My foot

[Kate B]

A while back I posted about stress fractures in my first and second metatarsals.

 

Well, they just haven't seemed to get any better, and I am finally (after spending about 8 months seeing physiotherapists and osteopaths and hundreds of pounds) going back to my GP with a letter asking for an x-ray (something I probably should have been given earlier on.)

 

The osteopath I've been seeing thinks I may have done some permanent damage, and we will know if this is the case when I get the x-ray done. She says that if there is permanent damage I should not go back to ballet or contemporary ever as it will just get worse and more painful.

 

I'm finding this a difficult prospect, as not being able to go to class for all of 2004 (apart from a brief attempt to go back at Easter) has been hard enough.

 

I just wondered if anyone had had to give up dancing for injuries, and whether at some point I could go back. The osteopath said there was nothing I could do as far as resting it was concerned.

 

Thanks. You are always very helpful and supportive.

[JennyKaye]

Awww Kate thats really bad!

 

I had to stop dancing for ages when I hurt my back last year and I found that really hard. I still can't do very good forward and back bends!

 

Maybe the osteopath could suggest some kind of foot support so that you can keep on dancing. You probably won't be able to do all the excersices but at least you would be at class.

 

Or maybe if you can't dance you could ask your teacher if you could come and help teach the class e.g. help with correcting the students, choreograph dances for shows....

 

Take Care and make sure you rest it so that it doesn't get worse!

[Victoria Leigh]

Kate, I would request an MRI if I were you. That will give them much more information than an X-Ray. Before you give up hope of continuing to dance, find out exactly what is going on there and why it has not healed. Even after all the treatment you have had, without a positive diagnosis there is no way to know for sure that it was/is a stress fracture, and certainly no way to know why it has not responded to rest and the treatments.

[Guest Pigeon]

Kate, cheer up!

I had metatarsal stress fractures, and they required REST. Wear VERY supportive shoes, and know that you're only stopping dance class temporarily. I went back, have been dancing again for over a year. Give it the required time (that may be different for everybody), and I'll bet you'll be back in ballet slippers (NOT pointe shoes!)

[DreadPirateRoberts]

Hi Kate --

 

I am sorry to hear your sad news -- the loss of the time and the

money are both discouraging, I am sure. My advice is to see an

orthopedic specialist and receive a thorough diagnosis and treatment

from them. That's what worked for me (I had a 5th metatarsal

stress fracture). The surgeon told me that the proper treatment

for 5th metatarsal fractures can vary widely, depending on the

location of the primary fracture on the bone itself. I was lucky;

my fracture required only immobilization for several weeks or so.

He said that had the fracture been in a slightly different place on

the same bone, the proper treatment would involve surgery and

the insertion of a metal pin! The difference (as he explained it,

and as I later read on the web) is that the amount of blood supply

varies considerably as one moves from the distal end to the proximal

end of the bone.

 

I have never worked with an osteopath, so I cannot comment on

the efficacy of their treatments, etc, but based on what you've said

it might be time to line up a orthopedic surgeon and get a real, solid

diagnosis from an MD...

 

Good luck, and please do keep us posted on how things are

going for you! I'm wishing you all possible good...

[Guest Lizzie 37]

Dear Kate, The clinician in me agrees with DPR. Get thee to an orthopedic doc post haste. [board certified, please] He or she will examine you and order the appropriate imaging tests to diagnose your injury and plan your treatment. Be involved. Let the doc know your concerns and perferences. [i prefer the docs with dance or sports expertise] However...once you have the treatment plan, follow it. Don't rush, cheat, or push. Patience is difficult, but in orthopedic cases, it will bear fruit. The other course is asking for a chronic problem. Best wishes. Liz

[scoop]

Oh Kate, very sad news but also kind of baffling -- I've never heard of permanent damage from a fracture, unless I suppose it healed badly or in a misaligned way? Hope you find a specialist who can give you a better prognosis.

 

For what it's worth, I broke a metatarsal some years back -- the fifth -- in a class, and eventually was able to return to dancing. It wasn't a stress fracture like yours, but a break (I came down badly off a tour jete), and I was in a cast for about six weeks. I took a long time off class -- it was more psychological than physical, I'd lost my nerve more than anything else, plus my job got more demanding and I just didn't have time. But I started taking class again several years ago and my foot seems just fine.

 

Best wishes to you!

[Kate B]

Thank you everyone for your kind support.

 

I am going to see my GP this morning (ordinary doctor.) The last time I saw him with this problem he didn't take me seriously at all, gave me pills and told me to rest, and that if it was still causing me problems after several months I could go and ask him to refer me for physiotherapy. In the UK you can't really go and tell your doctor you want to see a certain kind of specialist - they would just laugh at you and say 'Who do you think you are telling me how to do my job'! Which is why since January I have been paying for PT and osteopathy privately.

 

I am taking a letter from the osteopath detailing exactly what she thinks is wrong with my foot but she has not said 'Kate must have an x-ray/MRI/anything like that' - I have to go to the GP and ask his opinion. He could ask me if I took the NSAIDs he prescribed me and if I tell him the truth, he could just prescribe me some more.

 

While the NHS is great when you are bleeding or broken (and of course it offers so much essential care for everyone) it is not sympathetic to people like me who don't just want to be able to walk (which is what they see as a kind of health benchmark), but to run and jump and dance barefoot.

 

I will let you know how I get on. Thanks again for your lovely words of support.

[2 Left Feet]

Kate:

 

I hope your doctor takes you seriously this time. If not, there has to be some board you can report him to. I think it's ridiculous that any doctor can be so calous as to write off a patient's concerns the way he seems to have brushed off yours.

 

Has the physiothereapist recommended orthotics? If your problem is continuing it sounds as if it is a structural problem, perhaps a hi-instep. You're likely putting your weight in the wrong spot when you walk. Ask your doctor about seeing a podiatrist or someone who can do a gait analysis. This would determine if orthotics will help. The symptoms may be showing up in your feet while the problem originates elsewhere. Gait analysis would show this.

 

If you want to get a quicky, amature reading, look at the bottom of the shoes you wear most regularly. If they are evenly worn, chances are your porblem is not something orthotics will fix. If they tend to be more worn to one side of the other, especially around the toes, you're not placing your weight evenly when walking.

 

I'd also recommend finding a shoe store that specializes in running shoes. Don't go to a sports store, find one strictly for runners. They should spend time helping to fit a shoe that is correct for your feet. Tell them about your foot problem and they'll take this into consideration while fitting you. Many people have problems because they try to squeeze feet into shoes htat are too tight or without enough room for the toes to move while walking. Your problem could be as simple as your toes can't spread out in the shoes you're wearing. This is the same for technique shoes. Make sure you have shoes with enough room to spread your toes out in them.

[Kate B]

Hi 2Left - you're right about the orthotics. I got a pair made back in February and also started wearing running shoes. They have made a difference, in that my foot doesn't hurt when I'm just walking about, but if I spend all day standing about (like when I took my American cousin touristing round London a week ago) then my toe really aches.

 

Today the doctor said he doubted it was a stress fracture (turns out the last doctor I saw didn't even put it in my notes that he saw me way back in January!) but he took me quite seriously (I told him I was a dancer and he assumed that meant it was my profession) and gave me the form I need to take to the x-ray department. So I'm going there tomorrow. If there's evidence of fracture, then I get referred to the fracture clinic. If it's not, who knows? I'm going to make a fuss about this I think because it's gone on and on for the whole year and it's really getting me down to think that dancing might be permanently out of the question.

[2 Left Feet]

I wonder... This is starting to sound like a bone spur. These are treatable if thats what it is. It could also be a stone bruise that wasn't properly treated. Improper orthotics could cause a stone bruise to be aggravated like it was by walking around all day. Stone bruises are inflamation of the tissue between two joints like a metetarsle. I have one that pops up every now and then. The orthotics should help heal it but it also needs heat and a good working out. Mention these when your X-rays are read. And have someone look at your orthotics to make sure they're correct. I had a podiatrist cast me in a pair last year. My feet did not get better and he insisted the orthotics were correct. After watching me walk around in his office and working with my foot over the course of two weeks, an osteopath decided my orthotics were in fact turning my foot the wrong direction, forcing me to roll out instead of inward like I needed. He was right. The new pair he ordered for me works quite well. Better yet, he had them made out of leather. I now start my classes with the orthotics in the technique shoes. By the time we reach frappes I switch to a different pair of shoes without the orthotics. By then my legs are nice and srtetched out and I can handle class.

[Kate B]

My orthotics are OK - they were checked out by my PT and my osteopath. (My foot hurts if I don't wear them - e.g. when I want to wear pretty/trendy shoes!)

 

The x-ray was fine, apparently, no sign of fracture. It's going to be read by a consultant and I will find out in two weeks if there are any abnormalities.

 

I guess I just have to keep being patient.

[2 Left Feet]

I've had foot pain that actually radiated from my hip before. It took weeks to figure it out and one simple crack of the back fixed it immediately. I now add stretches for the low back, twisting the torso and so forth, several times a week and it keeps the low back nice and open.

 

Glad to hear the X-ray was clear.

[Kate B]

At last... A diagnosis of sorts...

 

No problem with the bones, which rules out stress fractures and bone spurs and arthritis, which is, I think, on the whole, very good news. However, my foot is still painful and the consensus from the professionals I've seen is that there is something wrong with the ligaments in my big toe.

 

Ligaments, not bones. My doctor said there wasn't much that could be done, just wait until they stop hurting. The osteopath did some excruciatingly painful acupuncture, and said that they don't heal very fast because they don't really have a blood supply.

 

So my new question is:

Has anyone heard about problems with the ligaments in the big toe before?

And is it true that time will sort things out and some time in the not too distant future, I will be able to go back to class? (I know I can't really ask this as you haven't seen my foot, and you're not doctors, but I thought it wouldn't hurt to just ask anyway!)

 

Thank you all for your lovely support.

[Mel Johnson]

I've survived chondritis (which is inflammation in and around the cartilage) of the foot, and you're right, it takes a long time, but you can emerge from it totally healed. In a way, I would rather have had a broken bone, as that heals far more quickly!