Graceful and nimble, ballerinas often appear to fly through the air effortlessly, landing on their feet without missing a beat. In reality, this delicate art can be incredibly physically taxing, sometimes resulting in serious foot and ankle injuries for even the most experienced dancers.
"In addition to putting an amazing amount of stress on their feet, ballerinas are often well below an ideal body weight," said Dr. Sean Peden an orthopedic surgeon at ONS. "This leads to several different and often unique foot and ankle conditions."
According to Peden, one ballet-specific foot and ankle injury is caused when dancers assume the "en pointe" position. "In this position, an enormous amount of strain is put on the dancer’s great toe, as it is essentially holds up the entire body weight through a small joint," he said. "The main flexor tendon of the toe takes over the job of the largest tendon in the body, the Achilles." Over time, as the tendon grows in size due to repeated use, it will get pinched in the posterior ankle joint and result in significant pain.
Ballet dancers also suffer from many foot and ankle problems found in other sports. "Corns, calluses and blisters, are all common," said Peden. "These are necessary adaptations to allow a high level dancer to compete." The lateral ankle sprain, the most common orthopedic injury in any sport, is also very common among ballet dancers. "The mainstay of treatment for ankle sprains is rest, ice, compression and elevation," he said. "A short period of rest and immobilization is then followed by aggressive physical therapy, with strengthening of the muscles that stabilize the ankle."
Ballet dancers can also develop anterior impingement at the ankle, which comes from repetitive dorsiflexion, which occurs when the foot and toes pull upward towards the shin. "Landing from jumps and deep knee bends exacerbate this problem," said Peden. "Pain is felt in the anterior ankle."
Treatment for this condition is customized to the patient, but minor activity modifications and a period of rest can dramatically improve the side effects. "Many dancers will treat the symptoms with a combination of anti-inflammatory medications and occasional steroid injections in the region of maximal tenderness," said Peden.
For more information about how to keep ankles and feet healthy, click here.