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Painful Ankles, Cramping Arches, Strained Hamstring

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Recitals are around the corner, please remember to take care of yourself!

Onto the questions of the week:

Hi. The top of my left ankle is continually painful, in an aching sort of way. It must be some sort of tendon thing. I also have arthritis in the big toe on that foot. Any helpful suggestions?

My first suggestion is to do some daily work to release any muscle tightness from the front of the calf by kneeling on a pinkie ball and massaging the anterior Tibialis muscle which is on the outside of the shin bone.

Next, I would check out your alignment of that foot. Do you have a tendency to pronate? The reason why I ask is that when you pronate the big toe takes a hit, and often a bunion begins creating an ideal arthritic situation. If this is true, try taping your foot for pronation which will lift and support the bones in the arch of your foot. If it feels better to be in a running shoe with good support I would suggest not going barefoot and teaching in a shoe with an arch or taping your feet.

If the dull ache continues you’ll want to go to the physicians and get an x-ray to rule out a stress fracture or other boney problems, such as a spur. I just took my daughter in for this exact reason – and fortunately – it got ruled out temporarily – which gives me permission to work in these other ways. Although, that being said, if the ache doesn’t improve within a couple of more weeks I will have more x-rays done, because stress fractures are tricky and sometimes don’t show up right away.

Hoping it is an easy fix!

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First of all, thank you so much for the Amazing Turnout and Arabesque DVDs. They have been extremely useful!

My question for you is: I sometimes get cramps in the foot or both feet during class. The cramps concern the 2nd to 5th toes, making them completely frozen. Can you tell me if this is because of tight extensor digitorum longus or could it be more due to tight intrinsic foot muscles? I do proper warm-up and even use a golf ball to massage the tight spots on my soles before each class. I wonder what I am missing. Can you recommend a good stretch for that?
Thanks! Louisa

You are doing the right actions to release the plantar fascia and the intrinsic muscles of the foot. The act of cramping usually happens when there isn’t enough strength in the intrinsic muscles, they fatigue, and then cramp. (I’m making an assumption here that you eat well and do not have a chemical/nutritional imbalance in your body)

Sit in a chair or on the ground with your leg and foot straight and in front of you. You are going to watch your toes as you slowly lengthen through the ankle keeping the toes flexed and separated, before slowly continue to lengthen the toes while keeping them separated. At first this can be hard! Only pointe your foot as far as you can keep the toes lengthened. Once you have reached that point, gently wave your toes in the air. If you cramp during this exercise you know that you have to strengthen the foot muscles and that should cut down on the in class cramping. Of course, keep using the pinkie ball or golf ball to release any tension in the foot and calf. You can use the golf ball for the foot, but when working on the calf I would only use the pinkie ball.

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I’m 34 and I’ve been dancing (ballet) since I was young. I currently take 5-6 intensive ballet classes a week. Last July I pulled my right hamstring when a guest teacher pushed my leg into a higher penché. My hamstring in my supporting leg gave out. It was very painful for several weeks, but I danced through it, taking anti-inflammatories and going easy on my extensions. My physio gave me stretches and strengthening exercises and I had some massage work done.

Nearly 10 months later and I’m still having issues with it. I’m only now getting some flexibility back, but I don’t have nearly the same flexibility in that leg. Stretching after class or at home only seems to make things worse — I’m usually quite sore the next day.

The routine seems to go like this: My hamstring starts to feel better (ie. it doesn’t hurt); I take my extensions and splits a little further; I get sore; I back off until it feels better, etc. etc. It seems to be a chronic problem now.

I guess my question is: is stretching making things worse, or am I just stretching too much?? I’ve been told that inactivity will result in scar tissue (I sit all day at a computer at work) so I try to stretch for at least 15 minutes every day.

Thanks so much for your help!

My heart goes out to you. I have seen 2 other dancers whose hamstrings were torn by well-meaning but anatomy-ignorant teachers. Sometimes the damage is done before the dancer thinks to say ‘stop’! It is never appropriate to increase a dancer’s extension in this way. One of the other dancers was taken out for a full year from her professional career in Europe! She was lying on the ground stretching, and had a teacher lift the leg up into a hamstring stretch and press it towards her body. This dancer was very flexible, but her body did not have the time to adapt to someone else’s force and tore her hamstring. Enough said – never – stretch out someone’s hamstrings unless you are a physical therapist who has been trained to listen, feel and watch for the subtle cues from the muscles.

There are 2 suggestions I have for you. The first would be to have someone who is trained either by Tom Meyers (http://www.anatomytrains.com/kmi/practitioners) or a massage therapist that does myofascial release work. Rolfing is another name for another type of myofascial release work. They will work slowly, deeply, and along the entire posterior muscular line, as well as any other fascial lines they see are off. The whole body adjusts to trauma, and your hamstring tear was certainly a traumatic event. By releasing corresponding areas that tie into the fascia of the hamstrings you are treating the whole body rather than just the hamstrings. (An aside, Tom Meyers book, Anatomy Trains is wonderful!)

The second suggestion may seem a little more off the beaten track. It seems like common sense to acknowledge that our emotions have an influence on our physical body just as our thoughts do. Our thoughts and our emotions are integrally connected as thoughts create the chemicals of emotions.

I’m not going to go into a deep conversation about the field psychoneurophysiology, but I am going to suggest that you try working on the issue of this injury with EFT. EFT is a tapping technique that has been described as emotional acupuncture. If you go to
http://www.emofree.com you can first watch a very short video introduction to EFT, read the online manual, and search in the thousands of case reports where athletes and others have used EFT for performance enhancement as well as relief from physical ailments. Just typing in injuries in the search box will bring up 171 cases of where EFT was used for injuries.

I use EFT and while I don’t totally understand how and why it works I am all for any and all techniques that empower us to create change in our own lives.

Please send me an update on how you are doing.

To your good health!

Deborah

“Education is the key to injury prevention”