High arched feet
Quick reminder to check the 2009 workshops listed on the website. I still have a few spots left for my ‘Analyze This! Train Your Eye for Dance’, being offered in June. Being able to look at the relationships in the body and translate that into effective training for your students is essential – and that will be the focus of the entire workshop!
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My 12 year old takes 13-14 classes a week at this rigorous studio, and is a member of the performing/competition company. She spends very little time on pointe due to her age, but focuses on ballet. She also has several jazz, lyrical and musical theater classes. Over the last several months, my daughter has developed more and more pain in the first metatarsal/phalangeal joint on the medial side. It first started as just soreness, and she worked to not get too far over her toes on rélevé, something she slips into sometimes. We have consulted with a podiatrist, who tells us that her very high arch is placing more load on this joint than average, especially in rélevé. His suggestion is to place a small pad right behind the joint (not under it) to help off-load the joint. Obviously, rest is called for as well due to the pain she’s experiencing. The medial side of the ball joint is sore to the touch, and sometimes so sore that she doesn’t want to even bend this joint. She is sitting out of many classes at the moment while we “tend to” this issue…icing, rest, anti-inflammatory topical cream, etc.
Do you have experience with this sort of overuse injury, especially in a very high-arched foot? Any pearl of wisdom or recommendation you have would be greatly appreciated. Thank you so much.
Sue
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I asked Sue to send me some pictures of her daughter’s feet – which she graciously did. Let’s take a look at them together. When I first looked at the picture of her feet from above I was struck by the difference between the two feet. I first see the bunions on both feet, left more than right. When you look at the way the two feet are placed she is more ‘on’ her right foot than left. See the angle at the ankles? The left foot is pronating slightly – which is probably why her bunion is larger on that foot.
Her toes are long and straight, and she has a somewhat narrow foot – with a very high arch – which used to be the favored foot of an aristocrat! (alas, it probably has to do more with the genes you got from your parents than nobility in your background)
When you look at her feet from the front you see the high arch, which so many dancers desire. (I imagine she has a beautiful pointe!) Comparing the 2 feet do you see the difference in the arches? The left one has less space between the foot and the floor – again showing the left foot in slight pronation. It is also showing up around the ankle, where you can see the outline of the tendon below the ankle bone. She again appears more ‘on’ her right foot than her left.
When I look at her rélevé, she has the wonderfully flat base to rise from. Looking at her heels, her right ankle/foot looks more pulled up out of the toes than her left one does. (I don’t know if both or just one foot is bothering, but if it is one I would bet money on the left foot being the foot that hurts more) I can’t tell from this angle where the her weight is centered and if it is shifting over the big toe instead of between the 2nd and 3rd toes.
So what to do with this pes cavus foot? (the medical term for the high arch, often slightly rigid food)
I would start by gently massaging the bottom of the foot, as well as gently massaging inbetween the toes, and the top of the foot. Depending on how tight or loose her calf muscles/hamstrings are – it may be useful to massage and release any excessive muscle tension all the way up the leg. With this type of foot the challenge is to keep the arches flexible instead of just plopping up on rélevé.
She is already pulling back, icing and focusing on deinflamming the foot – all the right things to be doing. I know taking time off during the dance year is challenging, but if the bunion area may almost have a bone bruise type of feel to it – and that is going to take some time to feel better.
She’ll need to really have her releve and first positions and how she is traveling on her feet looked at carefully – because somewhere there is a pattern of pronation with the bunion formation. (Sorry guys, I don’t buy into the genetic factor in bunions – although I do see similar postures in families based) I would also have her leg lengths evaluated because of the right/left asymmetry that is in all three pictures. That could be fueling the problem, and if I had to make a guess, I would guess the left leg being longer.
She’s 12 – so she is going through growth spurts – and her muscle balance needs to be checked. What is the strength versus flexibility in her legs? Is she sitting too much into her rélevé because of the high arch?
After she massages her feet for 5 – 10 minutes, gently but firmly, stand up and note how the feet feel. Any difference? After she ices – how do they feel? Whether or not the feet are responding to the care she is giving them will determine how ‘off class’ she may need to be.
An aside note – NO FLIP FLOPS! If she loves wearing sandals and closed shoes are too warm for where you live, she must find ones that strap onto her feet so if she lifted her foot up behind her they would not fall off – and her toes would be totally relaxed in the shoe. Flip flops are fine for walking from the car to the beach – but not as everyday shoewear. If she is doing all the right stuff – and still wearing flip flops – then her rehab time is going to be increased.
Let us know, Sue, how your daughter does with these suggestions.
Warmest regards,
Deborah