In any sport or activity that puts demands on the body, injuries can occur, and dance is no different. Some of the most common injuries seen in physical therapy clinics in regards to dancers, are injuries related to the foot and ankle. The following information serves to help educate dancers on some of the more common ankle injuries, along with techniques that could be applied to help minimize the risk of these injuries. It is important to note that only a licensed medical professional can diagnose an ankle injury.
The most common type of ankle injury in all athletics, including dance, is an inversion ankle sprain. This occurs when the ankle rolls over the lateral (outside) border of the foot resulting in over stretching or tearing to the ligaments.1 There are various grades of ankle sprains which can result in mild to severe impairments. Ankle sprains most commonly occur en pointe or in demi pointe if movement result in a rolling of the ankle.1 Ankle sprains have also been found to occur with poor jumping and landing mechanics.1 If you believe you have an ankle sprain, and pain has not resolved in one week’s time, it is important to seek treatment from a medical provider.
Tendinopathy is described as irritation to a tendon with or without inflammation being present. Tendinopathies can occur to any tendon and typically result from overuse and improper loading leading to a breakdown in mechanics.1 In dancers, these pathologies typically occur when there is poor technique, improper jump/landing mechanics, increase in training, and overloading the tendon.1 Most commonly this occurs at the Flexor hallucis longus and Achilles’ tendons.1 Flexor hallucis longus is a muscle on the medial (inside) of the ankle that can help control the great toe. Tendinopathy of this muscle occurs almost exclusively in dancers and can be recognized when the dancer experiences an exacerbation of symptoms en-pointe position, jumping, plié in fifth position, tendu, or relevé with pain on the medial (inside) portion of the ankle.2 Achilles’ tendinopathies can occur most commonly in dancers who force their turnout/pilé or who land jumps with poor mechanics with pain occurring at or just above the heel.1
Impingement is when there is compression of the soft tissues (muscles, tendons, ligaments, capsules). This can be due to movement issues, mechanical faults with jumping, bone issues (excessive bone growth), or inflammation.2 This can occur at both the anterior (front) and posterior (back) of the ankle. Typically, with impingement, dancers will experience a painful pinching with active motion, passive motion, or with touch to the ankle.1
Fractures can occur at any time and can be the result of a trauma or overuse. Fractures from trauma can be the result of a fall when dancing. This will likely result in instant pain and loss of motion. Stress fractures occur as a result of bone remodeling being impaired when loading is increased too rapidly, weakening the bone and leaving it at risk for fracture.1 This most often occurs with over training, hard floors, nutritional deficits, hormonal deficits, and menstrual irregularities (in women).1 Pain with stress fractures typically occurs at night, with specific activities, or immediately following activity.1
There are a lot of ways ankle injuries may be prevented!
If you experience an injury or your pain lasts longer than a week, seek advice from a medical professional. Athletico Physical Therapy offers free assessments both in-clinic and virtually through our Telehealth platform with clinicians that specialize in treating dancers. Being seen by a dance-specific clinician can reduce the time away from dancing and quickly assist the dancer with their recovery needs.
The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.
References:
1. Kadel, N. (2019). Foot and ankle injuries in dancers. Performing Arts Medicine, 63-76.
doi:10.1016/b978-0-323-58182-0.00008-0
2. Vosseller, J. T., Dennis, E. R., & Bronner, S. (2019). Ankle injuries in dancers. Journal of the American Academy of Orthopaedic Surgeons, 27(16), 582-589. doi:10.5435/jaaos-d-18-00596