We get a lot of athletes in our clinic who are dealing with foot and ankle injuries, but we also see a large number of women who need treatment or surgery because of the toll that dancing has taken on their feet. Dancers are often on their feet for more than 12 hours a day, and the twists, moves and jumps can all wreck havoc on their feet.
However, a recent study out of Australia found that targeting one specific muscle group can really help to reduce the need for surgery among ballet dancers. In today’s blog, we take a closer look at how muscle conditioning can help keep dancers out of an orthopedic surgeon’s office.
The Calf Is Key
The idea to take a closer look at some of the risk factors for ankle injuries among dancers was led by Dr. Sue Mayes, director of artistic health and principal physiotherapist at The Australian Ballet. She noted that while many of her dancers had sculpted calf muscles, many of them lacked calf muscle endurance. And as muscles fatigued, the likelihood for injury skyrocketd.
Dr. Mayes asked each dancer to perform 25 consecutive single-leg heel raises, and she compared their ability to complete the exercise with their previous reports of ankle pain. She found that the dancers who could not perform the heel raises, an exercise that targets calf muscle endurance, were the dancers who had experienced ankle pain within the last six months.
Dr. Mayes convinced ballet staff to add 16 single-leg raises in parallel at the end of their warm-up session in hopes that these exercises would help to “fill in the deficit,” as Dr. Mayes explained.
“We wanted to give the calf muscle the conditioning and activation it needed before doing more challenging work.”
Dr. Mayes also asked dancers to perform additional heel raises outside of class to really drive home calf strengthening and endurance. Not only did the dancers quickly say their injuries felt better, but they also said they felt stronger. Just six weeks after incorporating conditioning, the dancers actually asked to increase the number of single-leg raises after warm ups to 24 for added calf muscle strengthening.
Dr. Mayes also found that “obsessive” calf muscle stretching prior to dancing could contribute to injury. Many dancers were hyper-focused on stretching out their lower bodies and ensuring they were ready for activity, but in dance, Dr. Mayes believes that could actually do more harm than good by reducing muscle strength output.
“We need the body to be able to work like a spring,” Mayes says. “If we stretch these tissues out too much, they lose their recoil capacity.”
The changes have been effective, as there have only been four ankle surgeries among The Australian Ballet’s dancers in the last 10 years, and three of those were in dancers who joined the company from outside the development program.