Ankle and foot injuries in ballet dancers

Lower limb injuries have been shown to account for 65-80% of all ballet injuries, with the ankle and foot making up 53% of these injuries.
Below are some common foot and ankle injuries seen in ballet dancers:

Posterior Impingement Syndrome
This condition causes pain in the back of the ankle when pointing the toe, performing a releve or dancing en pointe.
It is caused by the compression of soft tissues in the back of the ankle when the foot is plantar flexed (pointed). In some cases, it can be caused by an accessory bone in the ankle.
This can cause an ache behind the ankle, as well as stiffness which prevents the dancer from being able to be fully en pointe.

Achilles Tendinopathy
The calf muscle attaches onto the heel of the foot via the Achilles tendon. Problems with the Achilles tendon can arise due to rolling of the ankle to achieve turnout has opposed to creating this from the hip, as well as landing jumps without the heels on the floor. Issues with the Achilles tendon can also happen in young dancers during large growth spurts, as bones grow faster than muscles leading to muscles becoming shorter and weaker.
Achilles tendinopathy is an overuse injury, and is characterised by pain in the calf into the heel. It can be aggravated by tight ribbons or jumping sequences.

Plantar Fasciitis
The plantar fascia is a band of tissue that runs underneath the bottom of the foot. Inflammation of this can cause pain on the bottom of the foot, especially upon getting up in the morning. This injury is commonly seen with an increase in training load.

Flexor Hallucis Longis Tendinitis
The action of moving from demi pointe to full pointe places large amounts of load on the tendons around the foot and toes. Inflammation of these tendons can lead to pain along this tendon – starting from the big toe, travelling along the bottom of the foot or up the back of the ankle and lower leg.
Symptoms can include pain, swelling or clicking/locking of the big toe.

Anterior Impingement Syndrome
This involves compression of the soft tissues structures at the front of the ankle when the foot is flexed (for example in a plié position or landing from jumps).
Symptoms include a sharp pain during these flexed positions with an achey pain afterwards.

Shin Splints
Shin splints is described as aching and/or tenderness along the tibia (shin bone), which is worse during exercise such as jumping. Ballet dancers are at risk of shin splints due to the repetitive jumping and landing they perform.

Ankle Sprain
This involves a stretch injury to the ligaments and/or tendons of the ankle, caused by rolling or landing onto the side of the ankle. Symptoms can include pain and swelling over the side of the ankle. If the sprain is severe the ankle may feel unstable.

Stress Fractures
A stress fracture is an overuse injury that causes a small crack or bruising to a bone. These are most commonly found in the metatarsals (at the base of the toes) in ballet dancers.
Symptoms of a stress fracture can be pain localised over the bone, which reduces with rest. Pain is worse with external pressure such shoes. It is important to diagnosis stress fractures and treat them correctly to prevent them progressing into a regular fracture.

If you are experiencing pain in your foot or ankle and you are a dancer, we would love to help. Our newest physiotherapist Annissa has an extensive background in ballet and other dance forms, both performing and teaching. She is able to adapt your treatment plan and rehabilitation to suit your dance style and training regime, ensuring you will be back on your toes as soon as possible.

If you live or work around Mount Hawthorn, Leederville, North Perth, Glendalough and Joondanna and would like advice about the physiotherapy management of feet and ankle injuries in dancers or to make an appointment contact Oxfordstreet Physiotherapy today.