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A Better You | “Ouch” to “Ahhh”

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ABetterYou2Swollen, aching legs and feet are an occupational hazard—but here’s how to cope

By Suzanne Martin, PT, DPT

It’s one thing all dance teachers have in common: standing for mega-hours. I remember talking to a friend who had stopped teaching dance; she said the best thing about it was that her feet didn’t hurt anymore. And when I sympathized with a dancer caught in ridiculous traffic, a similar thing happened: She said she was so grateful just to be sitting down. Sound familiar?

Why do dancers’ feet and legs hurt so much? It’s true that most dance injuries occur in the feet and legs, but on a day-to-day basis, apart from actual injury, the cause of the discomfort is simple: overuse. Teaching is hard work. To have longevity in the field, your feet have to be constantly restored, daily. Here are some tips to help you turn your standing hours into happy hours.

Footwear
Take a close look at your footwear. Can tape, toe spacers, or ball-of-the-foot gel pads help you? It’s amazing how many great new products are available now that were not around only 10 years ago. Some of them, like Scholl’s products, are available in drugstores; others can be found in dance-specialty (Discount Dance Supply, Bunheads Dance Accessories) and foot-specialty (FootSmart, Hapad, Inc.) catalogs and websites.

What you wear in your shoes can definitely help you survive long hours on the dance floor. Most dancers get pretty savvy about all the helpers and inserts that can make huge biomechanical differences in their feet and ankles—but as teachers, it’s easy to forget that yours need the same care. It’s well worth the effort to find out what works, both in the studio and on the street. For instance, I double-padded the carpet in my Pilates studio, and I wear elastic ankle braces when doing lengthy standing work. I also wear Kinesio bunion tape when taking ballet class now.

Foot care
Routine maintenance can strengthen the feet and ankles. Have you transitioned into a managerial role, or into teaching from performing? Most dancers have shaped their feet as a rite of passage, aiming for flexibility and the status symbol of a beautiful foot. But once they move into teaching, often they don’t realize that though the shape and the skill are still there, the strength might not be. My transition from teaching 12 classes per week to sitting in physical therapy school and ultimately working clinically was more drastic than I expected. It was a big shock to find out how much day-to-day teaching had strengthened my feet and ankles and how quickly that strength was lost.

Exercise tools
Several quick and dirty tools can make a serious difference in day-to-day foot comfort. Number one is the tennis ball. Just rolling the foot firmly over the ball in the morning or before you teach can activate the four layers of muscles in the sole of the foot and begin to stretch the strappy connective tissue, the plantar fascia.

Next, get a Thera-Band. I keep one attached to the foot of my bed and religiously perform three exercises on each foot. Another helpful tool is a wobble board. I use the Rock Ankle Exercise Board, available from optp.com. (See “Exercises” for how to use both tools.)

Restorative practices
Feet appreciate having the toes stretched apart. Something as simple as placing one of those toe gizmos for keeping the toes apart when applying nail polish can provide a great end-of-day stretch.

Leg swelling is an often overlooked problem. Typical complaints include a feeling of heaviness and/or aching. I notice in my clinical practice that women tend to suffer more from swelling, likely due to monthly hormonal fluctuations and the natural flexibility they have in the pelvic and leg region for childbirth. Add to that a dancer’s flexible body and you’ve got a favorable scenario for more-than-usual leg swelling.

Most dancers get pretty savvy about all the helpers and inserts that can make huge biomechanical differences in their feet and ankles—but as teachers, it’s easy to forget that yours need the same care.

From exercise physiology, we know that blood travels from the trunk to the limbs during strenuous exercise and can pool there if not redirected. Do your socks leave a line on the shin? Check the amount of swelling in your lower legs by pressing the pad of your index finger into the soft tissue about 3 inches above the anklebone. Press front, sides, and back. Is there an imprint? If the finger indentation persists more than 5 seconds, it may be worth a doctor’s visit to determine whether a circulation problem exists.

How to tackle the problem of swelling depends on its severity. Compressive stockings and knee-highs are available from hosiery companies like Hanes. Compressive stockings can be immensely helpful during long flights, which often bring on quite a bit of leg swelling. New mothers will find that wearing bike pants, girdles, or slimming undies from companies like Spanx will lessen postpartum swelling and pelvic pain. Check out ballet tights that have Supplex added, which can provide helpful compression during class.

An end-of-day restoration can be particularly useful. A simple practice is elevating the legs above the heart. Lie down, place the legs on two bed pillows so that the knees are supported, and shake them vigorously with a vibrating motion to start moving the fluid out of the legs. A more aggressive and extremely beneficial practice is to do contrast baths before elevating the legs.

You’ll need two tall containers (try plastic trashcans) because the water needs to go up to at least mid-calf in order to have the desired effect. Place ½ cup Epsom salts in one and fill to mid-calf level with warm (not hot) water. What’s most important is the contrast between the two temperatures, not the absolutes of hot and cold. Pour cold tap water with perhaps only 5 ice cubes in the other. (I know a dancer who lost sensation in her skin by over-chilling her legs in ice water.) Place your feet and lower legs in the warm container, then in the cool one, for 10 minutes each. Repeat the cycle once (ending with the cool container) for a total of a 40-minute soak. Then, for optimal results, rub the lower legs and feet with a liniment or homeopathic salve such as Traumeel or arnica cream before elevating them above heart level for 20 minutes. Try this after your longest day and your legs will love you forever.

Payoff
Yes, it takes effort, but good leg and foot care will never let you down. The benefits are less irritability, more endurance and patience, and actually enjoying your days and nights in the field you love.

I have faith in you.

Exercises

Thera-Band

1. Loop the band over the leg of a bed or heavy chair. Sit with your right leg perpendicular to the loop of the band. (This should be the leg that’s closest to the bed or chair.) Place the right foot into the loop, extending the band over the top half of the foot and toes (on the big toe side). Stretch against the band to make it taut. Remember the motto “Meet it, don’t beat it,” giving a nice amount of resistance without overdoing it.

2. Now make a windshield-wiper action with just the foot; hold your knee to prevent thigh motion.

3. Circle the foot 20 times in each direction, working against the resistance.

4. Stay seated in the same direction and perform the same three exercises with the band looped over the little toe side of the left foot. Then rearrange yourself by sitting with the left leg perpendicular to the loop and perform the same three exercises with the band centered on the left big toe and right little toe, respectively. It might seem like too much to do in one sitting, but once you get it down you can knock it out in 5 minutes.

Wobble board

1. Stand on the disc, centering your stance with your feet in parallel about 4 inches apart. Tip the disc forward and back about 10 times, making sure to move your whole body up and down rather than making the motion with the pelvis. (A mirror helps.)

2. Next, swivel the disc, touching the rim along the floor, making the motion by bending the knees—first one, then the other. Go about 10 times in each direction.

3. Stand on the center of the disc on one parallel foot with the other in parallel passé. Keeping the supporting knee straight, touch the rim of the disc to the floor front and back 10 times. Then circle the standing foot so that the disc makes small swivels again, 10 times each way. Repeat with the other leg.

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