Athletes or Artists?
Conservative pedorthic treatment and the use of well
padded footwear, at least during rehearsals and long
hours of practice, are recommended. If plantar surface
gait analysis is available, off-loading in the form of
custom orthotics or underfoot padding is effective in
relieving specific pressure and pain. Custom orthoses
will help reduce pressure on the metatarsal heads, as
will a metatarsal pad. Properly fitted shoes, which is a
basic recommendation in all categories of footwear, is
particularly important in dance to reduce shear inside
the shoe and restrict excessive metatarsal phalangeal
joint motion.
Nails:
It is essential for the professional or serious dancer
to receive regular podiatric nail care and inspection.
Particularly in ballet, when the dancer’s weight is
largely on the hallux and tips of the lesser digits,
pressure on the distal tips of the nail pushes the nail
back into the nail bed. As a result, over time, nails
may become thickened or discolored and eventually
deformed. Subugunual hematomas and even loss
of the nail is common and often accepted as an
occupational hazard amongst ballet dancers. Ingrown
toenails necessitate immediate attention due to the
resulting intense pain and swelling that accompany
this condition. Again, properly fitting shoes with
adequate toe room helps to protect the nails from
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Pedorthic Footcare Association | www.pedorthics.org
direct collision with the toe box of the shoe. A custom
orthotic will help to hold the foot in position inside
the shoe to prevent the foot from sliding forward. If, as
in ballet, nail pressure is unavoidable during certain
dance movements, a wad of soft lamb’s wool or a low
density silicone pad or sleeve in the toe box will help
to protect the nails from excessive abuse.
Patella Femoral Syndrome:
Misalignment of the patella and femoral trochlea
can be greatly influenced by rearfoot and forefoot
pronation. It has been proven that foot mechanics can
be changed by using a custom-made or total contact
orthotic that limits overpronation of the foot. Dancers
are often off balance, or when wearing high heels,
severely plantarflexed. Because pronation is dynamic,
it is more difficult to control the entire gait cycle in
a typical heeled dance shoe or classical ballet slipper.
Externally, a broader medial base of support in the
shoe will help to shore up the medial arch. Internally,
a semi-rigid ¾ length custom orthotic will help
control the rearfoot. If the shoe allows, a full-length
Q-angle stabilizing orthotic has been developed to
help this condition.
Plantar Fasciitis:
Along with ankle sprains and toe nail issues, dancing
on hard surfaces with the foot under severe pressure
4Stress Fracture