Dancers need to develop tough but supple feet. This is achieved by stretching and strengthening the muscles that work the feet and by ensuring that the skin is well nourished and tough enough to withstand the forces applied to it when dancing.

Blisters: - develop between the skin layers, are filled with serous fluid and are due to abnormal shearing forces, usually from rubbing against footwear or from toes rubbing against each other.
     -         may be deep and involve several layers of skin,
     -         may involve blood vessels, and if these vessels rupture blood will be seen inside the blister.

Common sites are heels, on tops of toes, in between toes and under the balls of the feet.

Helpful hints

v     Tape around toes and heels prior to dancing,

v     Check that footwear is not too tight or too loose,

v     Use a sterilised needle to burst blisters, and apply “Friar’s Balsalm”and tape.  Friar’s Balsalm is also known as T.B.Co (Tincture of Benzoin Compound).

v     Keep area clean and protected till healed,

v     Use sports tape or “second skin” to cover the vulnerable area,

v     Methylated spirits can be applied to toughen up the skin.

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Callus: - is thick skin that develops because of a constant abnormal pressure over an area. Dancers need to develop some thicker skin over vulnerable areas but callus sometimes becomes so thick and hard that it causes pain.

Common sites are on top of the toe joints, underneath the metatarsal heads of the feet, at the side of the big toes and big toe joints or at the heels.

Helpful hints

v     Check fitting of dance footwear,

v     If the big toe is particularly short, packing can be used within a ballet shoe to create a “longer” toe,

v     Minor callus can be reduced with a pumice stone while thick or painful callus should be removed by a podiatrist.

v     Tape can be applied over callus to protect vulnerable areas,

v     Creams with Urea can be applied to soften the skin.

Small bursal sacs over the joints can become inflamed.  This is called bursitis and the area becomes hot, red and swollen and is very painful.  Callus can sometimes form over a bursa. 

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Corns: - are painful and usually circular in shape.  Corns are due to abnormal intermittent forces to an area and can be hard or soft.  Corns can  be surrounded by callus.  Mechanical abnormalities of the foot can create the abnormal forces responsible for callus and corn formation.

Common sites for corns are between the toes, on top of toes, under the joints of the feet and sometimes under the nails.

Helpful hints

v     See a podiatrist for the removal of corns,

v     Protect the area with appropriate padding,

v     Have a biomechanical assessment to detect abnormal foot function.

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Bruising: - occurs after a blood vessel bleeds into soft tissue.  This occurs when a blood vessel ruptures, and in dancing, is usually a result of trauma.  Bruising around the nails can occur if the toe box  of the shoe is too short or excessive pressure is exerted to the end of the nail, or from the nail itself.

Common sites are under the toenails, or at the base of nails if the nails are too long for pointe and demi-pointe.  Bruising can occur under the forefoot or when associated with ankle sprain, torn ligaments, avulsion or true fractures.

Helpful hints

v     Keep toenails short. Cut nails straight across and curve gently at the sides,  

v     Check pointe shoes to ensure they are not too short, too wide or narrow or require cushioning,

v     Apply RICE principles to ankle injuries.

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Ingrown toenail: - is the result of a piece of nail penetrating the skin of the toe.  The area swells, becomes red and painful and often becomes infected.  Hypergranulation tissue often forms along the affected side of the toe.  Inappropriate nail cutting, pressure on the nails from other toes or footwear can all contribute to ingrown toenails.

The most common sites are either side of the big toenails.

Helpful hints

v     Nail care as described above, and antibiotics maybe needed,

v     See a Podiatrist to have the offending nail splinter removed, or to have nail surgery if necessary,

v     Bunion deformity causes abnormal pressure between the 1^st and 2^nd nails.

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Soft tissue and bone injury: - most of these injuries occur due to poor foot structure, muscle weakness or imbalance, overuse, over training, poor technique, inadequate flooring, performance and choreographer demands, and changing stage conditions, eg when “on the road” and performing in a variety of locations.  Tiredness and lack of concentration is also a common cause of injury.

Common sites for injury are ligament damage within the foot, stress fractures of the metatarsals and overuse injuries of various tendons – particularly the flexor hallucis longus tendon.

An accessory bone at the back of the talus can cause pain at the back of the ankle when the dancer is en pointe.

Helpful hints

v     Ensure that you or your child has a reputable dance teacher,

v     Increase the demand on the feet according to strength and balance skills,

v     Ensure good habits are gained early in dance life,

v     Practise balance skills,

v     Do not dance when injured,

v     Seek early advice if injured and don’t dance in pain,

v     Check for biomechanical abnormalities and address problems that might increase the risk of these injuries,

v     Recognise “tiredness” as a risk factor for injury,

v     Wear Arch Angels to strengthen and protect the foot.

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