A Guide To Diagnosing And Treating Common Dance Injuries

Lisa M. Schoene, DPM, ATC, FACFAS

   The materials that dancers place in pointe shoes can range from bubble wrap and gel pouches to paper towels and the more favorable lamb’s wool. Dancers may tape their toes and wrap them as if they are going into the boxing ring. Unfortunately, if injured, the pointe dancer does not have the luxury of wearing looser shoes. However, jazz or modern dancers may have more flexibility in this regard as their shoes are slightly forgiving and some dance barefoot so jazz and modern dancers may use flesh-colored bandaging and taping.

   If dancers need some supportive measures inside the shoe, they can modify some shoe styles with simple padding or small dress orthotics. If injured, the dancer may be able to take a class in another more supportive shoe like a jazz gym shoe that can accommodate padding. Understanding dance shoe gear and being creative with modifications can augment the podiatric physician’s treatment plan.

Pertinent Insights On The Psychology And Expectations Of Dancers

It is still commonplace that studios expect their dancers to be at class and perform in dance shows on a regular basis. Quite often the dancer feels the need to be perfect and to have a beautifully aligned, slim body that is pleasing to the teacher. Like professional companies, the pre-professional company has high expectations and will also have a rigorous schedule, testing individuals to their limits to prepare them for a new career.

   It is imperative that dancers can handle the rigors of dance classes and show schedules, and be able to cope with the mental and competitive stresses as well as any possible injury potential. Management of their bodies is a reality at this point of their career and they need to take that management very seriously.

   Dancers are usually high achievers with type A personalities. They may be insecure perfectionists who always strive to take themselves to the limit. The nature of dance pushes dancers to improve their technique and achieve milestones of strength and technique abilities. All of this can promote some unhealthy eating patterns, habits and possible anorexia issues. Dancers may have a poor diet due to insufficient calories or a lack of nutrient rich food. They may also smoke to appease food cravings.

   All of these bad habits can ultimately be disastrous due to the predisposition toward injury and downtime. It is known that psychological distress has a significant association with injury duration so it is important to address these psychological stresses and intervene when necessary.1 In the professional world, dancers are expected to dance or be available for choreographic training, even if they are on workman’s compensation. The doctor should feel comfortable communicating to the dancer, parents of minors, artistic staff and therapists.

Delineating The Variable Factors That Cause Dance Injuries

When treating dancers, there are factors we must understand that may be more problematic than in some other typical athletes. The level of difficulty and the movement of this sport ride on extreme precision so any of the intrinsic and extrinsic factors I will discuss below can and will cause injury, big or small.

   Intrinsic factors include anatomical variations in height and weight, biomechanical lower extremity alignment issues, strength and flexibility deficits, age and sex, fatigue, diet, cardiovascular endurance, sleep allotment and personality/stress coping strategies.

   Extrinsic factors include hours spent dancing (or what we call “exposures”), shoe fitting issues, flooring issues, set design, lighting and music tempo, temperature, travel and performance schedules, and rehearsal schedules.

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