A Dancer’s Life: Foot Pain and Arthritis

An abrasion is the when a portion of the epidermis has been scraped away or damaged. An abnormal mechanical movement caused by excess friction or rubbing is generally the cause. Barefoot dancers are more prone to this type of injury. As the foot slides or glides across the floor surface, it may stick causing the skin to scrape off, which is very painful.

The skin’s reaction is similar to a burn, raw and exposed. The affected area should be cleaned with antiseptics and an antibiotic of topical remedy should be applied. The area should be protected with a sterile dressing while it heals. These are necessary precautions to prevent infection. Proper padding and scrapping techniques help reduce friction to the abraded area. Dancing may resume immediately depending upon the location of the injury and the presence of pain. Do not dance on the area if it causes more pain, this only delays the healing process.

Epiphyseal plates are the growth area of bones. If the growth area of a bone is traumatized, inflammation occurs, called an apophysitis. In the dancer’s foot, the most common area affected is the heel. A young dancer will experience pain in the back of the heel.

Apophysitis occurs only in adolescents who are still growing. It is one condition that can truly be called growing pains. It frequently occurs between ages 10 and 15 and affects boys more than girls. The condition is a product of repetitive trauma, resulting in decreased circulation to the affected area. It is worsened by jumps, turns and a running motion. Additional pressure on the affected area will cause substantial pain and an inability to bear weight. While the heel is the most commonly affected area for a dancer, any growth plate in a bone of a growing child can be affected.

Initial treatment is rest. Pressure must be taken off the area for 3 to 4 weeks. Ice can be used during the first 48 to 72 hours to reduce swelling. Anti-inflammatory medication can help relieve pain, inflammation and discomfort. A heel lift will reduce some of the pull of the Achilles tendon, relaxing the area. Apophysitis is usually fully healed within 30 to 60 days with full return to dance at that time.

Arthritis is pain and inflammation of a joint. There are numerous forms of arthritis describing 100 different diseases. They include; osteoarthritis, rheumatoid arthritis, psoriatic, and bacteria arthritis, gout and many others. Each disease has a unique treatment plan and prognosis, it’s important to properly diagnose the particular arthritic condition. The most common arthritis for dancers is osteoarthritis or degenerative joint disease. As the name implies, excessive wear and tear breaks down joints. This traumatic arthritis occurs from the excessive force a dancer generates on a specific joint. The force is greater than the joint‘s available range of motion, progressively worsening with repetition over time. Pain is greatest after dance activity and stiffness can occur with inactivity, joint motion can become limited. A painful joint with decreased range of motion will affect a dancer’s performance greatly.

Arthritis can develop as a secondary condition after trauma, known as traumatic arthritis. This injury causes damage to the joint causing the formation of arthritis. For this reason; sprains, strains, dislocations, fractures, and other injuries should be treated swiftly and correctly.

Injection therapy with anti-inflammatories and anesthetics can be helpful in reducing discomfort to the affected joint. Physical therapy also reduces swelling, limits scar tissue and promotes healing. Oral medications may be necessary to limit inflammation and pain. Biomechanical devices, like orthotics, can limit abnormal motions that cause a strain on the involved joints, maximizing the efficiency of the joint and keeping it in a neutral position. Surgery may be necessary for joints that are constantly painful and have a limited range of motion. This should be performed only when conservative measures fail.

Treatment is needed to prevent arthritis from worsening and to stop further deterioration of the joint. Scar tissue formation can be limited with a prompt response to the condition. Arthritis cannot be cured, but can be made more manageable without disruption of dance time.

Blisters are a separation of epidermis, the outer layer of the skin, that fills with either a watery serous fluid or blood. This condition is one of the most common problems for dancers. As the blister develops, one feels a hot spot, if the pressure is removed from the area at this point the blister will not form. However, as soon as a hot spot on the foot can be felt, stop the offending movement. A covering, like a bandage or moleskin, will reduce friction and allow resumption of activity.

The most common causes of blisters are improperly fitted stocking, socks and footwear. This creates an area of friction from movement in the shoe and or constant pressure from a tight fit. Sometimes the dance floor surface adds to the problem. Friction usually occurs in a twisting fashion, disrupting the skin layers. Some people are prone to blisters because of the anatomical structure of their foot.

Blisters can be extremely painful, a raw layer of skin can be exposed and the fluid accumulation can put great pressure on the underlying tissues. Self-treatment should start with an antiseptic cleansing of the affected area. Puncturing the blister should only be done if there is pain. To do so effectively and safely, sterilize a needle by holding it to a flame, let it cool, then make a small puncture at the proximal-most border. Drain the fluid and leave the blistered skin intact. The skin acts as the best dressing to cover the area. A dispersion pad can be used to alleviate pressure from the area, dance usually resumes without any lost time. If treatment is not initiated immediately an infection can develop, leading to a loss of several days of dancing.

Prevention is more important than treatment. Make sure dance shoes are the correct fit and check for problems with stockings and socks. Perspiration can enhance the of formation of blisters as moisture increases friction. Use powder and natural fiber socks to absorb counteract developing moisture.

For those who have a history of blisters in one area, applying petroleum jelly can reduce friction. Covering the area with a bandage, tape or moleskin will add further protection. Where biomechanics come into play, orthotics may be helpful. A pronating foot has an increased amount of friction and twisting, the orthotics will stop abnormal motions, and hopefully prevent chronic blistering.