Dr. Sinkoe Offers Advice for the Dancer with Plantar Fasciitis
What is Plantar Fasciitis?
The plantar fascia is a thick ligament-like structure which originates on the heel bone (calcaneus) and attaches within the ball of the foot and toes. It functions to support the intrinsic muscles within the arch of the foot and to stabilize the toes during walking, running and jumping. The plantar fascia is always under tension with walking and running, but also during stance.
What causes Plantar Fasciitis?
During dance, the tension within the plantar fascia is increased as the muscles decelerate the foot when rolling down from demi-pointe and particularly when landing from a jump. The muscles contract and tighten with relevé.
Therefore, with repetitive relevé and jumps in dance the plantar fascia and the intrinsic foot muscles are placed under a lot of tension. To add to this, any tightness of the Achilles tendon will place additional stress to the plantar fascia. Even in the most flexible dancer, the Achilles tendon will tighten with pointe work and relevé. Tightness of the Achilles tendon and hamstring muscles are the reason that the heel is more painful when first standing in the mornings or after rest. As the Achilles tendon and hamstrings tighten during the night or with rest, the plantar fascia also tightens.
How to treat Plantar Fasciitis?
- After dance, take the time to perform at least 5 repetitions of hamstring and calf muscle stretches. Sit upright with the knees straight and toes pointing to the ceiling. There is no need for a theraband or overstretching of the toes. Lean forward from the waist and hold this position for 30 seconds.
- Perform the stretch at bedtime as well.
- Drink plenty of water after dance- the muscles and tendons need water. In the mornings, prior to standing on the floor, rotate the foot clockwise and counter clockwise for 5 repetitions and do one calf and hamstring stretch, as above, for 30 seconds.
- At bedside, have a sandal with a good arch support and the heel slightly elevated above the level of the ball of your foot. Wearing the sandal when first standing is helpful to support the foot muscles. This may also be helpful after dance if you are not wearing an athletic shoe.
- Prior to dance, strengthen the foot muscles with a single leg plié, bending the knee approximately 30 degrees. Hold this position for 5 seconds and return to the starting position. Repeat for 10 repetitions.
- Single leg stance exercise with a half foam roller: Stand on one foot with the other foot extended to the side. Hold this position for 30 seconds and perform 10 repetitions. Repeat with the other foot.