Most dancers will complain of some foot injury at some stage in their training, and professional ballet dancers will often be plagued with chronic foot injuries, ranging from mild ones that are nursed for years, to severe injuries that may be career ending. The truth is, that many common foot and ankle ‘injuries’ occur as a result of poor “intrinsic” foot muscle strength. The “intrinsic” foot muscles are tiny little muscles that start and end within the foot, that help control the position of a ballet dancers arch, and are responsible for the control of her toes within the shoe en pointe. If these small muscles are not working effectively, larger muscles called the “extrinsic” foot muscles, that originate further up the leg become overused, as they attempt to perform two roles. This often leads to conditions such as “Anterior Compartment Syndrome”, “Stress Fractures” of the shin bone (tibia), or ‘Medial Tibial Stress Syndrome” , commonly known as “Shin Splints”.
Weakness in the intrinsic foot muscles and overuse of the extrinsics will also result in the toes ‘clawing’ both when rising, and en pointe. This is the biggest cause behind the nasty blisters that are often seen in photos of professional ballet dancers, however this does not have to be the case. Control of the intrinsic allows the middle joint of the toes to remain straight while fully pointing the rest of the foot. This does not affect the look of the line of the foot, but does make dancing much more enjoyable when free of pain!
In many other sports, orthotic devices may be worn in the footwear required that will help stabilize the arch and settle symptoms related to poor intrinsic muscle strength. Unfortunately, in ballet slippers, these orthotics cannot be worn (although many have attempted this!) so the dancer is often left to ‘live with’ symptoms, or have repeated extended breaks from dancing.
Watch the following video to see Lisa's perspective on whether dancers should or shouldn't wear orthotics.