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Pain in the Big Toe Causing Restricted Pointe Range

THE QUESTION:

“Hi Lisa! My daughter age 13 does a lot of ballet hours each week. She has developed a very stiff and sore big toe joint on one foot. As a result she finds demi pointe very restricted on this foot, although the full pointe is not such a problem. She has tried massaging and mobilising it often but it’s not getting any better. Would you have any suggestions for her?”

THE ANSWER:

Yes, Carol, we do have lots of ideas to help with this as it is quite a common problem. We have to separate the things that we do in this situation, into pain relieving techniques and then some more corrective techniques.

Pain Relieving Techniques

1. Removable Toe Thong

In this situation I usually create what is called a “Removable Toe Thong.” This is part of the Advanced Foot Control course, but I can post the video down below for you. In this video we demonstrate how to make a removable toe thong, which has padding under the second, third, fourth and fifth toes but keeps a gap underneath the big toe, giving it a little bit more space when she’s working on demi pointe. Basically if there is pain or restriction in range at the big toe joint, when she tries to rise it will put all the pressure through the top of the joint. This is something we want to avoid because we don’t want to get any bony damage through this area.

2. Padding with Rises

BigToeRiseAnother tip is to use a folded up towel when she is practicing her rises. This will help improve the control around the ankle without putting any stress on the big toe. So simply fold up a small hand towel and place it on the floor when she’s doing her rises, so she can place the second, third, fourth and fifth toes on the pillow. Have the big toe off the pillow so that when she rises, the big toe is not forced back into that position. This is something that I would try when she’s doing any training exercises on demi pointe for  and then use the slide on/slide off padding when she’s actually doing her classwork. You may find that she needs to have a slightly wider demi pointe or flat ballet slipper to allow her to use the padding but it can take a lot of strain off the big toe.

3. Massage to release tension in the muscles around the joint.

AFC - 173You say that she has been massaging it, and I would very much recommend she continue with this. Massage especially between the toes, and in her Flexor Hallucis Brevis muscle underneath the big toe. We go through a lot of these hands-on techniques in the Advanced Foot Control Program. I would highly recommend that you get that for her, because it will teach her a lot about how the foot is made up and how to release all these kinds of issues.

4. Ice Bath

The other thing that you might like to try is actually using an ice bath after she has been in class. If there is some inflammation around here, try putting the foot in a bucket of cold water and gradually add the ice cubes to it. It’s a bit nicer to put your foot in the water and then add the ice cubes, rather than making up the icy water and then plunging your foot in. However, that’s a personal preference! While the foot is in there, gently press up to demi pointe and come back down so that the foot doesn’t seize up. This will actually chill down around the big toe and help settle any active inflammation.

Corrective Techniques

There are other taping techniques, such as those used to correct bunions that can be used to correct the alignment of the big toe if that is an issue. I would also take a look at her placement on demi pointe. Sometimes if the second toe is a little bit longer, she may be pressing in on the big toe when she’s turning or up on high demi pointe. We need to look at her placement to make sure that she’s not rolling in in this position. This can come either from weak muscles around that support the ankle or even weakness up in the hip so it’s very important that she strengthen her whole body in order to create a really nice placement up on full height at demi pointe.

The big toe often won’t be irritated when she’s dancing on pointe because you don’t actually go right up into that full forced high demi pointe position. She will actually move through that position a little more gently than when she is on flat.

I do hope this has helped you understand a little bit about how the big toe is made up and I hope that she goes very well with these suggestions.

The Advanced Foot Control program is designed to help dancers with any issues they have with their feet or foot injuries. It includes all of the anatomy and self treatment techniques needed to fix most common foot injuries, and has special injury reports for each of the most common injuries so that you can get yourself back to dancing as soon as possible.

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