Hi Lisa! This is great what you are doing! My students all at one time or another have and are currently suffering from pain under the ball of their foot. The physio’s have said just to rest but of course they can’t with exams etc. what is this and how can we treat it and them prevent this? Thanks for all the great work you are doing Lisa. Tina.
Hi Tina! Many students have issues underneath the ball of the foot and there are few reasons for this…
1) Sesamoiditis – If the pain is underneath the big toe, this may be irritation of the tissues around the sesamoid bones. These are two little bones under the base of the first metatarsal that provide a tunnel for the FHL tendon to pass through, but they often get irritated with loaded work on demi pointe.
If it is this, they will be tender to touch right over the area and especially if they roll in on demi pointe. Along with icing and careful use of anti inflammatories, padding in a doughnut shape over the area can help get them through the show, until they have time to deal with the true cause. Often the deeper cause of irritation in this area is actually stiffness in the joint at the top of the first metatarsal – where it joins the medial cuneiform bone, resulting in increased load on the head of the first metatarsal with walking and dancing. Often mobilisation of this area results in less load on the sesamiods especially with normal walking.
2) If the pain is more under the ball of the second toe – this may be if the second toe is longer. In this case I often create a custom made (from regular strapping tape) toe thong with supports to offload the tip of the second metatarsal. This is a GREAT tip and will also help the student balance more on demi pointe. I have made a video that shows this taping in detail, that you can access in the members area of The Advanced Foot Control program. CLICK HERE to watch the video.
3) If the pain is more tenderness over the whole area – it may be that they are landing too heavily on the ball of the foot, and not using the Soleus muscle effectively to control the landing… To download a free 10 min video that explains everything about this CLICK HERE There are of course many other things that can cause pain here… but that should help weed out a few! Hope that helps!
The number of different reasons for pain under the big toe means that the Physio will have to search a little deeper to find the true cause. Simply resting the area is not enough, as if the student returns to class with the same issues still in place, then the pain will usually reoccur. I highly suggest looking into both the Advanced Foot Control for Dancers program (for long term strengthening) and also the Will I Ever Dance Again? DVD’s for ways to allow the studenst who do need “Relative Rest” to continue with their training.
Our “Will I Ever Dance Again?” program shows you exactly how to manage your dancing in class while taking the appropriate timme off, allowing the inflammation to settle. It guides you through a detailed floor barre, as well as a barre that can be done in an orthopaedic boot (if you have been fitted with one) so that you can continue working all parts of your body while resting the foot. It also has great exercises that you can do while not jumping to actually improve your jumps long term, as well as gradual progressions to build back into the Allegro, Adage and Pirouette sections of class. In each of these parts of classs it is essential that you build back slowly, making sure to deveop perfect technique, correcting any weaknesses that lead to the Sesamoiditis developing in the first place.
This is an essential step in the rehabilitation of any injury to ensure that it does not return once you start back in class. For more information on the “Will I Ever Dance Again?” program, CLICK HERE.
Often students find that they actually come out of an injury like this stronger and more mobile than before if they learn how to work with their body in the correct way. Improved flexibility and foot control help all areas of dancing, and correct dynamic bio-mechanics of the foot will result in much improved height and ballon in Allegro work.