Dance Injury Index

Hi everyone!  Today’s blog post is a list of common ballet injuries and their symptoms, prevention, and treatment.  Please see my Disclaimer on my About page.

I really hope this helps you get better faster or diagnose any existing injuries so that you can dance your best.  Enjoy!


Pulled and torn muscles

Pulled muscles occur when the muscle is overstretched and the small fibers within the muscle tear or are ruptured.

PREVENTION:

  • Always properly warm up before class.  That first cambré forward is risky if you haven’t warmed your muscles.  Never stretch before class without doing strengthening first – stretching is not a warm up!
  • Don’t do any large stretches until your muscles are warmed up and ready to go.  Big, static stretches and ballistic stretches especially are a recipe for a pulled muscle.
  • Know your body.  If a stretch especially hurts today that usually doesn’t, just don’t do it.  Never, ever risk it.

SYMPTOMS:

  • Pain in joints or muscles
  • Swelling
  • Cramping
  • Muscle spasms
  • Painful stretching in area

TREATMENT:

  • Pain relievers – a pulled muscle can be extremely painful and annoying to work with.  Pain relivers can help you recover easier without constantly having to think about your pulled muscle.
  • Ice is very important for pulled muscles.  It helps with the muscle fibers to strengthen up again and is fantastic at relieving swelling.
  • Splinting can help the muscle fibers heal while the joints and bones of the area are stable and collected so the fibers can re-develop faster.  It will automatically speed the healing process.

DOCTOR VISIT?  For a major pull or tear especially, a doctor visit is necessary to know the degree of care or treatment that needs to take place for maximum and efficient healing.  For minor sprains that are only bothersome, just follow the directions above.

Sprained ankle

As you heard in my Core Workout, I recently sprained my ankle.  So, I have lots of first hand experience with dealing with and treating sprains.

A sprained ankle occurs when the foot rolls off laterally either outwards or inwards, stretching or even tearing ligaments.

PREVENTION:

  • Practice ankle stabilization and thera band exercises to keep your ankles strong and steady.  The more you wobble on flat or on demi pointe, the more vulnerable you are to an ankle sprain.
  • Do some quality tendus.  Make sure you practice shaping your feet correctly and not rolling in/out.  Keeping your weight level and feet nicely shaped will prevent you from landing awkwardly in a jump.
  • Use your plié correctly.  Practice using your plié, core, and lower back to support you as you land from jump to prevent wrong landings and wobbling.  Keep it stable and supported so that not all of the work goes to your ankle, making it vulnerable.

SYMPTOMS:

  • Swelling
  • Pain during plantar and dorsi-flexion

TREATMENT:

  • The basic RICE treatment is fantastic.
    • Rest – Cease all activity until pain is completely relieved
    • Ice – Swelling is common during ankle sprains, plus the ice helps tighten up the ligaments
    • Compression – This can help keep the foot bones in place to give the ligaments a chance to heal; I recommend an easy ankle wrap, or cast for more severe sprains
    • Elevation – This is great to help reduce swelling and promote resting

DOCTOR VISIT?  If you cannot walk, then yes.  Otherwise, don’t worry about it!

Achilles tendinitis

This is an extremely common injury in dancers because of the strain and use put on the calves.  Every time your relevé, your calf muscles and Achilles tendon are in extreme use, especially en pointe.  If you don’t take good care of your ankles and calves, Achilles tendinitis is inevitable.

Achilles tendinitis occurs when the Achilles tendon, the largest tendon in your body, located on the back of your ankle, becomes inflamed do to overuse and not proper care of the calf muscles.

PREVENTION:

  • Always stretch your calves and roll out your calves before and after class.  This is about the best you can do without modifying activity.
  • Watch your pointe shoe ribbons.  Some ribbons that are tied to tightly along the back of the ankle (the Achilles tendon) can cause tendon inflammation.  This can be fixed by simply tying ribbons looser or using an elasticized ribbon, which are available by commerical dance retailers or can be made yourself.
  • Always land from jumps with your heels completely down.  Heels up can cause tendon inflammation and tightness.
  • Watch your rolling (pronation and supination).  This can cause tightness, rubbing, and inflammation on your Achilles tendon.

SYMPTOMS:

  • Pain in the back side of your ankle at your Achilles tendon
  • Severe pain during jumping

TREATMENT:

  • Keep stretching and rolling out your calf muscles.
  • Rest.  This is needed too much with Achilles tendinitis, but if it gets severe, let it heal before re-starting activity.
  • Ice.  This helps the tendon re-heal faster and is vitally important with Achilles tendinitis.
  • Compression.  You can use a splint to help it re-heal with severe tendinitis.  Generally, massage is a good option for the calves.
  • Elevation.  This can help relieve swelling and have the tendon heal faster.

DOCTOR VISIT?  I recommond going to the physical therapist for Achilles tendintiis because they can help massage your calves and assign exercises.  From sever Achilles tendinitis, consult your physical therapist for a recommendation for the doctor.  Minor tendinitis can be treated on your own without a physcial therapist or doctor.

Flexor hallucis longus tendinitis

This is an injury very unique to dancers.  The flexor hallucis longus begins in the upper calf and runs all the way down the bottom of the foot and attaches near the ball of the foot via the flexor hallucis longus tendon.  The muscle is primarily responsible for flexing the big toe, rising up to demi pointe or full pointe, and pointing the foot (plantar flexion).  As y0u can see, this is a lot of things that dancers do.

Tendinitis is an overuse injury caused by very common activity by ballet dancers.  It is when the flexor hallucis longus tendon becomes inflamed.

PREVENTION:

  • Make sure your shoes fit – shoes that are two wide make extra work for the flexor hallucis longus, causing tendinitis.
  • Stretch and strengthen your feet to reduce the risk of overuse.  Your feet won’t get as tired when they have to do a lot of work in class if you’ve been working on gradual strengthening beforehand.
  • Make sure to pay attention to the way you roll up to demi or full pointe and make sure you’re using your technique correctly.

SYMPTOMS:

  • Pain in the inner ankle (typically extends down to the big toe)
  • Pain upon compression of the flexor hallucis longus tendon
  • Pain usually follows activity, for example when you wake up the next morning or when resting after class

TREATMENT:

  • Rest.  This is vitally important when flexor hallucis longus tendinitis.  It allows time for the tissues and tendon to heal fully before activity resumes.
  • Rehabilitation with a physical therapist.  This is important to re-strengthen and re-train the demi pointe to work correctly.
  • Anti-inflammatory medication.  Flexor hallucis longus tendinitis is an inflamed condition, so anti-inflammatory medication is very helpful.  Consult your doctor.
  • Ice!  This is another very important one when it comes to tendinitis because it helps the tendon heal faster and helps with the inflammation.

DOCTOR VISIT?  Yes, for sure.  I highly recommend going to the doctor to get a professional diagnosis followed by a physical therapist for rehabilitation if you believe you have or have this condition.

Plantar Fascitis

Plantar fascitis is the severe inflammation of the band of tissue connecting the heel bone (calcaneous) to the toes.  When this muscle becomes inflamed, it is very distinct.  This condition is also called “policeman’s heel.”

PREVENTION:

  • Stretch your calves and your arch.  You can do the basic calf stretch which is listed in my Flexiblity Guide along with a plantar fascia stretch that involves pressing your toes up against a wall, bending your knee, and lunging with the other leg.  Otherwise flexing the toes should be beneficial.
  • Make sure you’re wearing fitting and supportive pointe and flat shoes.

SYMPTOMS:

  • Sharp pain in the foot or heel
  • Foot sole pain
  • Limping
  • Swelling
  • Tenderness

TREATMENT:

  • RICE – This injury should do the usual Rest, Ice, Compression, and Elevation treatment regimen.  This allows the fascia to inflame less and heal faster.
  • You may need to use a brace or splint to allow the fascia to heal faster and become less inflamed.

DOCTOR VISIT?  Not usually.  Unless in extremely severe cases, a doctor visit won’t be necessary for plantar fascitis.  The basic RICE remedy and maybe a splint or brace will be all that’s necessary.

Over-turnout of the knee

Knees are very vulnerable parts of the body for dancers.  Because of the turnout required of the legs in all ballet steps, twisting and over turnout of the knee is very likely.  It occurs when forced turnout endures and the ligaments of th knee can’t support the twisiting taking place.

PREVENTION:

  • Work your turnout correctly.  Originate the turnout of the legs from the quadratus femoris and other 5 turnout muscles of the hip, not the knee or ankle.
  • Strengthen your hamstring and quadriceps muscles.  These support the knees so that twisting does not occur so easily.
  • Strengthen and stretch your qauadratus femoris and other hips muscles to increase turnout from the hips so it does not originiate from the knees.
  • Double check your training – is your teacher forcing turnout on their dancers?  That is un-safe training and you may have to switch schools if that is occuring.

SYMPTOMS:

  • Extended pelvis – hip muscles are released and pelvis sent backwards
  • Pronation of the feet (rolling in)
  • Inability to hold turnout from the hips
  • Twisting knees
  • Unmaintained turnout during centerwork

TREATMENT:

  • Re-training of the muscles of the hip and leg to work correctly as one – not twisting.  Pain shoud release upon working correctly.
  • Strengthening of the hamstrings and quadriceps muscles to help re-align leg and release twisiting motion.  It is also important prevetion, but it can help with treatment, too.

DOCTOR VISIT?  Not necessary.  Twisting knees is self-treatable by the dancer learning to work and control his or her turnout correctly.

Snapping hip syndrome

This is an ever-common injury and condition among dancers.  It occurs when the iliopsoas tendon snaps over the lesser trochanter or head of the femur bone (thigh bone).  Basically, it’s a band of muscle snapping over top of a upper leg protrusion.

It’s important that while you may hear a snapping sound, an UNPAINFUL snapping hip is not a cause for alarm, it is certainly normal.  If the syndrome becomes painful, it must be treated.  But be aware that unpainful snapping hips can become painful if they don’t undergo prevention.

PREVENTION:

  • Stretch your iliopsoas!  In my All About the Iliopsoas blog post, I made a video showing you various iliopsoas stretches and exercises.  Doing these daily can help you prevent this or prevent it from become inflamed.
  • Maintain turnout throughout all movements to prevent snapping.

SYMPTOMS:

  • Snapping sound during grand rond de jambe or développé alisicon

TREATMENT:

  • See a physician or physical therapist if snapping becomes painful.
  • Iliopsoas stretches and exercises.

DOCTOR VISIT?  Yes, if painful.

Spondyloslisthesis

Spondyloslisthesis is a severe condition that occurs when stress is put upon the bones and vertebraes of the lower back.  It is very important to get a professional diagonsis.

PREVENTION:

  • Properly lifting up out of the pevlis at all times when dancing and not crunches into the lower back by an anterior tilt or “tucking.”  Always feel good posture and your feet rooting into the ground as your head lifts upwards toward the ceiling.
  • Not pushing down into the vertebraes of the lower back during cambré derrière is vitally important, in addition to supporting the lower back with eecentric engagement of the abdominals in arabesque.

SYMPTOMS:

  • Pain in the legs, thighs, and glutes that worsens when standing
  • Hamstring tightness or stiffness

TREATMENT:

  • Severe spondyloslisthesis may require surgery.
  • In the short term, rest and pain relievers as well as anti-inflammatories are recommended and encouraged.
  • See a physician or doctor.

DOCTOR VISIT?  Absolutely.  Spondyloslisthesis is a very serious condition.


I hope this helps you!  See you on Friday.

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