showed a torn ligament, and his doctor advised immediate rest, or risk doing permanent damage if he continued to dance on the injured ankle. But the Cuban heart throb danced on performing an Argentine tango that had judges passing out some pretty high praise. Sherri Shepard mysteriously lost a shoe and sustained an ankle injury that left her unable to dance up to her full potential. This proves that the ankles just aren’t safe on the dance floor.

Whether you are ball room dancing or ballet dancing, the leaps turns, spins and shuffles are hard on the feet and ankles, and very little support for the difficult moves is provided by the shoes. In the ballroom, the typical shoe has a somewhat high heel, is strappy and light, and has the dancer moving on the balls of her feet. Unfortunately, there is no cushioning or support for the lateral movement, jumping and sliding a dancer is required to do.  Ballet slippers are worse. There is virtually no support, a little cushioning but no toe protection. Considering the moves a ballet dancer makes on stage, and the rigorous hours spent training, physical exhaustion and stress, it is little wonder injuries occur. Just ask Maria Menounos who is reportedly nursing stress factors.

If you have an ankle or foot injury regardless of the origin, call Dr. Boucher at (203) 238-3668. Central Connecticut Foot Care Center is the go to place for all dance injuries foot or ankle related.  Expertise in Podiatry and interest and background in dance make Dr. Boucher just the right person to keep you on your toes.

References:

http://www.washington.edu/news/archive/id/1952

Every BODY Can Dance

I love getting e-mails from people in the dance community, asking questions, looking for me to help them promote a product or service, or just looking to chat about dance! I got an e-mail this morning from Ryan Beck, a dancer and choreographer, who has performed around the world and with some of today's biggest names. He has co-started a project with Jason Ray Brown called Every BODY Can Dance, a project which I think many of us can relate to.
If you've ever thought "I'd love to dance but I don't have the right body for it" and given up on your dream of dancing, then you need to check this project out. For those of you who've read this blog and know my story, you know that I was told I could never dance because I was too tall- no shoes would fit me, no leotards either (although now thinking back, I would have made a great Balanchine ballerina [Balanchine was known for loving very tall ballerinas]). At the age of 16 I threw caution to the wind and followed my heart.
Ryan and Jason are firm believers that every one can truly dance, no matter what body type or anatomy they have. They are looking to study the body's anatomy first, and then develop a technique that will fit you personally. It's a stand out idea. Ryan likens those who try one style and find that their body won't work in it like putting a square peg into a circular hole.
Research will begin in October and culminate with a free community workshop at the Manhattan Jewish Community Center in March 2012.
They are looking for pledges to get their project started. Donations fit every pocket, with pledges starting at $1. I hope they are able to make their goal, because this is a project I would love to see come to fruition.
Dancingly, Jenn
jenn@centralctfootcare.com
Dr Tina Boucher, Dance Podiatrist

Improving Your Arch: Gone Bad

In an April 2011 I received an e-mail about improving your arch, but I think it's an important topic that needs to be reemphasized. Safe products like the AFX will help you maximize what you already have, but if your foot is not designed that way, you will be disappointed. Dancers who become obsessed with how beautiful their feet are are only setting themselves up for disaster, and more importantly, injury. When you put your feet under the couch, have a friend sit on your toes, or hang from the barre putting all your weight on that arch you are likely overstretching the tendons and ligaments in your feet. After doing this for several weeks or months you will lose the stability you need in your feet and ankles. Bad news is ligaments don't heal on their own and take forever to heal.

If you're looking for ways to get a better arch, work harder on using all the muscles in your feet, from ankle, to midfoot, to toes. You can also use the AFX to work your foot safely and properly.

Dancingly, Jenn

jenn@centralctfootcare.com

Dr Tina Boucher, Dance Podiatrist