Category Archives for "ballet"

What is Cuboid Syndrome?

Ever feel pain or swelling on the side of your foot? These symptoms may be due to a condition called Cuboid Syndrome, also known as cuboid subluxation or lateral plantar neuritis. In addition to pain in the lateral mid-foot, redness and a restricted range of motion in the ankle may be present. This syndrome is typically associated with an inversion sprain of the ankle. This is when the foot is forced inwards causing the cuboid bone to sublux, or partially dislocate. The cuboid bone is located near the mid-point of the outer side of the foot and is one of the seven tarsal bones that make up the arch of the foot. It connects the foot and ankle as well as provides stability to the foot.

The peroneus longus muscle is a muscle that runs along the outer side of the lower leg and attaches to the lateral side of the foot. Repetitive strain of this muscle due to activities such as ballet, jumping, or running, may place tension on the cuboid bone. Commonly found in athletes, Cuboid Syndrome may also occur in sports such basketball, football, or soccer. Weight-bearing, uneven pavement, or quick changes in direction that occur in sports may aggravate symptoms. A third cause of this syndrome may be an individual’s altered foot biomechanics. Athletes who have over-pronated feet, also known as flat feet, may be more prone to cuboid subluxation.

Imaging such as x-rays, MRIs, and CT scans can be used to rule out other causes of pain. However, a cuboid subluxation can be difficult to diagnose and therefore, must be carefully assessed by a general physician or other health care professional.

STRENGTHENING

Daily strengthening and mobility exercises should be performed on a pain-free basis to prevent the foot and ankle from becoming weak or stiff. Watch the videos below on how to properly perform strengthening exercises:

Use a resistance band tied to a stable anchor and wrap it around the unaffected leg. With the affected ankle, stand either in front of the band or inside while keeping your posture tall and inner core engaged. Hike the foot with the band wrapped around the leg up off of the ground and slowly push the leg out to the side and then slowly return it back to the middle while keeping the foot off of the ground the entire time. Resist the movement with the standing leg by squeezing the butt muscles. Repeat this 10 times for 3 sets daily.
Start by putting your weight on the side of the affected ankle and hike the opposite foot up off of the ground. Remember to keep your inner core tight below the belly button. Then with the foot that’s off of the ground touch the first point in front of the ground, then to the side and then behind you, and then cross over to the other side of the body. Repeat the 4 points of contact (front, left side, back and right side) for 30 seconds 4 sets 4 times per day. As you get stronger increase it to 60 seconds 4 sets 4 times per day. If you have a fracture as a result of your injury or you are unsure if this is the right exercise for you to do, consult your physiotherapist before starting this exercise.
Starting with tall posture, engage your core muscles below the belly button by drawing the lower abs inwards toward the spine. Avoid arching the low back. With arms in a ready position do a one-legged squat with your body weight distributed equally over the foot. Don’t go any lower than a ninety degree bend in the knees, keeping your knees in alignment with your second toe and over your heel as much as possible. Hold for a good long second and then straighten back up with your butt muscles to the start. Do three sets of ten repetitions daily. 

TREATMENT

Other treatment options include foot support such as padding, taping, or orthotics to help stabilize the bones of the midfoot or correct for over-pronation. Rest from repetitive, weight-bearing actions such as jumping or running may help alleviate pain. Ice affected area for 10 minutes at a time to reduce swelling and inflammation. Consult your family physician, physical therapist, or podiatrist to perform a manipulation if the cuboid bone is suspected to be dislocated.


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5 Strengthening Exercises for Dancers

Overuse injuries are commonly found in dancers due to their intense training regimes. Nearly 60 to 90% of dancers experience an injury or multiple injuries during their careers (Steinberg, Siev-Ner, Peleg, et al., 2013). These injuries include chrondromalacia patella (“runner’s knee”), Achilles tendinopathy, and metatarsal (foot) fractures. Some major causes of injury may be due to anatomic structure, genetics, training regime, improper technique, floor surfaces, age, body mass index, muscle imbalance, nutrition, and menstrual function (Steinberg et al., 2013).

Dance typically includes being on the toes and forefoot in a extreme plantar flexion position, known as “en pointe.” Individuals with poor balance and landing techniques will experience higher ground reaction forces which may subsequently strain the back, knees, and ankles. Incorrect form in many non-professional dancers entail a valgus knee position (knees caved inwards) and hip adduction. Conversely, mature, experienced dancers are able to rely on stronger hip and knee joint muscles to stabilize themselves during landing from jumps. Young dancers also experience lower back pain. Causative factors include high preseason training intensity, history of low back pain, low body weight, scoliosis, and stress fracture in the pars articularis of the spine (Steinberg et al., 2013).

Studies have recommended minimal exposure for young dancers to overload exercises, especially those involving the spine and caution with extensive stretching exercises (Steinberg et al., 2013).

Prevention

Here are a few essential tips to reduce the risk of injury:

  • Wear proper footwear and clothing
  • Drink fluids regularly
  • Do not dance through pain as it will exacerbate the damage
  • Practice correct dance technique 
  • Take adequate breaks during and between dance sessions
  • Ensure proper warm-up and cool-down (approximately 5-10 minutes)
  • Use preventative taping and/or braces if necessary

Strengthening

1) Woodchops – hold a light dumbbell or single cable in the highest pulley position with both hands and bring the weight downwards diagonally to the side of the leg opposite to the starting position. Remember to keep a flat back and tight core through out the motion. Repeat 8 to 12 reps on each side.
2) Lateral Step Downs – stand beside a step or a box, then place one foot on the step. Lift the other leg upwards by bending the knee to 90 degrees. Then bring the foot back down to the ground. Repeat 8 to 12 reps before switching sides. 
3) Core Stability – place your stomach onto a ball and keep the spine in a neutral position. Keep the inner core muscles engaged and reach one arm up in front with the opposite leg extended back. Hold for 3 to 5 seconds before switching sides. Repeat 10 times on each side.
4) Superman Deadlifts – hold a light dumbbell to the same side as the leg that will be extended back on. With a nice tall posture, engage the core and bend forward at the hips while you extend the leg back and reach forward with the opposite arm. Repeat 10 times on each side.
5) Squat Jumps – start with a tall posture, engage the core muscles by drawing the lower ab muscles inward toward the spine. Avoid arching the low back, with arms in a ready position, do a one-legged squat with the body weight equally distributed over the foot. Lower the body downwards by bending at the knees, then jump straight back upwards by engaging your glute and thigh muscles. Repeat 10 to 15 times for 3 sets.

Steinberg, N., Siev-Ner, I., Peleg, S., Dar, G., Masharawi, Y., Zeev, A., & Hershkovitz, I. (2013). Injuries in Female Dancers Aged 8 to 16 Years. Journal of Athletic Training48(1), 118–123. http://doi.org/10.4085/1062-6050-48.1.06
InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.