Physicians skip to a new beat when treating common overuse foot injuries in dancers

2015-04-08 19:36:22 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the inside.akronchildrens.org blog.

CC Flickr / Gabriel Saldana CC Flickr / Gabriel Saldana

Spring has sprung, and that means dance performances abound. Unfortunately, that also means so do overuse injuries from practicing moves over and over again to perfect them.

In addition to many stress fractures and ACL tears, we commonly see injuries to a small, accessory bone on the back of the heel or talus bone. It causes extreme pain for ballerinas when they get up on their toes in that fully pointed/flexed position.

Last week, I spoke with Jasen Sokol on 1590 WAKR about this injury and recent advancements in treatment. When physical therapy isn’t enough, we’ve performed surgeries on a few of these cases to remove the bone altogether and have seen great success in resolving this issue.

Below is an audio file and transcript of our discussion.



SOKOL: Joining us on the line right now, Dr. Joe Congeni is with us. Joe, good to talk to you again. It’s been awhile.

CONGENI: Hey, Jasen. How been?

SOKOL: I’ve been alright, and uh, I hear you wanna talk a little bit about dance injuries today, which I don’t think is something that a lot of people think about.

CONGENI: Yeah, you know what, it is usually around this time of year Ray and I usually throw this in and begin to understand it. And you say, “Hey, this is supposed to be a sport segment right? Is dance a sport?”

Dr. Joe Congeni Dr. Joe Congeni

And, the resounding answer to that question that we always talk about is without question. These performance athletes work as hard or harder and are as well conditioned as about any group of athletes we see.

Down at a place like the Sports Medicine Center at Akron Children’s — Do you believe this, Jasen? — 10 to 12 percent of my patients, 10 to 12 percent, are in dance or ballet. It’s really, really big in northeast Ohio and really big in Akron. And uh, these kids dance 15 to 25 hours a week, so the next question is do you think they get injured?

The answer is without question. I mean, when you’re dancing that much . A lot of the instructors talk about they have to perfect these movements they do, so they dance over and over again. It’s called muscle memory, and by dancing so much, they’re very, very prone to overuse injuries. So, we see a lot of stress fractures and we see ACLs, and we see a lot of things.

But, one injury I wanted to talk about specifically today that we’ve made some advances lately is one that occurs in the foot. … In the back of the foot near the heel, there’s a small bone. It’s a pretty tiny bone, probably the size of, uh … probably smaller than a marble.

This small bone breaks off (or does not fuse) in the back of the talus bone — or there are actually some people born with an extra bone back there — and what happens is when these girls try to get up into that pointed position, where the foot is fully pointed, we call that plantar flexed, they can’t do it without pain, or they can’t do it at all.

We try treatments of rest and boots and casts and injections, but one of the things that has helped us lately is we have done surgery on some of these cases to remove that bone. And, it’s been something that’s been very helpful for a very frustrating and difficult problem for young ballerinas.

SOKOL: You know, I’m glad you brought that up. And, I’m glad you said that dance is a sport … because you’ll get angry phone calls if you try to say that dance and cheerleading and stuff like that aren’t sports. They do take ‘em very seriously.

CC Flickr / Niels Linneberg CC Flickr / Niels Linneberg

So for people, I mean, this is dance season for everybody, right? So, what are some things that people can do to try to avoid these injuries?

CONGENI: Well … you are right that it’s dance season. There are performances all over the place. Go to a performance if you don’t have a daughter who’s gotten involved in this discipline and you’ll be blown away with how beautiful and fantastic these young athletes are, incredible performance athletes.

So from the standpoint of injury, it’s a lot like a lot of other things, Jasen. First of all, listen to your body. When you’re starting to get into problems: pain that’s bothering you, uh, during the day, then all day long, swelling, loss of range of motion, things like that, you need to take a period of rest.

If it’s still not getting better, you probably need to get in to see somebody medically to help begin to understand . Is this a boney problem? Is it something where rest will help? Is it something where, as in most cases, physical therapy (PT) will help?

We don’t want to do surgery and that’s a last, last resort. And most of the time, these problems get better with PT. But, the point is don’t let ‘em fester. Don’t let ‘em stay too long. Get on these injuries early on.

And, dancers are really fun to work with. They listen to what you say, unlike a lot of my other athletes.

SOKOL: Athletes can be stubborn that way sometimes.

CONGENI: They sure can.

 

SOKOL: Alright. Well, Joe, good to talk to you again. Thanks for being with us.

CONGENI: Thanks a lot for having me on. Have a great week in that big seat.

SOKOL: Alright. Joe Congeni from Akron Children’s on 1590 WAKR.

Originally aired on 1590 WAKR-AM on April 1, 2015

Related video

Dedication and hard work are ideal qualities in a young dancer, but can also lead to injury concerns without proper precautions. In this Children’s Channel video, Patrick Riley, Jr., MD, a pediatric orthopedic surgeon at Akron Children’s Hospital, discussed typical overuse injuries in dancers, and also offered tips for prevention. For more about our orthopedics services, visit https://www.akronchildrens.org/cosm.

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