Where dance knowledge and medical knowledge join for the patient’s benefit.

Author: Georgina Barr, specialist dance podiatrist 

Injury recovery and refitting pointe shoes using dance medicine best practice - a case study.

 

Last year, a 15 year old classical ballet dancer (en pointe) was presented to the Merivale Podiatry clinic. The dancer had fractured her right foot during class in March, and was still experiencing pain and functional limitations at the end of the year. She was referred by her ballet teacher as she was not recovering from her injury in time for her upcoming ballet exam. 

Her injury was right foot based on the fifth metatarsal fracture. Her left foot metatarsophalangeal joints and left achilles on palpation were also in pain with dance. 

Previous treatment prior to her initial consultation had been 6 weeks in a moonboot.

 

Merivale Podiatry Initial clinical analysis

Lack of bilateral lower limb strength and compensatory gripping of the toes in pointing and hyper-extending of the knees in weight bearing dynamic postures.  Ankle and ball of foot range of motion within normal requirements too limited for dance (hypermobile for general population) and very weak foot strength rating. 

Merivale Podiatry Initial clinical recommendations

No pointe work until correct joint ranges of motion and appropriate strength had been achieved.  Strength exercises for the intrinsic foot muscles and lower limbs were advised.
Pointe shoes were also reviewed and were shown to be incorrectly fitted and did not work with the three points of support. This was causing compensatory mal-alignment en pointe and was the reason for a lack of pain improvement.

One week follow up 

The patient showed all pain was resolved and strength improved. At this stage discussion of cardiovascular and strength cross training was initiated.

The dancer was then re-fitted with pointe shoes that supported the foot appropriately.
A final review showed no pain and, with ongoing focussed strength work, improvement in dance technique and style.

At Merivale Podiatry we have a team of highly experienced podiatrists who can assist you in injury recovery and refitting pointe shoes using dance medicine for your children. Click here to contact us or book online!