Amber Tacy, personal trainer and founder of Dancers Who Lift, an online strength training and nutrition program aimed at dancers, first experienced plantar fasciitis when she was in college. “I remember my legs screaming at 8 a.m. and having to go through 90 minutes of barre, and then modern and rehearsal right after that, and then another technique class,” she says. “I was concerned because I couldn’t imagine putting any weight on my leg.”
Tacy’s experiences are not unusual, especially for dancers who experience a dramatic spike in activity level. Joshua Metzl, an orthopedic sports medicine physician at the UCHealth Steadman Hawkins Clinic who works with dancers at the Colorado Ballet, says that increasing the amount of time spent in practice — and the resulting potential for overuse — is the leading cause of plantar fasciitis among dancers. .
What is plantar fasciitis?
Plantar fasciitis is an inflammation of the thick tissue at the bottom of the foot called the plantar fascia. It often manifests in dancers as heel pain, especially during weight training. Metzl notes that it’s often most painful first thing in the morning, and symptoms can wax and wane throughout the day.
In addition to sudden increases in activity levels, plantar fasciitis can also be triggered by changes in footwear, such as switching from pointe shoes to flats. The quality of the studio floor or performance surface can make an impact. Outside of the studio, walking more than normal and/or on different types of surfaces can lead to plantar fasciitis.
Although plantar fasciitis is common among dancers, there are other conditions that can cause similar pain. Metzl explains that the bones of the feet can also be to blame, with the common bone-related counterparts of plantar fasciitis being instead calcaneus stress fractures and calcaneus apophysitis, an inflammation of the growth plate in a younger dancer’s heel. An X-ray can help determine the underlying cause of this type of leg pain.
Treatment and Treatment:
COURTESY OF THE CU SCHOOL OF MEDICINE.
Treatment for plantar fasciitis usually involves working with a physical therapist to create a daily program to stretch and strengthen the plantar fascia, Metzl says, adding that if the condition is more chronic and doesn’t respond to initial treatment, an MRI, corticosteroid injection, and/or an injection of platelet-rich plasma, which acts as a localized anti-inflammatory agent, may also be used.
When symptoms do occur, Tacy recommends taking over-the-counter anti-inflammatories to relieve pain, as well as using gentle massage techniques. She says icing—either by simply applying an ice pack to the bottom of the foot or gently rolling the sole with a frozen water bottle—can be helpful.
It’s also important to be strategic about casual shoes. Metzl says wearing orthotics or arch supports in your shoes can relieve symptoms by taking pressure off the plantar fascia. Tacy found that choosing shoes with a wide toe that better mimics the natural shape of the foot proves beneficial. In more severe cases, a walking boot may also be recommended. Although plantar fasciitis doesn’t always require time off from dancing, don’t underestimate the power of time off to relieve and prevent pain. “There is a really great saying. “If you don’t choose when to rest your body, your body will choose for you,” says Tacy.
Everything is connected
When plantar fasciitis is severe, dancers may decide to change their technique to relieve the pain. While this may seem like a way to muscle through class or rehearsal, both Metzl and Tacy agree that this approach can cause more problems down the line. “The term we use in orthopedics is the ‘kinetic chain’—all these structures in the body are interconnected,” says Metzl. This means that untreated plantar fasciitis has the potential to lead to pain in other parts of the body, such as the knees, calves, hips and lower back.
When Tacy was dancing professionally in New York, she suffered a serious injury that sidelined her for months. Although the injury involved a set accident and was not directly related to plantar fasciitis, she believes the imbalances caused by the pain in her feet were a contributing factor to the severity of the injury and recovery time. “Right after I graduated college and got my first job, lo and behold, the foot that was most affected by plantar fasciitis was the one I hurt,” she says. “Looking back, I can see how everything is connected. If I had taken care of my plantar fasciitis and strengthened and healed my foot the right way, I don’t think my injury later on would have been as bad or needed as much care.”
Two stretches for plantar fasciitis
Joshua Metzl, an orthopedic sports medicine physician who works with ballet dancers in Colorado, recommends these two stretches for dancers suffering from plantar fasciitis.
Calf stretch with towel roll
- Roll up one end of a towel.
- Stand on the towel with one leg, with the rolled part under the toes and metatarsal bone and the flat part under the heel.
- Get into a small jump position, with the back leg straight and on the towel and the front leg slightly bent.
Slippage of the FHL tendon
The flexor hallucis longus (FHL) tendon connects the calf to the big toe and plays a large role in pointing the toes and standing on tiptoe.
- Place your feet flat on the floor.
- Keeping the heel and ball of your foot in contact with the floor, lift your toes.