Dear Dr. Burk,
I am a professional ballet dancer. In the past month, I have been having pain on the back of my ankles. When I dance “en pointe” (the tips of my toes) the pain worsens, becoming almost unbearable. There is also a bump on the back of my heels making it hard to walk in my regular shoes. Would you please tell me what I can do to eliminate these pains in my ankles and on the backs of my heels?
Amy S, Nampa, ID
For professional dancers and gymnasts, there is a high level of risk associated with contracting foot and ankle injuries. This is due to the twists and turns that the ankle must endure, and the pressure that is put on the feet. Common injuries are ankle and toe sprains, and a condition called Dancer’s Heel, also known as Posterior Ankle Impingement. This condition occurs when the bone and soft tissue at the back of the ankle become compressed, causing a bump to form. There will normally be some swelling and redness around the bumpy area.
There is the possibility that you have Dancer’s Heel in combination with some other ankle injury, so it is important that you get a proper diagnosis from a knowledgeable podiatrist before the condition worsens or becomes chronic. There is a risk associated with continuing to dance through the pain, like having a career-ending tendon rupture. Practitioners who treat dancers and gymnasts should have a good understanding of the dynamics associated with these performing arts. With accurate assessment and early treatment, most cases of Dancer’s Heel respond well to therapy.
- Diagnosis: A podiatrist will gently move your foot and ankle to see what positions are causing you pain. This will include moving your foot up and down and asking you to rise up on your toes. If Posterior Ankle Impingement is suspected, x-rays will be given to show if the impingement is due to bone pinching the soft tissues. An MRI can also be done to see if there might be other ankle problems causing your pain.
- Treatment: You will need to rest and elevate the ankle with the intermittent use of ice packs to reduce swelling and inflammation. A steroid injection might also be given. Mild pain medications and anti-inflammatory medicine could be prescribed. To facilitate the healing process, you will need to progress in a series of therapeutic exercises that improve your range of motion and ankle strength. Working with a physical therapist who is familiar with dancers and their injuries might be advised. You can also see a massage therapist for soft tissue work and gentle muscle stretches on your calves and feet.
Our experts at Rocky Mountain Foot and Ankle have extensive experience both in diagnosing and treating the heel and ankle problems of professional dancers. Contact my office for an appointment online or call us at (208) 855-5955.