Drat!

[Rio]

Well, after 1 week back at ballet (after school holidays), I've gone and injured myself. I've strained my hamstring and will be off ballet for 2 weeks. Bleurgh!

 

In addition to which, I have sesamoiditis (if anyone can tell me about their experiences with this "wishy washy" diagnosis I'd appreciate it) in my left foot. I also hurt a muscle in my groin about 2 months which still "niggles" every now and again.

 

I'm finding that this is occuring with alarming frequency these days. After every class (and I've dropped one ballet class and one NYCB class) I have aches and pain and limps and what not.

 

Does anyone else go through similar patches? I've had a really dreadful couple of months and I *am* feeling tired and washed out (hence the cutting back on classes).

 

How do I get myself over this speedbump and avoid hurting myself anymore?

Obviously the psychological factor is something I will have to deal with myself, but how can I be kinder to my body?

 

Thanks

Rio

[Mel Johnson]

Rio, sesamoiditis is really found more often in horses, but here's what it is: Many people have an extra bone in the big toe side of the metatarsal arch on the very inside of the foot. It's encapsulated within a muscle or other soft tissue, and sometimes the the capsule and surrounding tissue became inflamed (-itis) and pain ensues. The basic first aid is Rest, Ice, Compression, and Elevation. And rest means not just cutting back, but actually stopping dance for about 72 hours, and give the inflammation chance to get all over the acute phase.

[lampwick]

Rio,

I always have little aches and pains. My friends who dance a lot do as well.

 

How bad did you strain your hamstring? I wouldn't want to contradict the good advice your doctor gave to rest it for two weeks (and rest is sometimes wonderful advice), but I think it's still possible to dance with a strained hamstring. Two weeks rest seems like a generic "doctor" response to just about anything You just have to baby it a bit and be VERY careful about grand battements. If you completely rest it, it may tighten up and you'll actually increase your chances of straining it all over again. When I pulled mine after returning after a break from ballet, I was instructed to ice it and do some specific isometric stretching. It healed up in an eighth of the time it usually takes. Maybe you can ask your doctor or ballet teacher for some advice about this. Are there any sports physical therapists you could work with?

 

 

I can totally sympathise with you though. I have a small "collection" of issues myself...stiff back, possible torn meniscus, intermittent shin splints. The knee problem is an old OLD injury from improper training of turnout which I can't fix through a technique change, but my teacher has helped me work through the other problems by getting me to work in a safer manner. Just don't overdo anything and be very diligent about working correctly. Good luck

 

PS. If you don't have a qualified sports PT, then rest IS probably the best thing to do. Let the body take care of its own healing.

[Rio]

Thanks Mjr Mel.

 

My problem is that the orthopaedic surgeon I went to neglected to take into account that I developed sesamoiditis *before* I started ballet last year, and 6 months of rest before taking up ballet did nothing to combat the problem. So, in my opinion, rest is not going to help at all. I personally think the guy was at a loss for a diagnosis.

 

Lampwick, I couldn't straighten my leg after Saturday class. After icing it all weekend, there was slight improvement, but it was still painful as all hell, so I popped in to see my GP. She also a very active young woman, so I don't think she would book me off longer than necessary. I'm seeing a physiotherapist (if that is what you mean by PT), and it's improved. I've been doing some mild stretches.

 

Thanks

R

[2 Left Feet]

Rio:

 

I have a nice little case of sesamoiditis in my right foot so I have lots of experience with it. The sesamoids are two tiny little bones that float inside the muscles just behind the big toe. They act has pulleys for the muscle to slide across as they pull and relax. The good new is that you llikely have not injured them. Chances are you're either pronating (due to a high arch), or you've simply lost weight.

 

These bones are usually protected by a layer of fat or caluses on the bottom of your foot. Losing weight reduces your natural padding under the bone, increasing the amount of pressure you put on the sesamoid when you jump. I've been there. There's nothing like that friendly little way it has of reminding you it's still there when landing from a tour jette. It hurts.

 

It can also be caused by pronation. I have the challenge of weight loss and pronation (No I don't diet to maintain my ghoulish figure, I have food allergies -- I'm one of the only people I know who fights to keep weight on ). Sesamoiditis can be cured pretty easily with a good pair of orthodics. If your podiatrist does not feel you have a pronation problem, you could be putting your weight in the wrong place in your toes when coming down from a jump. When you've recovered, ask your teacher to watch your jumps closely for their advice.

 

The other thing that contributes is the floor. If you have a hard dance surface, your sesamoids are going to constantly remind you they exist.

 

I'm not a doctor, but from my experience with this nasty little affliction I can recommend the following: First of all, see your podiatrist. Have him look at your foot, see if you pronate and perform a "gait analysis." This will show if you roll in when you walk. A good physical therapist can also perform a gait analysis. Second, try padding the area around the bone. Do not put padding over the bone. Instead, cut a pad to fit around the sesamoid to shift weight away from the bone when jumping. This will relieve the pressure. As Mel said, RICE is very important in the first few days. Sesamoiditis is an inflamtion of the bone, so take an anti-inflamatory like Advil.

 

I'd also try to find a book called "The Dancer's Foot Book" by Dr. Terry Spilken. He was (I'm not sure if he still is or not) the podatrist for the Alvin Ailey in New York. It's a great book with lots of helpful advice for situations just like this one. It even shows how to do your own self-padding when a doctor isn't available.

 

The good news is that it is easy to fix, you've just got to identify the exact cause. Mine flare up once in a while, usually when my weight gets too low or I've done a few days on hard floors. Let us know how it goes.

[Paul Parish]

Rio, part of hte discipline of dancing is taking care of yourself, and relzxing in hte midst of it all.

 

All of us who started late are afflicted with a sense of having to hurry, push ourselves, and most of us get into spells where we work too hard -- not all teachers will tell you if you'v stopped breathing, even if you have -- but if one ever tells you all to breathe, take that one personally.

 

THe best set of thoughts about this is Daniel Nagrin's book -- It's FAMOUS, EVERYBDOY swears by it, and I can't remember its name. Buy yourself a copy and read it like the bible.... just open it up, any page, and read what's in front of you, It will do you a lot of good. He's a wonderful example.

 

Other ways to be good to yourself- Get MASSAGE; it squeezes hte toxins out of hte muscles, imrpoves circulation, helps you sleep. SO good for your co-ordination.

 

Take long baths.

 

Get enough sleep.

 

Eat your vegetables.

[Mel Johnson]

Good advice, all! That's the pull-together spirit!

[Sanna Koulu]

Rio, hope you get better quickly

 

I've been fighting assorted ills for maybe half a year, and feel perfectly ready to chew fences and climb up walls It started with achilles tendonitis and then developed into a more difficult problem of irritated tendons, with bouts of shin splints, sore knees, stiff and painful ankle and suchlike.

 

Actually, I've also had symptoms very much like sesamoiditis but caused (apparently) by an irritated flexor hallucis longus tendon. This hasn't been very amenable to anti-inflammatories, ice or rest, since it would recur whenever I went back to class. (If I understood correctly, the irritated tendon then irritates the sesamoid structure.) This might be worth a look in your case as well?

 

What helped me was working with a good PT, with a background in ballet and experienced in working with dancers. He has helped me correct the alignment problems that lead to over-using the FHL. (Apparently I supinate more than pronate, but gait analysis shows a perfectly normal gait with nothing to correct.)

 

The PT has also assigned a lot of warm-up and stretching for me - half an hour to 45 mins of warm-up and short stretches before class, and an hour or more for stretching after. It's been a pain to find time (and space in the studio) to do all that each and every time, but it really helps me with all the minor irritations since the muscles recover faster from the exercise. I feel that with the drastically cut number of classes I'm allowed now, my muscles get weaker and more easily fatigued, and the risk of injury or over-use grows.

 

So.. in addition to PT stuff, lots of stretching with careful warm-up and cool-down, massage as often as I can afford it, taking extra vitamins and magnesium, going to sauna whenever possible (a good thing, living in Finland ), sleeping plenty... what Paul said

 

(By the way, thank you all for the comments! I've been focusing rather compulsively on recovery, so it's good to hear the voices of reason and patience at times )

 

- Sanna

[Rio]

Thanks, folks

 

What exactly do you guys mean by PT?

 

I've decided to try find a swimming pool (at a gym) that I can use to exercise when I'm out of (ballet) action. These enforced breaks are wreaking havoc on my general fitness (and my clothes are getting tighter. Erk!)

 

2LeftFeet, the orthopaedic surgeon I saw recommended something called Dancer's felt. This is a shoe insert that relieves pressure around the great toe joint. Still trying to find time to go have it fitted.

 

The leg is feeling a wee bit better, still not ready for dancing though (or any other form of exercise - managed to get up early this morning and comtemplated going for a brisk walk but the leg put the cowbosh on that).

 

Thanks for all the advice.

 

Rio

[Mel Johnson]

PT=Physical Therapist, or Therapy.

[Guest beckster]

Is physical therapy the same as what we call physiotherapy? I've never had it, but I think it's massage and manipulation to treat/prevent injury - footballers have a lot of it!

[Jaana Heino]

It is the same, I think, and in addition to different massages and manipulative therapies it involves giving the patient excercises (strength building, stretches, bettering of alignment, whatever) that help in the treatment / prevention / recovery from injury; I think these are considered the more important part these days.

[christa1217]

i just found out yetserday that i injured my sesamoids. as mentioned, my podiatrist said i was pronating and my dance school moved to a place with a different surface. i'm terribly upset because SI auditions are here....

Edited January 19, 2006 by christa1217