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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine (no longer in print).

October 2001

Tender Tootsies: Foot Pain in the Elderly Dancer

By Rick Allen, DC

"Better health leads to better dancing."


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On of my patients, Ron Nelson, owner of Cary B's dance supply store, tells me that that he knows lots of folks from dancing that have "tender tootsies." Their feet are sometimes so sore that they cannot even dance! What's the problem? What can be done?

The Problem: Plantar Fasciitis

The most likely cause of "tender tootsies" is plantar fasciitis. Let's review the material I explained in my earlier article, "Soles of Fire" that appeared in the July 1997 issue of Instep, and add some new twists that I've learned over the past four years.

Plantar fasciitis is a painful degenerative condition of the connective tissue, or fascia, that forms the soles of the feet. The condition may also be associated with a spur on the heel bone, or calcaneous. It hurts the most when you stand up in the morning or when you walk, run, or dance on a hard surface.

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Treatment

The goals of treatment include reduction of the acute pain so that you can stand on your feet comfortably and, longer term, restoration of healthy tissue that can produce of protein collagen, the healing glue of the tendon. Rehabilitation to restore strength, endurance and flexibility must include all areas of the leg.

Treatment of plantar fasciitis may seem frustratingly slow, requiring treatment several times a week for a few months. It is hard to provide the relief from repetitive re-injury, especially when the condition is painfully acute. Often times, the condition waxes and wanes because you dont allow it to heal fully before resuming the activities that precipitated the injury.

Anti-inflammatory medications, both steroidal and non-steroidal, while having short-term beneficial effects that may be necessary for serious acute crisis, actually slow healing and have serious side effects. They should be used judiciously, not given out like candy, as they often are for conditions such as this.

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Conservative Treatment Protocol

I believe a good conservative strategy of treatment and rehabilitation includes the following elements:

  1. Consult a therapist or doctor who is familiar with hands-on techniques to progressively loosen the area. Get a massage of the legs and feet to help restore better flexibility and blood flow. Start gently and work more deeply as the area can tolerate deeper pressure. A doctor of chiropractic will also check for incorrectly aligned bones and improperly functioning joints.

  2. I often use ultrasound as well to stimulate better blood flow and healing of the plantar fascia. An herbal ultrasound gel seams to work better than plain ultrasound lotion for relief of pain.

  3. Stretch your back, hips, legs and calves, and feet daily. Ron Doran, a dancer from Silverton, recently told me that he was helped immensely by doing the five stretches demonstrated in the attached photos by local dancer JoEllen Jarvis. Calf Stretch-2

  4. If the plantar fascia is tender, rolling a frozen golf ball under the soles of your feet may help to loosen the fascia while minimizing painful inflammation.

  5. Take an Epsom salt bath or use the pool and hot tub for 15 minutes of relaxation.

  6. A night stretching splint or foot box appears to be help the restoration of flexibility. A chiropractor, osteopath, podiatrist or other sports doctor familiar with the treatment of foot problems ought to be able to help you.

  7. Make sure your shoes are in good shape, with reasonable mid-foot flexibility. You may find it helpful to change your shoes during the dance.

  8. Protection of the foot during the rehabilitative phase with taping or soft orthotics is generally helpful. Kinesio tape, which I reviewed in September, is an excellent tape that gives adequate support while allowing good flexibility of the leg and foot.

  9. Drink lots of water 6 to 8 glasses each day.

  10. Eat a good, natural diet, supplemented with a good, natural multi-vitamin and mineral supplement, which includes 1000 mg of vitamin C. (This is a topic worthy of an entire column itself!)

  11. Do some alternative exercise, such as swimming or bicycling. This will keep you in shape and avoid irritating the plantar fascia.

  12. When you restart weight-bearing exercise, start slowly, again avoiding irritation of the plantar fascia.

Up on Toes

For the vast majority of cases, conservative treatment and rehabilitative measures will be all that is necessary to get you back out on the dance floor.

Next article: Let's look a fresh look at one of my favorite subjects: some new aspects of assessing and correcting poor posture. There are some new high-tech tools that are quite helpful.

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