|The nature of
ballet movements is unusual, and therefore leads to some
unusual injuries. Dancers frequently suffer minor trauma,
which would not trouble an average person however they make
such demand on their bodies as to prevent the ballerina from
performing. Many dancers attribute the cause of injury to the
hardness of the stage floor. Most are wooden and laid directly
on concrete to provide a very hard, unremitting surface. This
is essential to support the body mass when landing.
Traditional pointe shoes provides no shock attenuation and
subsequently the number of injuries were higher prior to the
introduction of the newer pointe shoes. Deterioration of the
toe box with use meant no support was given to the foot.
Segmental deterioration of the shoe also caused the dancer to
use her body to compensate when standing on pointes. This was
thought by many experts to be the reason why the ankle was so
often damaged when the dancer sprang onto the full pointe
position. Pointe work often results in damage to the great
nail with Black nail, Onychauxis and ingrown nails commonly
reported. According to Quirk (1988) ballet dancers are no more
prone to bunions than non ballet dancers but may suffer
arthritic changes on the first metatarsal phalangeal joint or
hallux rigidus. Corns and calluses are common however and
pressure to the Achilles tendon at the posterior aspect of the
malleoli is reported. Everting the foot when the dancer adopts
a turned out position can lead to tendinitis. Repeated jumping
and landing may irritate the sesamoids causing sesamoiditis.
Dancers are taught to land lightly and with a small bend of
the knees to dissipate the shock of hitting the hard floor. To
ignore this may lead to chondromalacia of one of the sesamoids.
Stress fractures are frequently reported with the most common
site in the second metatarsal. This is thought however to be
more common in demi pointe work. Impingement syndrome is
caused when repeated pointing of the foot which compresses the
lower tibia and the upper calcaneum, thus flattening the
posterior tubercle (os trigonum).
Another consequence of repeatedly pointing the foot is the
development of traction osteophytes at the front of the ankle.
These can break off forming loose bodies in the front of the
ankle joint that lead to anterior impingement when the foot is
dorsiflexed. The ankle tendons are often overused and sometime
crepitus occurs. The most vulnerable is the flexor hallucis
Dansko Shoes. This tendon plantarflexes the big toe and helps the
dancer get up onto pointe. Overuse of this tendon can produce
a nodule which can be felt moving with the tendon just behind
the medial malleolus. The tendo achilles often involved with a
calcaneal bursa and this is caused by tying the ribbons too
tight. Anterior compartment syndrome (or shin splints) may
also be found with tibial stress fracture. The most common age
for girls to start ballet classes is five years but pointe
work would normally not commence until around the age of 11
years. Most authorities agree the introduction of pointe work
at earlier years is dangerous and may harm normal development.
In contrast to ballet injuries, some modern dance performers
wear stiff boots or hard clogs to amplify their stomping
sounds. Instead of dancing softly on pointes, dancers stomp on
their feet. Many are not trained dancers and subsequently
their accidental and repetitive-motion foot problems are more
similar to injuries suffered by the general public than those
seen in traditional dance companies.
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