The athleticism of dancing involves the performance of complex manoeuvres, footwork combinations and intricate body movements; this places an intense level of demand on the musculoskeletal system and can predispose a dancer to a number of pathologies and/or conditions.
Various dance forms such as hip hop, modern, tap, tango and classical ballet require an individual to possess high foot flexibility, muscle strength, endurance and joint stability in addition to proper skill and coordination to avoid lower limb injuries.
A dancer’s overall physiological well-being and fitness also need to be taken into consideration because of gruelling training routines, performance schedules and the largely physically stressful nature of the profession.
The prevalence of a myriad of techniques and positions specific to each dance form can contribute to the development of lower limb injuries that are exclusive to a style of dancing.
Ballet is a good example, in this regard, with numerous studies conducted on various stresses to the ankle joint, metatarsals, interphalangeal joints and first metatarsophalangeal joint that are entailed during long practice hours.
The en pointe position (tip of the toes) has been associated with increasing the risk for orthopaedic injuries as it involves repeatedly placing the ankle in maximal plantar flexion which, in turn, places the anterior talofibular ligament in a particularly vulnerable position.
Rehmani et al. reported some of the commonly encountered foot and ankle injuries while studying lower limb injury patterns in elite ballet dancers as: tendinous overuse injuries mainly involving the peroneal and flexor hallucis longus tendons, ligamentous injuries of the anterior talofibular ligament, a multitude of osseous injuries, impingement syndromes, Morton’s neuromas and plantar fasciitis.
The extreme movements of hip hop performers, particularly of Breakers, Popper/Lockers and New Schoolers, leads to a high injury incidence rate when compared to other forms of dance such as modern, ballet or tap.
This was outlined in detail by Ojofeitimi et al. who observed high incidences of joint/ligament, muscle/tendon, and bone/stress fracture injuries in all three groups; with most injuries occurring in the foot/ankle complex, knee, hip and 50 percent of the dancers indicating overuse as their most common mechanism of injury.
The authors advocate education about injury prevention and use of protective equipment in addition to recognising injury patterns among these dancers while formulating preventative and treatment strategies.
Protective equipment should involve the use of customised orthotics either for the treatment of any underlying biomechanical problems such as hyperpronation that can further predispose a dancer to overuse injuries or for the management of any lower limb injuries developed during the course of training or performance.
By optimally aligning the musculoskeletal system and evenly distributing weight across the plantar surface of the foot, MASS4D® customised foot orthotics reduce any abnormal movements of the lower limbs while offloading stress to the affected regions.
This allows for the speedy healing of injured muscles, tendons or ligaments and promotes optimal posture and range of motion as a result of improved foot function, helping dancers achieve the most out of their performance.
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Repetitive plantarflexion can lead to pain and mechanical limitation in the posterior ankle joint which is known as posterior ankle impingement syndrome. This pathology commonly occurs in ballet dancers and football players.