Foot And Ankle Injuries In Dance

By Beth Shum

Introduction

Professional dancers spend many hours on their feet training, and it is no secret that we see foot and ankle injuries accounting for many musculoskeletal conditions amongst this population.

The ankle joint is a hinged joint and its biomechanical function is very complex. Dancers' feet are often required to be in maximum plantarflexion and in a turned-out position. This position adds strain around the ankle joint, thus increasing the risk of acute and recurrent ankle injuries.

This blog post will explore the management of dance-related foot and ankle injuries.

Incidence rate

A recent study looking at the incidence and prevalence of injuries requiring medical attention in a professional ballet company showed an incidence of 3.9 per 1000 hours in women and 3.1 per 1000 hours in men with a prevalence of 91.5% of women and 79.2% in men (Mattiussi et al. 2021). That is approximately 9 in every 10 female dancers, and 8 in every 10 male dancers experiencing injuries requiring medical attention!

Risk factors

There are several risk factors that increase the probability of foot and ankle injuries in dancers. These factors include

• Fatigue-induced overuse injury

• Chronic instability

• Foot anatomy

• Metatarsophalangeal joint injury

• Rigid hallux (Stiff great toe)

• Increase foot plantar pressures

• Footwear conditions

How to reduce the risk of injuries:

There are several strategies which can be used to potentially reduce the risk of injuries.

These strategies include:

• Reviewing your dance's shoe conditions

• Reviewing foot biomechanics in different regions of the foot.

  • gait analysis

  • jumps

  • peak force

• Addressing the loading on the foot through strengthening and mobility exercises

Pain and swelling managment

Common conditions that may cause pain and swelling include:

• Ankle impingement

• Tendinopathies

• Sesamoiditis

• Metatarsal stress reaction

• Sprains

• Ligament strains

• Lisfranc injury

To manage these conditions, relative rest, activity modification, ice and elevation of the injured area, and taking an anti-inflammatory such as ibuprofen (NSAIDs) are recommended.

Goals for Conservative Management

The aim of conservative management is to promote optimum recovery of the foot and ankle. This includes improving range of motion, active stability, and movement coordination.

Dance-Specific Rehabilitation

Rehabilitation should be specific to the style of dance and consider factors such as:

• location of dance training

• frequency of training and performance

• quality of instructions

• footwear

• flooring

• dancer’s schedule.

Working Towards Injury Prevention

Even though injuries can be a part and parcel of a professional dance career, working towards reducing your individual injury risk is a critical aspect of a sustainable dance career. Technical retraining, plyometric training, improving foot loading capacity, self-correcting habitual compensation patterns, and stamina and endurance training are also essential components of rehabilitation.

References:

Iafrate, J.L., Townsend, C.E., Scott, C., Yun, H.J., Ventola, A. and Semanson, S. 2021. Diagnosis and Management of Foot and Ankle Injuries in Dancers. Current Physical Medicine and Rehabilitation Reports 9(3), pp. 47–56. Available at:

https://link.springer.com/article/10.1007/s40141-021-00313-8

[Accessed: 9 May 2022].

Mattiussi, A.M. et al. 2021. Injury epidemiology in professional ballet: a five-season prospective study of 1596 medical attention injuries and 543 time-loss injuries. British Journal of Sports Medicine 55(15), pp. 843–850. Available at:

https://bjsm.bmj.com/content/55/15/843

[Accessed: 10 May 2022].

Li, F., Adrien, N. and He, Y. 2022. Biomechanical Risks Associated with Foot and Ankle Injuries in Ballet Dancers: A Systematic Review. International Journal of Environmental Research and Public Health 2022, Vol. 19, Page 4916 19(8), p. 4916. Available at:

https://www.mdpi.com/1660-4601/19/8/4916/htm

[Accessed: 9 May 2022].