Put your best foot forward
Published on 23/09/2018
For a relatively small body part, we dancers expect a lot of our feet. The role of the foot in dance – perhaps more so than any other part of the body – is both functional and aesthetic. Our poor feet! We push them to the limits of their capabilities, but we expect them to look absolutely fabulous at the same time.
When we consider the demands we’re making of them, it’s not surprising that, inside our pointe shoes or pumps, our feet may not feel (or look!) particularly beautiful. But, as dancers, it’s also vital that we DO take care of our feet.
So, what can we do to ensure that our feet can continue to meet our expectations? Nina Levy spoke to Lauren Kemp, a podiatrist specialising in the treatment and management of ballet and dance related foot and ankle injuries, to find out.
Anatomy of a foot
Before we talk about how to look after our feet, it’s important to have an understanding of the physical make-up of a foot.
So many bones and muscles!
The first thing to know is that feet are complex. Kemp elaborates, “A quarter of your body’s bones are in your feet – 52 out of 208!” You’ve got 26 bones in each foot plus two sesamoids and 33 joints – over 100 ligaments, tendons and muscles. There are four layers of muscles, made up of the intrinsic muscles (muscles within the foot) and the extrinsic muscles (muscles that cross over from the leg and attach into the foot).
“We classify the foot into three sections: fore-foot, mid-foot and rear-foot,” says Kemp. “The fore-foot comprises of your long metatarsals and toes, the mid-foot is made up of the tarsal bones, and the rear-foot is the heel bone, talus and ankle joint.”
The all-important arch
An arched foot is central to ballet’s aesthetics, whether completing the line of the foot en l’air or à terre, so it’s no wonder that, as dancers, we’re pretty focused on the shape of our arches. “Unfortunately, you can’t really change the make-up of your arch,” Kemp remarks. “What you’re born with is what you’re stuck with. You can increase the strength of the arch, though.” More about that presently!
“Typically people fall into two categories, flat-footed or high arched. Those who are flat-footed usually have a lot of mobility but then sometimes have trouble with controlling that mobility. So they might have a great plantar flexion (pointe) when non-weight-bearing, but when they get into weight-bearing, if they don’t have the appropriate strength, they can’t control it up on demi-pointe or on pointe. High arched feet tend to be quite stiff. They tend to be poor absorbers of shock, prone to stress fractures, stress injuries.”
Exercises to improve foot strength and articulation
While you can’t change the make-up of your arch, there are plenty of exercises you can do to improve your demi-pointe and pointe, by working on the strength and mobility of your foot. Kemp shares her favourites below:
Want to strengthen your arch? “I’m a big fan of ‘doming’ or ‘short foot’ exercise,” says Kemp. In this exercise, the dancer places his or her foot on the floor. Keeping the toes long and flat on the floor, the dancer then ‘shortens’ the foot by lifting the arch.” Keeping the toes flat, long and pressed into the floor is vital, Kemp explains.
“The purpose of the exercise is to recruit and use the small intrinsic muscles to lift up the transverse arch. The toes need to be straight so that the big extrinsic muscles are not recruited, because they tend to overtake and then they get overworked, which can lead to injuries.” If we think back to the anatomy of the foot, the extrinsic muscles are the ones that connect the ankle to the foot ¬– so if you see or feel any action around the ankle joint then you need to try to stop using those muscles. It’s the intrinsic muscles – the ones within the foot – that need to be active.
“So tibialis anterior and the calf shouldn’t be contracting at all. It should all come from the muscles underneath the foot,” she continues. “The ball of the foot can come off the floor slightly. Eventually you’ll see the heads of the metatarsals make a nice curved dome position on top of the foot.”
2) Big toe isolation exercises
This exercise also begins with the foot placed on the floor. “This is where we isolate and lift up the big toe while keeping the other toes long and straight into the ground, and then put the big toe down and isolate and lift the other toes,” says Kemp. “It’s important to note that people sometimes cheat by moving the foot. Nothing else should move – only the toes.”
3) Foot articulation with a ball
Many students use elastic resistance bands for warming up and building strength in the foot, but Kemp says she prefers to use a small, partially inflated Pilates ball. “I’m not a fan of using resistance bands for working through the foot because students sometimes crunch their toes and don’t target the intrinsic muscles… they tend to recruit the flexors,” she remarks.
For this exercise the ball is placed on the floor, against a wall. The dancer then sits on the floor, with the leg stretched out, the foot flexed, and the ball of the foot resting on the ball. “I get the student to articulate through the foot, so the foot starts in a dorsiflexed position (flexed). They then plantar flex (point) the ankle, keeping the toes flexed (‘demi-pointe’). Then when they can’t get any further ankle flexion, they lengthen their toes into full pointe, without crunching or gripping the ball.” This action is slowly reversed, then repeated. “The idea is to work through the foot, controlling the ball as well, so that the foot doesn’t roll from side to side. Pressure should be even across the foot so that it doesn’t wing or sickle. That’s my preferred warm-up.”
4) Calf raises
The simple calf raise (rising onto demi-pointe, either on one or two feet, and lowering with resistance and repeating) is one of the most effective ways to building foot strength and calf strength, says Kemp. “Calf strength has a direct influence on ankle stability and ankle strength, and this exercise will develop arch control and arch strength as well.”
What about foot stretchers?
We’ve all seen those moulded plastic devices that promise the pointed foot of your dreams, but Kemp isn’t keen. “Foot stretchers are a no-no,” she advises. “They tend to overstretch everything. They might overstretch the ligaments and make your foot more unstable and also might encourage posterior ankle impingement.”
You can still work on the mobility of the foot and ankle, though. “You can self-mobilise your foot by sitting with one leg bent, so that the foot rests just above the knee, and moving the foot with the hands, using a gentle ‘towel-wringing’ action,” suggests Kemp. “You can also mobilise the toes. You hold the ball of the foot and hold the toe, and then move the toe in a clockwise direction five times, and then an anti-clockwise direction five times. You do this to each toe. Mobilisations are good for getting the joint fluid moving and working.
“I also encourage students to do self-release, using massage cream ¬– I’m a fan of arnica cream – working their fingers through the arch muscles. You can even get on top of the foot and massage between the metatarsals. Rolling the underside of the arch on a golf ball or a spiky ball is also great.” Because there are muscles and tendons in the foot that travel up into the calf, massaging the calf can also help release the feet. “Massaging up through the calf, or using a spiky ball or foam roller, can also help to loosen fatigued muscles in the arch,” says Kemp.
Looking after your feet
Getting the best out of your feet isn’t just about building strength and mobility. It’s also about taking care of those tootsies, and Kemp has a number of tips for foot-care, especially for those in pointe shoes.
• Toe nails
“Toe nails should be cut straight across and kept relatively short, but not too short – you should have a small amount of white nail growth at the end,” says Kemp. “Regular nail polish is a no-no. It tends to affect health of the nail, but also, if you get bruising or an ingrown toe nail, you can’t see what’s happening. Nail polish also tends to make you more prone to things like fungal infections. It’s ok for short term use, if you’re going to a party or something like that, but not for long term use.”
• Calluses and corns
“Keep calluses trimmed,” recommends Kemp. “They are there for protection, so I don’t normally suggest removing them. If they get overly thick, they can become painful and might need podiatry intervention. It’s best to avoid cutting them off yourself, or soaking them to try and take them off, because you risk opening up the skin and getting infections. You can gently pumice them on a regular basis to keep them down.
“Corns are a common problem we see in dancers. A corn is a hard lump of skin, almost conical in shape. We commonly see them between toes where they can get quite moist from being in dance shoes, and because of that they’re prone to getting infected. So we say don’t cut them off yourself, and don’t use corn plasters. Corn plasters are acid and break down the skin, so you’re more likely to get infections. If you have a painful corn always see a podiatrist.”
“If you have a blister and there’s lots of fluid in it, you can disinfect the skin, sterilise a needle, and prick it at home, but don’t remove the skin. Then apply antiseptic and a dry dressing and keep it intact. If it’s a blood blister we don’t recommend draining those ones.”
• Skin care
“It’s good to keep the area in between the toes really dry, so you can use surgical spirits in between the toes to keep them dry,” advises Kemp. “For rest of the foot, use a good moisturising cream on a daily basis.”
• Air your shoes
“If a dancer is full-time or in class for a number of hours per week, it’s good to have a couple of pairs of shoes on rotation, so you can air them between classes,” suggests Kemp. That goes for both pointe shoes AND soft ballet pumps. “Usually shoes need at least 24-36 hours to dry out properly. None of your shoes should be stored in your bag. Ideally shoes should be kept out of your bag and hung up after class, to air and dry.”
• Toe pads
“We see really gross toe-pads! Dancers need to wash toe pads on a regular basis.”
“For post-class/rehearsal/performance recovery, I often recommend that full-time dancers and dancers who do a number of classes per evening use compression tights or socks,” advises Kemp. “You can get specialised, targeted compression socks for feet.”
• Street shoes
“Because dancers’ feet get such a huge workout in ballet, I recommend that, outside of ballet, they wear a really supportive shoe, even going to and from training. I know warm-up booties are great but they don’t provide any support. So if dancers are walking any distance, even just going to the shops, sneakers are preferable because they’re supportive and have lots of cushioning.”
Lauren Kemp is a podiatrist at The Perth Foot & Ankle Clinic. She specialises in the treatment and management of ballet and dance related foot and ankle injuries.