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Ballet Injuries—Risks for Your Feet and Ankles

Reviewed by
Dr. Patrick DeHeer

Ballet dancing has been a popular art form for centuries, and for those who have never danced, it has tremendous appeal as either a hobby or a potential vocation.

Children—especially girls—are often fascinated by the apparently effortless grace with which dancers move, and by the colorful, intricate costumes they sometimes wear.

But ballet has a darker side, and the placid expressions worn by dancers often mask terrible pain caused by ballet injuries.

The careers of professional dancers are often short; before they turn 30, most of them retire from dancing, either to teach or to pursue some other, unrelated occupation.

The purpose of this article is not to discourage children or their parents from considering ballet lessons, or even to discourage anyone from pursuing ballet as a career; rather, our purpose here is to make the reader aware of the risks that ballet injuries can pose to their future well being.

Types of Ballet Injuries That Can Happen

Many of the various injuries dancers can suffer are not severe, and pose no serious threat to the dancer’s future as a performer, or to his or her ability to participate in other sports or to walk with a normal gait.

Other types of ballet injuries, however, can be cause for concern. As you read about the various types of ballet injuries, feel free to click on any of the related links to read more about them.

Injuries and conditions that can be caused by ballet include:

Dancer’s Fracture is the most common acute fracture suffered by dancers. It strikes the fifth metatarsal, the bone that lies along the outer edge of the foot. It usually happens when a dancer jumps and lands badly, coming down on an inverted (turned-in) foot. As the name “dancer’s fracture” suggests, this is a common ballet injury.

Sesamoiditis: When a dancer is on demi-pointe, her weight rests on the sesamoid bones, which lie just behind the big toe. Regular application of this kind of stress can cause gradual onset of sesamoiditis, and the dancer will experience pain when bending or straightening the big toe.

Hallux Rigidus or Hallux Limitus: The dancer may notice pain associated with full relevé, and will eventually have difficulty moving the big toe.

Plantar fasciitis: This is an inflammation of the plantar fascia, a band of tissue running along the bottom of the foot from heel to toes. The injury is related to overuse.

Ankle Impingement: Many variations of this condition exist, but the one that concerns us here is posterior ankle impingement syndrome, also known as os trigonum syndrome, and commonly referred to as “dancer’s heel.” This happens when soft tissue becomes trapped and pinched by bones, which causes painful spurs to form.

Achilles Tendonitis: This condition can be brought on by dancing on a floor that is not properly “sprung,” or in other words is too hard. Overtraining can also cause Achilles tendonitis, especially hard training in a short time after a period of inactivity.

Cuboid Syndrome: Repetitive movement (such as one does when training) or sprains (another common ballet injury) can cause cuboid syndrome, a painful misalignment of the cuboid bone on the outer edge of the mid foot.

Metatarsalgia: This condition generally manifests itself as pain in the ball of the foot, and in dancers it is often brought on by years of overwork and by forcing the foot into extreme positions, leading to instability in the joints of the toes.

What Causes Ballet Injuries?

The particular causes of particular ballet injuries vary, of course, depending on the movement being performed. There are, however, certain techniques and types of footwear used in ballet that are particularly dangerous.

Pointe Technique: Dancing en pointe puts a great deal of stress on various parts of the foot and toes. Poor technique or poorly fitted shoes can make matters worse and increase the chances of injury.

Although dancers who practice this technique wear shoes designed for it, dancing en pointe still causes friction between the toes and the shoes themselves, which can cause chaffing and blistering. En pointe dancing is the culprit in many cases of bunions, hammertoes, sesamoiditis, bursitis, trigger toe, and stress fractures.

What Long-Term Complications Can Result from Ballet Injuries?

The long-term complications associated with ballet injuries are as varied as the injuries themselves, but the outlook for such injuries if they are not treated usually involves chronic pain and possibly antalgic gait (or in layman’s terms, a limp).

How You Can Prevent Ballet Injuries

Ballet injuries can be prevented by making sure that you are wearing properly fitted shoes, especially if you are dancing en pointe.

There are professionals you can see who know how to fit you properly for pointe shoes; ask your ballet instructor how to find one. Once you have your shoes, take proper care of them.

Dancers should not try dancing en pointe before the age of 11 or 12. By doing so, they can risk growth-plate injuries, and the bones of their feet may develop improperly.

Indeed, no dancer should ever attempt a feat that he or she is not ready for. As in sports, proper training in dancing is crucial to injury prevention.

Other tips:

  • Ensure proper nutrition.
  • If you increase your training schedule, take it slowly; don’t suddenly go from once a week to every day.
  • If you spend most of one workout en pointe or demi-pointe, focus your next workout on something else.
  • Avoid dancing on hard surfaces.
  • Avoid dancing on uneven surfaces.
  • If you are in pain, STOP!

Medical References:

    References: Lower Extremity Review NYU/Langone Medical Center/Harkness Center for Dance Injuries | Hospital for Joint Diseases Dance Magazine Contemporary Dance

This page was last updated on October 30th, 2015

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There are five metatarsals in all. The metatarsals are the long bones located in our feet, between the tarsal (ankle) bones and the phalanges (toes).

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