Bone Bruises
Dancing Smart Newsletter
Friday, January 14, 2005
This week's newsletter is a bit different. I have a request to make of you. I am in the process of finishing my "Tune Up Your Turnout" book. I'd like to ask you for your top questions or concerns about turnout. I'm toying with the possibility of making the last chapter either a generally Q&A chapter, or perhaps I'll see a theme in your questions and address that in that last chapter.
I'm focusing on the book this month before I go back to a heavier teaching schedule, so I would ask you to send in your comments/questions by next Sunday, January 23rd. I sure would appreciate any input you would care to give.
The basic outline of the book is alignment, then muscular considerations, common patterns, stretches and strengtheners, and then this last chapter. I'll definitely keep you informed as to when it will be ready to order. Thank you!
First a follow up question to last week's newsletter:
I have just a quick follow up question regarding the popping noise heard during a ronde de jambe en l'air. You mentioned a tight iliotibial band. I was wondering if you could give some examples of stretches to ease this up.
Thank you! Lorrie
Dear Lorrie,
For a tight iliotibial band, I first suggest working with the ball to release tightness in that lateral hip. Instead of describing in words some different stretches I was able to find a website that had pictures. Most dancers are visual learners and so I will direct you to the website. (perhaps some day I will learn how to put pictures into my newsletter).
There are 4 different stretches – so hopefully one or two of them will work. Hereof the website:
http://www.csuchico.edu/phed/atc/Projects/ITband/stretching.html
A new question from Maria.
Dear Deborah,
I teach in addition to taking three professional level Ballet classes a week, one of which includes an extra half hour of Pointe. Three months ago, while demonstrating a grand jete for my students, I had a freak accident. The shoe I teach in (a Capezio jazz style they no longer make) which had a split rubber sole under the ball of the foot, buckled in mid-air. It forced my second from the end little toe to curl under so that when I came down from the grand jete, all of my weight went onto that bent toe. It felt like a sledge hammer had hit my toe - I thought I'd broken it. The top of the shoe is mostly elastic so there was pressure on the toes too. I kept teaching, with a slight limp, and wrapped and iced the toe that night. The next day I went to my doctor for X-rays, which showed a bad sprain. Besides tearing the ligaments, the ends of the bones at the mid-toe knuckle were rubbing together. My doctor said a broken toe would have been preferable as it would have been less painful and healed quicker!
I needed to perform in our early December Nutcracker so I placed myself in the back of the corps numbers and used slippers instead of Pointe shoes - which would have been excruciating. I haven't re-injured the toe but it's still too painful for Pointe. I continue teaching OK, in a different style of jazz shoe, but had to skip most of my own classes in December. I'm starting to take my advanced classes again, can point the foot and releve, but can't put pressure on the tip of the toe. Is there anything I can do to speed the healing as I need to dance on Pointe in our June recital. I no longer wrap the toe nor take Alleve (which my Doctor had recommended initially) and stopped using heat or ice on it. I continue to take my Glucosamine/Chondroitin/MSM supplement. Should I massage the joint, use my sonic vibrator on it, or would this just irritate it? Also, does being older slow the healing?
Thanks for any ideas,
Maria
OUCH! This is a great example of how amazing dancers are. How many people can land with all their weight onto a toe and continue teaching, much less walking? Not many other groups of athletes, let me tell you.
The short answer to your question about age and healing is maybe – the older we get – often the longer it takes to heal from injuries. BUT – and this is a big but – health and healing is a complex combination of three areas. The first area is the physical arena which includes nutrition, muscular fitness, organ health, etc., emotional well-being, and environmental influences such as toxins and chemicals. All three areas impact each other – and typically – the older we are the more imbalances we might have in one area or another.
For the average person, getting over an injury might take longer for a 50 year old as compared to a 15 year old because of their general level of health, but if the 50 year old were as healthy or healthier than the 15 year old, then there should be little difference in how quickly one heals.
So, in general, let's not blame age for our various woes. (You're not doing this at all, Maria – just wanted to make that point) Dancers, because of their focus on their physical - structural health often look much younger than their biological age and are healthier than their non dance counterpoints. Yes! Dancers rock!
But I digress... back to bone bruises and getting you back on pointe. Bone bruises can often take 3 months or more to fully heal. (hopefully, your bone bruise will be long gone by June)
When you initially make significant contact with a bone you create small fractures in the outer layer of the bone called the cortex. The cortex is filled with fibers that have spaces between them where the calcium fills in to strengthen bone. When you have a hard strike on the bone you tear some of those fibers. If you break enough of the fibers the bone begins to separate and you have a bone fracture. Quite clearly, you had a significant bone bruise on your toe.
Even though on x-ray the bone looks intact, the body goes through a healing process similar to a regular fracture. It has to remove the damaged fibers in the area and begin rebuilding new fibers and laying down more calcium. This process can take 8-12 weeks.
The challenge is to not re-injure the area while the bone is rebuilding, which will slow down the healing process. You are absolutely doing the right thing by not going up on pointe, which would potentially slow down this rebuilding process. The tenderness on the tip of your toe will help guide you when it is okay to go back on pointe. This is one time where I would error on the side of caution since you have the extra months before the spring recital. Since it has already been over 3 months since the initial injury, I'm hoping you will feel much improvement in the next few months.
Time will be the main support for your healing. If a regular massage makes the foot feel better in class (generally it does) then massage away, or use the ball underneath your foot.
Taking the MSM and glucosamine Chondroitin isn't going to hurt at all, and may help quite a bit. I use MSM on a regular basis, orally and topically for strains.
I'm going to include a website address for you to check out. The article talks about natural anti inflammatories. The beginning of the article is talking about heart health but if you continue reading there are some good general suggestions for joint health and healing.
http://www.mercola.com/2005/jan/12/anti_inflammatory.htm
On with the dance!
Deborah
PS: remember to send me your questions and concerns about turnout!