foot injury in young girls

[Derin's Mom]

Hello.

My DD (13) who is a full time ballet student, is facing a bone marrow edema (a step before stress fracture) for the second time in 2 years' time. The injury is on the most common part, the 2nd metatars of the foot.

She has not gone through puberty, and she is growing fast. She has a thin body and her bones are definitely more thinner compared to her peers.

She definitely has a very good diet, does not lack calcium. Only D vitamin is low. And we are supporting this.

We have seen doctors, gone through physiotherapy last time after the treatment weeks (off from ballet) but we are keen to understand why this happens this often to her. She has recently achieved an audition abroad, she is an aspiring student but these pull-backs affect her emotions and her performance as well.

Any similar experiences, how you have gone through this, and any specific reasons why some face it more than others?

Thank you

[alison]

It should perhaps be pointed out that most people are low in vitamin D, especially in wintertime, so it's nothing unusual - although I believe there is a line of thought that virtually everyone ought to be supplementing it anyway.

 

Good luck - I hope you can get to the bottom of this.

[Nicola H]

5 minutes ago, alison said:

It should perhaps be pointed out that most people are low in vitamin D, especially in wintertime, so it's nothing unusual - although I believe there is a line of thought that virtually everyone ought to be supplementing it anyway.

 

Good luck - I hope you can get to the bottom of this.

re Vit D that fits with what an Endocrinologist known to myself and at least one other  forum member   states ,  as  his area of practice  id one where there is  both legitimate  convcern aobut  bone density and a lot of concern trolling ... 

[Colman]

Is she on pointe?

[Derin's Mom]

39 minutes ago, Colman said:

Is she on pointe?

yes for the last 3 years. Her instep is comparatively low and she needs to work of foot flexibility more than others. But since she has been injured once she does those execises sooo carefully and intelligently. And her ankle strength has improved.

We really would like to understand why this is happening.

[Derin's Mom]

1 hour ago, Nicola H said:

re Vit D that fits with what an Endocrinologist known to myself and at least one other  forum member   states ,  as  his area of practice  id one where there is  both legitimate  convcern aobut  bone density and a lot of concern trolling ... 

We intend to see an endocrynologist as well.

[Nicola H]

2 hours ago, Derin's Mom said:

We intend to see an endocrynologist as well.

not sure   of the utility of an endocrinologist in this situation at this point in time ,   certainly 13 is not  quite considered  unusually late for someone who is very physically  active , but further discussion on this  is best left  to the relevant clinical professionals

https://www.nhs.uk/conditions/early-or-delayed-puberty/

my  mention of Endocrinologists  was   in regard to the advisability  of  vit D supplementation  among most  people in the UK. 

[sarahw]

Have you seen a dance physio or dance scientist? 

 

My DD had probable stress fractures and other injuries and very often they are related to lack of strength or strength imbalances.

 

There are also 2 NHS dance clinics which are well thought of - Birmingham and London.

[sarahw]

https://www.rnoh.nhs.uk/our-services/sport-and-exercise-medicine/centre-for-dance-medicine

 

This is the London one.

[sarahw]

https://www.uhb.nhs.uk/news/new-nhs-dance-injury-clinic-at-qehb.htm

 

Good luck, it's very stressful.

 

[Clarkd3]

I sympathise as my DD had the same injury and was non weight bearing in a boot for 6 weeks which she was so frustrated about! The conclusion was that her pointe shoes weren’t supportive enough for her foot and she ended up switching to a very different shoe! Despite more hours of dance and pointe work she’s had no more problems since! Good luck, it’s a very tricky time!

Edited November 5, 2018 by Clarkd3
Typo

[Ruby Foo]

Maybe check with her teacher/ physio that she is landing from jumps correctly. Her pelvis is straight and not tilted on landing in plie and she is distributing her weight correctly through the center of the foot and not rolling ( again in demi plie on landing) and thirdly, going through her foot properly to soften and cushion the landing.

Maybe worthwhile researching diet to boost collagen which will strengthen tendons and add support to bones. Cashew nuts, pineapple, flax seed, sesame seeds and plenty vitamin c such as red pepper.

[drdance]

Is your daughter at vocational school? Are you in the UK? If the answer to these questions is yes then it will be difficult to talk to your DD's ballet teacher. However, if the answer is yes then she will also have access (hopefully) to at least a good dance physio and/or strength coach. Something in your post makes me think that you're not in the UK, though which makes my advice different so please let us know where you are. Thanks

[Derin's Mom]

41 minutes ago, drdance said:

Is your daughter at vocational school? Are you in the UK? If the answer to these questions is yes then it will be difficult to talk to your DD's ballet teacher. However, if the answer is yes then she will also have access (hopefully) to at least a good dance physio and/or strength coach. Something in your post makes me think that you're not in the UK, though which makes my advice different so please let us know where you are. Thanks

Hello and thank you for the reply. You are correct. She is a vocational student. We do not live in UK. We live in Istanbul, Turkey. There are good physios but not specificly working with dancers. So there is always an empty space remaining in therapies (in my point of view). She does pilates as well and that coach is a former sportsman, works on her core strength.

but somehow appearantly there is something missing, otherwise she wouldn’t be facing it twice in 2 years time.

Edited November 5, 2018 by Derin's Mom

[Derin's Mom]

48 minutes ago, valentina said:

Maybe check with her teacher/ physio that she is landing from jumps correctly. Her pelvis is straight and not tilted on landing in plie and she is distributing her weight correctly through the center of the foot and not rolling ( again in demi plie on landing) and thirdly, going through her foot properly to soften and cushion the landing.

Maybe worthwhile researching diet to boost collagen which will strengthen tendons and add support to bones. Cashew nuts, pineapple, flax seed, sesame seeds and plenty vitamin c such as red pepper.

Thank you very much. I prepare bone broth at home as well to support but will check for other diets as well.

for the correction of movements, she will understand better than i do :)) so I’ll speak with her.

[Derin's Mom]

1 hour ago, Clarkd3 said:

I sympathise as my DD had the same injury and was non weight bearing in a boot for 6 weeks which she was so frustrated about! The conclusion was that her pointe shoes weren’t supportive enough for her foot and she ended up switching to a very different shoe! Despite more hours of dance and pointe work she’s had no more problems since! Good luck, it’s a very tricky time!

Last time her treatment lasted for 6 weeks as well. We’ll see this time and really hope she gets better sooner.

pointe shoes are our nightmare, or were. With these new ones she was actually happy but my assumption is, the shank was hard for her and she was not ready for it yet. What were your DD’s shoes before and what did she switch to?

[Derin's Mom]

4 hours ago, sarahw said:

Have you seen a dance physio or dance scientist? 

 

My DD had probable stress fractures and other injuries and very often they are related to lack of strength or strength imbalances.

 

There are also 2 NHS dance clinics which are well thought of - Birmingham and London.

I only wish we could find a dance scientist here in Istanbul...

but will check the addresses, and see my chances when we go to UK sometime.

[Ruby Foo]

If you are able to visit the UK, you could combine some sessions with a dance physio with a thorough pointe shoe fitting. Beth at Freed is very good, but they obviously only sell Freed make, which your Dd may not like. Dancia is also excellent and stock all types. Try to go when it is not busy so you can take your time to get them exactly right.

[Clarkd3]

1 hour ago, Derin's Mom said:

Last time her treatment lasted for 6 weeks as well. We’ll see this time and really hope she gets better sooner.

pointe shoes are our nightmare, or were. With these new ones she was actually happy but my assumption is, the shank was hard for her and she was not ready for it yet. What were your DD’s shoes before and what did she switch to?

My DD was wearing Bloch B-morph at time of injury but now wearing Russian pointe Ruben V cut with particular specification available from the manufacturer, she no longer goes through them at a rate of knots and they seem more supportive in the right places. Each dancer is so different in their own needs, fingers crossed you get the right treatment and future support for your DD X

[Derin's Mom]

9 hours ago, valentina said:

If you are able to visit the UK, you could combine some sessions with a dance physio with a thorough pointe shoe fitting. Beth at Freed is very good, but they obviously only sell Freed make, which your Dd may not like. Dancia is also excellent and stock all types. Try to go when it is not busy so you can take your time to get them exactly right.

Thanks. We know both. DD did not try Freed, she used Grishko for 2 years and now using Bloch Balance and said she was happy with them. I suppose the shank (hard) was not correct this time. She actually had a very good fitting in  Bloch Paris. And said she was content with them...

[Derin's Mom]

7 hours ago, Clarkd3 said:

My DD was wearing Bloch B-morph at time of injury but now wearing Russian pointe Ruben V cut with particular specification available from the manufacturer, she no longer goes through them at a rate of knots and they seem more supportive in the right places. Each dancer is so different in their own needs, fingers crossed you get the right treatment and future support for your DD X

thanks, we do not have Russian pointe here in Turkey. So a fitting for that is not possible. But noted.