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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine.

August 1996

Becoming Well Grounded

By Rick Allen, DC

From my first article in the June issue of Instep you have mastered illusion of floating gracefully around the dance floor -- right? Well, more likely you are mid-stream, because it usually takes several months to retrain the body's natural posture and movement. DON'T GIVE UP! Consult with your dance teacher and, if necessary, the professional body workers I mentioned to obtain myofascial release and retrain the posture and movement your body thinks is natural. Then practice, practice, practice!

Part of the transformation is creating a solid foundation. Especially in Latin dance, your ankle works hard and you drive the ball of your foot into the floor. That is, you become well grounded! Powerfully! Passionately! (After all, this is Latin dancing!) That can result in four common injuries: bruises, blisters, tendonitis and sprains. Let's take a quick look at preventing and treating these injuries.

Bruises

Driving the ball of your foot repeatedly into the floor may cause a bruise to the soft tissues and even the bones of the foot, known as metatarsalgia. Treat the acute injury with "RICE":

Rest
Ice
Compression and
Elevation

Rest with your foot elevated, putting an ice pack on the site of injury. If necessary, use an elastic or ace bandage wrapped with only mild tension to hold the the ice pack in place. Be sure the bandage doesn't cut off circulation to your foot or make the toes swell. Keep the ice in place for about 20 minutes each hour for the first 24 to 48 hours after the injury.

Slipping an insole to pad the foot may be all that is necessary to prevent this overuse injury. However, if it continues to hurt for more than 5 to 14 days or you have sudden or increasing pain in the foot, have your chiropractic, osteopathic or medical doctor check for possible more serious conditions, such as Morton's neuroma, stress fractures, bursitis, tendonitis, and arthritis.

Blisters

Blisters are one of the most common injuries sustained by athletes. (As a dancer, you are an athlete - ballroom dancing is even being exhibited at the Olympic Games.) The blister is a collection of fluid between the outer layers of the skin caused by friction, pressure, and heat. During an evening of vigorous (and passionate!) dancing at your local Latin club, for example, you sweat (or "glow") from head to foot. Your feet and socks become moist. The trauma of dancing results in mild inflammation. Your feet swell. With the next dance, the moist socks now rub against the swollen feet, producing blisters.

Blisters usually respond well to self-treatment. Prevention is best. Take a second pair of socks and, if necessary, shoes to give your feet a break. Rinse your feet or at least towel them off when you switch socks and shoes. Keeping the foot clean and dry really helps. Lightly powdering the feet is advisable, too. Many products have been developed to prevent blisters, including special socks, insoles, moleskin, foam padding, and "Second Skin" liquid or spray. You may give these a try if you continue to have a challenge.

If you do develop blisters, it is best to treat them immediately, but you may have to wait until you get home to have an opportunity to clean your foot thoroughly with soap, water and an antiseptic. Using a needle that has been disinfected, place two or three puncture holes in the roof of the blister, allowing the fluid to drain out. Apply an antibiotic ointment and cover with a sterile gauze pad. Do not tape directly onto the blister because, when the tape is removed, the skin that was the roof of the blister may be pulled off, too. (Ouch!) The gauze dressing should be applied for 2 or 3 days, by which time the blister should be dry and the skin healing. If necessary, very carefully trim any loose skin. Watch for signs of infection -- redness or swelling -- which would require professional treatment.

Tendonitis

Another overuse injury is an irritation of the tendons of the foot. The muscles of your foot and leg attach to the bone via tendons. The tendons slide inside sheaths, much as a brake cable on a bicycle. With overuse, combined with inadequate rest and nutrition, irritation, adhesions and swelling may develop. Often times we are advised to use anti-inflamatory drugs such as ibuprofen to alleviate the symptoms. I recommend a more natural approach which is less toxic to the body: RICE as described above, followed by massage and chiropractic adjustment of the foot to make sure the bones of the foot are in alignment and moving properly, and nutritional supplementation with 1000 to 1500 milligrams of Vitamin C and 100 to 200 milligrams of bromelain (an enzyme from pineapple) for a week or two. Professional herbal suppliers may incorporate these ingredients with other natural anti-inflamatory herbs such as tumeric and quercetin. Your best source for this treatment is to check with a naturopathic or chiropractic doctor.

An additional note on the toxicity of anti-inflamatory drugs: we are encouraged to "just nupe it" with non-steroidal anti-inflamatory drugs (NSAIDS) and acetaminophen almost as if they are candy. Far from it! As documented in the New England Journal of Medicine in 1994, volume 331, pages 1675-1678, "people who take analgesic drugs frequently may be at risk of end-stage renal disease." A cumulative dose of 5000 NSAID pills per lifetime, which averages out to be just one pill every four days, increases the risk of kidney failure almost nine-fold!

Sprains

Unlike the overuse injuries described so far, ankle sprains are acute injuries, developed from sudden blows or twists. Most frequently, the ankle inverts, stretching or tearing the outer ligaments of the foot. Treatment of the acute injury is RICE. Mild sprains cause some initial discomfort, mild swelling, and little or no bruising. They usually resolve in a few days. If, however, there is increasing swelling and bruising within 12 to 24 hours, you have at least a moderate sprain and should seek professional help.

Repeated ankle sprains may leave the ligaments loose and more likely to give way to yet more sprains. Athletes often have their ankles taped, but this is not likely to be necessary for ballroom dance, even it is passionately Latin. You can help prevent re-injury by (1) strengthening the muscles of the leg, ankle and foot and (2) improving your sense of balance with proprioceptive exercises. Two simple strengthening exercises are towel scrunches and ankle eversion against elastic resistance tubing. Proprioceptive exercises are more complex, requiring balance boards and supervision to be safe when rehabilitating an injury. If you have a strong, healthy ankle and wish to improve your reflexes and balance, try standing on one foot, initially next to a wall for balance, and raise up and down on your ankle. If all goes well, add flexing of the knee and even doing this with your eyes closed. A sports doctor or physical therapist familiar with the work of Vladimir Janda, MD can give you professional help.

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