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painful foot


Spacy

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My daughter is complaining about a pain when she dances on the right side of her right foot underneath the ankle bone. It generally feels worse when she is jumping but comes at different times when she is dancing. She has had this pain on and off for about 3 months and keeps thinking its getting better but then gets worse again. We have decided that we will book to see a physio asap. We have a problem that she is due to take her RAD intermediate exam this thursday. So she would just like to know if anyone can offer any short-term advice.

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The best advise is dont dance on an injured foot, however if she must do the exam then you can apply deep freeze which you can buy in supermarkets and chemist, also under supervision iberbrufon is an anti inflamatory/ pain relief, and can be used to reduce any swelling inside the foot, you can also buy this in gel form to apply directly to the skin.

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Thanks Primrose, we will see how it is tomorrow but it is something that seems to come and go. She has been practising at home which I am sure does not help! Ibuprofen gel might be a good short term measure.

Then we must try and get to the bottom of what the cause is. This is her first complaint of any sort of injury so I guess it is important to try and find a good local physio. I guess if it gets worse we can always postpone exam.

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Spacy - I can't post a link from my phone, but please search for a thread I started about strapping an ankle. Sounds like your dd is having trouble with the same tendon that my dd is. She's now seeing an orthopaedic consultant and has had a steroid injection in the tendon after having a scan (luckily we have private health cover through my hubby's work which sped things up a bit). And she's now off dance for 4 weeks to let it recover before she sees him again. Ask your gp to refer her to a foot and ankle clinic - there's a lot about. My dd had been suffering for months and there was a risk it could've ruptured.

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My dd has a problem with tendonitis to the front of her foot and lower leg, I take her to Sue Harris who is the physio based at BRB in Birmingham. I have to travel for 1.5 hrs to do this and the reason for doing this is that she is a dance related physiotherapist and really knows what she is doing. Its well worth sourcing someone like her if you can. My dd is also waiting for a referral to the NHS dance related injury clinic in London.

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we were recommended to use Movelat for a ligament injury, it's a pain relief gel. We were told to apply a generous blob at bed time -DO NOT rub it in - wrap loosley in cling film and then put a sock over it to keep in place and to do this for 3 nights. the rest of the advice was as above, rest, ice, rest, rest and then rest lol!

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Thanks everyone for advice. My daughter has been looking at her symptoms on line and thinks it is ligament or tendon-she says it feels like it needs 'stretching out' when it starts hurting. she takes her dancing very seriously and has auditions for RB SA's early next year so we need to get this sorted out. The problem seems to go away and then come back.

Any recommendations forgood physio/injury specialists in the Bournemouth/Poole area where we live.

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(It sounds like it might be the peroneal brevis tendon from your description of the location)

 

Link to other thread:

 

http://www.balletcof...port-for-ankle/

 

As you can see from the thread, it took me a while to come to a sensible conclusion about treating, but my advice (with the benefit of hindsight) would be to get a diagnosis and not just rely on seeing a physio (I'm not saying don't see a good dance physio - I just think that it's better to get an accurate diagnosis so that you're certain the right thing's being treated)

 

This is useful:

 

http://www.sportsinjuryclinic.net/sport-injuries/ankle-achilles-shin-pain/peroneal-tendonitis

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Movelat contains NSAIDs or non steroidal anti-inflammatory drugs (aspirin and Mucopolysaccharide polysulphate) so is fairly similar to Ibuleve - each persons experience with them will be a bit like one person taking aspirin and one person taking ibuprofen. They are similar drugs in terms of their actions.

 

Having said that - I will reiterate something I've said many times! NSAIDS should only be taken or applied in conjuction with other anti-inflammatory strategies ie rest, ice, compression, elevation etc. If someone uses NSAIDS but then continues to do the activity that causes inflammation, it's pretty pointless, as well as likely to make the injury worse.

 

Accurate assessment and treatment of any tendonitis-type injuries, especially in the foot and ankle, is imperative. These type of injuries tend to be recurring, chronic and relate directly to slow, gradual wear and tear on a tendon that is either being stressed more than usual or sometimes stressed unevenly, or in a slightly different way to which it is used to. Thats why they tend to be related to an imbalance, difference in alignment, change in shoes or even a growth spurt.

 

True healing and recovery will only exist once the root cause of the wear and tear on the tendon is established, and corrected. Otherwise, you can treat the pain and let it recover, but then it will keep causing issues.

 

Good luck :-)

 

Edited to add: PS I advise people to steer away from internet self-diagnosis where possible, as there are an awful lot of horror stories around! And while others may be well-meaning, it's impossible to tell what is causing a problem without a full assessment - it's always best to seek advice from a pro.

Edited by drdance
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I also agree.....just about everyone has suggested seeking medical advice or going to see a physiotherapist. Those who have recommended temporary painkillers are merely making suggestions for temporary pain alleviation by using products that are all over the counter anyway. And quite frankly, I don't think any parent would rely on medical advice given over a website, no matter how well meant.

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I have said several times on this forum and by pm to the moderators that I really don't think that anyone on here should be handing out medical advice. I wonder if this could now become a policy of the forum?

 

Whilst I would most certainly seek medical opinion on any injuries or symptoms my dd may develop in the future, I would also always ask forum members to share similar experiences.

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As my original post said, I will seek professional advice as soon as possible.What could I do in the meantime. Obviously I am completely aware that these are other peoples experiences and may be completely different to my daughters problem. I have been given some advice on where I may go for that professional advice. It has been interesting to have feedback on what has worked for other people. It also helps us to ask the professionals the right questions and make informed decisions.

It is also really nice to share worries and concerns with other people who understand how upset our dancing children are when they cannot give their best to what they have been working so hard for.

I am learning so much about this new world and am really grateful to know there are people with similar experiences both positive and negative.

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Just a quick update. My daughter felt that her exam went well. her foot behaved itself. we used movelat a couple of times and just before the exam. It made her feel more confident anyway. We are ging to seek a professional opinion next week. Thank you all for your advice.

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  • 3 weeks later...

Just thought I woud update you on my daughters foot, and wondering if any of you knowledgable people have experience of this. After seeking a second physiotherapy opinion (actually first was an osteopath) it seems she has severs syndrome which is apparantly very common. I think it sound a lot worse than it is and it does make sense to me now. I think it confused me that the problem got worse during the summer when she didn't dance very much but now appreciate that the wearing of flip flops could have made the problem worse. Basically it is to do with the rapid growth of the heel bone causing swelling and tightening of the tendon. This creates tension where it attaches to the heel. Eventually, the tension causes the area to become inflamed and painful. Fortunately, the condition is not serious. It is usually only temporary although could last for two years and will stop when daughter stops growing. daughter is quite a late developer and at thirteen and since the summer(when problem started) has had a massive growth spurt.

She has been advised to wear supportive footwear, orthotics in shoes and basically self manage condition and stop dancing if pain gets bad, we will continue to rest, ice and apply topical anti-inflammatory as necessary. Today when we had appointment it didn't hurt but after a very full examination the pain did seem to originate from the heel which we hadn't really established up until now.

Just thought I would share our experiences with you. Not sure how she is going to self manage not overdoing it with auditions and exam next year but fingers crossed!! at least it will get better and isn't too serious.

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A friend of DDs had this at about the same age as your DD. After her initial painful flare up when she really did have to rest as she was not allowed to dance for 4 weeks, she was fine but she did have make sure she wore sensible supportive footwear and she had to learn to rest, especially after a class. I'm not sure how long it lasted as they moved house and we lost touch but I hope it is shortlived with your DD.

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Severs disease, or syndrome is very similar to Osgoodschlatters disease which affects the knee. Muscle tightness or shorter muscles/longer bones pull on the growth plate at the ends of long bones, causing inflammation and pain - this often happens during growth spurts when bones grow out of sync with the muscles and you end up with longer bones for a while until the muscles catch up. Most young dancers notice getting a bit stiffer during this time, but some end up with Osgoodschlatters or Severs.

 

Both issues are fairly common and the major piece of advice in either case is to stretch the muscle so in the case of Severs its to take a lot of care to stretch out the calf muscles (both muscles, so a straight leg stretch and a bent leg stretch). Ice is your best friend - with these type of conditions where the issue lies near the bone, ice massage is soothing. Get a paper cup and half fill it with water and freeze it. When it's frozen you can cut part of the cup away to expose the ice block but theres still cup there for you to hold.

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I always keep a reusable ice pack in the freezer. In addition, I have also found a bag of frozen peas very useful. You can shape the bag to your needs, stays frozen quite a while, and can endlessly refreeze (don't eat them!)

 

It is also effective to take a cloth and wet it - then wring out - put it between you and the ice source. It conveys the cold very effectively without the ice actually on the skin.

 

A can of frozen orange juice is handy for rolling around the bottom of the foot.

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Any advice for me!

My dd has a pain in her achilies that only comes when she fully points her foot. She can walk,run,jump and fully flex her foot with no pain at all.I stopped her from doing any jumps,releves and pointing her foot and it is getting better but very slowly.Could this be growing pains as well?It started about a month ago.I want to take her to a doctor but I don't think they will take us seriously as it is only when she fully points and where I live they will think I'm being over the top also because she is only 9!I'm sure they will say " stop pointing then"

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The Achilles tendon is quite vulnerable and always ALWAYS should be treated with great care and respect.

 

When the foot is pointed the Achilles becomes all squeezed up just above the heel which happens to be where it inserts - is attached - to the back of the foot. Any injury to this tendon has to be seriously considered.

 

Resting it is crucial. Check her street shoes. Sometimes a very low heeled shoe will help rest the tendon. No high heels, for sure. You are doing the right thing by stopping jumps, relevés, no pointe work. However, pointing her foot just before the pain and then flexing will usually help keep that tendon flexible. For every pointe there has to be a countermove - a flexing of the foot.

 

She has to learn to carefully and slowly warm up her feet - and that tendon - before any dance work. And then again after class - it has to be carefully stretched and kept flexible.

 

I would still urge you to seek medical advice. If they don't take you seriously - you make them take you seriously. You are the customer - insist on it. If there is a dance company or a sports team in your area - call them explain the situation and ask them to recommend a good doctor and a good physical therapist.

 

Don't give up.

 

Usually the biggest culprit in this kind of problem is not getting the heels fully down after EVERY jump - no matter how fast the alllegro may be.

Edited by Anjuli_Bai
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Anjuli, thank you so much, it has been worrying me and she is so sad about the situation.I think I will go to the opera and ballet theatre here and see if they can recommend someone to me,I know this will be our only option.

When you say stretch it, do you mean by flexing it, and stretching the hamstrings?her achilies are very flexible maybe to much, but I have noticed that when she takes class her legs are not always completely straight when in releve, could this be a reason?

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In relevé the knees must be straight with the muscles of the thigh fully engaged.

 

I am not going to speculate on exactly what her problem might be. That must be done by professional help - which includes her teacher. What does her teacher say?

 

When I say "stretch" - I do mean flexing the foot - which is the safest method.

 

One can also put the feet in parallel, face the barre, take a step back and with both hands on the barre and heels firmly on the ground, lean into the barre, being sure to tuck in the derriérre. This has to be done carefully and since she is having problems it should be supervised so she doesn't step back too far from the barre and thus stress the tendon..

 

She must also be careful in plié that she keeps her heels firmly on the ground in demi. I would avoid grand plié except in 2nd position and don't ever go past parallel in 2nd position grand plié.

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Well, something further - of course she's sad about this - that's natural.

 

However, it seems she is catching this before it becomes worse and she is young and will heal. She can use the time to read about dance (some great books out there), draw dancers, write about dance, look at pictures and Youtubes - lots to learn and enjoy.

 

I wish her well - she'll get better. Just takes a bit of time and patience and dancers have to learn that, too.

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