Foot Concerns

Dancing Smart Newsletter
September 1, 2006

Announcements

Quick announcement that Level 2 of the FUNctional Guide for Dancers is on track to be finished by the end of September – ahead of schedule!

I'd like to start with some great reader feedback about bunions. This is in response to a June newsletter. Beth writes…

I hope my own experience with bunions will throw a little further light on the subject. I've had huge bunions for years, but only recently began to do some serious research on them. In my case, at least, they seem largely the result of hypermobility of the feet, first noticed by a shoe salesman when I was 5 yrs old: "My, this child has extremely flexible feet!" I said, "Is that good?" And he answered "No, this could be very troublesome." (Not bad for a worker in Children's Shoes over 60 years ago!)

My first year in NYC, doing modern dance every night of the week, I got terrible pains in the metatarsal arches, & was told that they were falling. I continued dancing, but in shoes, going on to ballet, pointe, etc., working constantly to keep the foot muscles strong (but the bunions were growing all the time), until in my 40s my feet were too deformed to do pointe any more. My shoe size went from AA to doublewide.
I continued dancing (mostly ballroom) and teaching ballet, and every few months or so the arches would drop another notch, extremely painfully, until I could barely walk. I usually managed to recover, but then realized that shoes wide enough to accommodate the bunion also allowed the foot to continue spreading.

I invented a solution: I made a strap out of woven nylon, secured with Velcro, that exactly fits the width of my foot above the bunion joint. It doesn't stretch at all, doesn't allow any further lateral expansion of the foot, no matter what shoes I wear. Naturally, the bunions remain, but there is no more pain. I'm still teaching and still dancing!

Best wishes, Beth Kurtz

For those dancers who want to try this note that above the bunion is not on the toes but the part just before the bunion area. I have not tried this, but appreciate the tips from readers that have worked for them. I'm delighted that Beth figured out an efficient low-cost solution for her feet! Beth has graciously said if other dancers have questions about her solution you can go to her website www.bethkurtzballet.com, click on students questions and post your question. Thanks, Beth!

Let's go onto another foot question from Donna

First Question

First, let's explain what a Morton's neuroma is. In 1876, Dr. Morton described this condition where there is a growth of nerve tissue that develops generally between the third and fourth toes. It develops over time, sometimes from poor foot mechanics caused by pronation or even wearing too tight of shoes. Sometimes there is no specific cause. It can create periodic episodes of pain. Generally, it is treated by getting off your feet, cortisone shots, arch supports and surgery in severe cases.

I have a few questions for you, Donna. Is the neuroma more painful when you are working in a turned out position rather than parallel? Does it other you more at the barre rather than center? The reason I ask is in my limited experience of seeing clients with this challenge is the majority of them had some pronation issues. If that seems possible in your case I would try taping for pronation to see if it improves.

I would also encourage you to see a massage therapist who works with myofascial release techniques. I'd be curious if the irritation that is continual with a neuroma is released at all after working the fascial (connective tissue) of the lower legs and feet. Actually, sometimes the fascia can influence an area that is far from it! For example, I will often have dancers stand in parallel and roll down to feel the tightness of their hamstrings. Then I'll ask them to roll the bottom of their foot on a dense rubber ball for a few minutes, before rolling back down to assess their hamstring tightness. Do you know that consistently, 60% or more will say that their hamstrings feel looser after rolling their foot on a ball? It's so cool! That's because from the bottom of the foot up to the base of the head, is connected by layers of connective tissue that draw a posterior line up the body.

Check your shoes out. Does the neuroma bother you less in tennis shoes that have a good arch? If so, purchase a flexible arch support and try putting it in your ballet shoe. It will influence the look of your foot in tendu – but may allow you to get through class without so much pain. I might even try taping the support to your instep if that felt more stable. The focus is on maintaining the arch of the foot both from the heel to the toes, and, from the big toe to the little toe. There is also an arch formation there. If you've got a callous under the second toe instead of under the big toe, you definitely have issues with that arch. The pads of the big toe and little toe are where the weight should fall, not on the second toe.

I hope I've touched upon some useful tidbit for you, Donna. I can certainly understand trying to stay away from surgery whenever possible. That would be my focus as well.

One more quick question about feet…

Final Question

My expertise is not in pointe shoes, so unfortunately, I can't make a recommendation about them. There are so many new types since I wore pointe shoes that I don't know about. What I can suggest is to focus on developing her awareness of 'sinking weight'.

It is common to have a high arched foot and extra flexibility in other joints, such as the knee. If this is the case for your student you want to focus her attention on not going into hyperextension on pointe. A difficult task for sure! This requires strong abdominal focus and balanced quadriceps and hamstring strength, to have all the body parts hold their own weight, instead of sinking into the feet.

If you have access to a Pilates studio with a reformer, you might suggest she try a session or two to help develop these new patterns. It can be very useful to work on the reformer as if you were standing, and feel the relationships between body parts. If your Pilates instructor is knowledgeable in dance that is better yet!

I empathize with you, Jane, because a hyper mobile student can be as challenging to teachers as the student who is overly tight. Good luck!

Warm regards,

Deborah

"Education is the key to injury prevention"

Copyright ©2003-2006 The Body Series. All Rights Reserved.

Deborah Vogel is a dancer, author, and master teacher who conducts workshops across the U.S. for both student and professional dancers. Her numerous articles on dance technique and injury prevention have appeared in Dance Spirit and Dance Teacher magazines. She is the Director of the Institute for Performance Studies and a faculty member at Oberlin College and the OC Conservatory of Music. During her years in NYC she co- founded the Center for Dance Medicine. Deborah makes her home in Oberlin, Ohio.