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Dear Lisa,

I have a question in regards to arches and plantar fascia pain.

I have a student whose arches give her an aching pain sometimes so bad that it brings tears to her eyes when she dances. This affects her when going on pointe as it makes her feet feel like she can’t do any more dancing for that lesson.

She has been to the doctors about this and a physio even to the point of having it strapped in all different ways but still no good outcome. I believe it is the plantar fascia as this is what she has been told(the pain is all the way down to her heel). Do you recommend any exercises that we can use to relieve this outcome. She has a major exam coming up and we don't want her feet to effect her dancing in any way.

Regards

Angela K

 

Hi Angela

Thanks so much for your question. It does sound like it will be the plantar fascia that is giving her so much pain, however treating the sole of the foot will rarely fix the problem. I have chosen to answer this one today as it is very common and is often treated poorly by even the most well meaning therapists.

The plantar fascia is an extraordinary structure that stretches along the full length of the foot and is very important in getting good propulsion in jumps and in walking. However, it is designed to cope with strain in an on and off kind of way, rather than be under constant load.

The three big things that need to be addressed to really fix the issue are:

  • Muscular support of the arches of the foot
  • Fascial mobility throughout the body and especially the lower leg
  • Gentle support to reduce load on the fascia while it heals.

1. Muscular support of the arches of the foot

As Leonardo da Vinci said “The human foot is a masterpiece of engineering and a work of art.” When working properly, it allows us to run and jump and dance in the most extraordinary ways. However when it does not work in the way it was designed, then we can experience a lot of pain.

The foot is designed in such a way that it has 3 dynamic arches. By dynamic, I mean that they are designed to move and flex as we move, rather than be held in one place all the time. These are supported by complex slings of muscles and facia that work together to power us forward. However if there is a weakness in the muscles that support the position of the foot, constant strain is placed on the plantar fascia and it will start to get sore.

Stretching and massaging the plantar fascia will actually often make it feel worse, as it is already inflamed. We need to retrain the muscles that support the arch to take the load off the fascia long term. This can be done with all of the foot intrinsic exercises in The Perfect Pointe Book (especially the ‘Doming’ ‘Toe Swapping’ and ‘Tripod Foot’ exercises. Make sure that when she performs these, the heel stays square and the arch stable (not rocking the foot in and out). They need to be done very slowly and deliberately to get the best effect. If you would like more detail about the anatomy and training of the specific muscles, contact us for a copy of The Advanced Foot Control Manual. This is not available online as yet.

2. Fascial Mobility

The Plantar Fascia of the sole of the foot has direct connections up onto the fascia that runs along the whole back part of your body. Thomas Myers describes this as the “Superficial Back Line”. Tension anywhere in the back line can cause pulling and tension down into the sole of the foot, so it is important that when dealing with any issues with the plantar fascia we also look at the mobility of the fascia throughout the back of the body. The Front Splits Fast Flexibility Program is the perfect way to assess and treat the whole back line, and your student will notice dramatic changes in her overall flexibility once she can isolate and release her own tension points.

3. Supporting the fascia

Providing some support to the fascia is essential in allowing the inflammation to settle while she builds up the strength to control the foot herself. I use a combination of a soft heat mouldable insert in school/running shoes and taping for class work. The best taping is a technique that creates a cross woven web over the sole of the foot that mimics the plantar fascia. The other technique I use actually involves taping Theraband to the sole of the foot! (Both of these techniques are in the Advanced Foot Control manual).

To get the fastest and best recovery possible, I definitely recommend combining the three approaches above with a short period of rest from allegro and pointe work. She should still be able to do a flat barre and adage to maintain her strength (especially with appropriate taping) however if it is very painful, she may have to wear supportive runners in class instead of ballet flats.

Please let me know how she goes with this, and I hope that you are able to help her settle the pain before her exam. What i often find is that students 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.

Kindest Regards,

Lisa Howell

Dancers

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