Achilles Tendon Pain in Ballet Dancers

DanceMom · Aug 1, 2007

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Hi:

I'm looking for advice for a ballet dancer (en pointe) with achilles tendon pain. Are there specific exercises to help alleviate this pain? Thanks.

drsarbes · Aug 1, 2007

I'll assume she has an isolated achilles tendinitis......if so, there are numerous stretching exercises she can perform; (see link for examples)
http://tms.ecol.net/Fitness/calfstr.htm
You may also want to be sure her training and conditioning are being done correctly and not increasing her chance of overuse syndromes.
In addition, there are other conditions that may cause pain in the area, such as Haglunds deformities, retrocalcaneal exostoses, bursitis, apophysitis, etc.....
If stretching, ice and correct dance/training techniques do not help then I would have her visit a foot/ankle specialist.
Good Luck
DrSArbes

Admin2 · Aug 1, 2007

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Jbwheele · Jan 16, 2008

Hi Dance mom, Have you had any success? Whats been done? .

Cheers

Joe

NewsBot · Aug 1, 2011

Dancers With Achilles Tendinopathy Demonstrate Altered Lower Extremity Takeoff Kinematics
Kornelia Kulig, Janice K. Loudon, John M. Popovich, Christine D. Pollard, Brooke R. Winder
J Orthop Sports Phys Ther 2011;41(8):606-613

STUDY DESIGN: Controlled laboratory study using a cross-sectional design.

OBJECTIVES: To analyze lower extremity kinematics during takeoff of a “saut de chat” (leap) in dancers with and without a history of Achilles tendinopathy (AT). We hypothesized that dancers with AT would demonstrate different kinematic strategies compared to dancers without pathology, and that these differences would be prominent in the transverse and frontal planes.

BACKGROUND: AT is a common injury experienced by dancers. Dance leaps such as the saut de chat place a large demand on the Achilles tendon.

METHODS: Sixteen female dancers with and without a history of AT (mean ± SD age, 18.8 ± 1.2 years) participated. Three-dimensional kinematics at the hip, knee, and ankle were quantified for the takeoff of the saut de chat, using a motion analysis system. A force platform was used to determine braking and push-off phases of takeoff. Peak sagittal, frontal, and transverse plane joint positions during the braking and push-off phases of the takeoff were examined statistically. Independent samples t tests were used to evaluate group differences (α = .05).

RESULTS: The dancers in the tendinopathy group demonstrated significantly higher peak hip adduction during the braking phase of takeoff (mean ± SD, 13.5° ± 6.1° versus 7.7° ± 4.2°; P = .046). During the push-off phase, dancers with AT demonstrated significantly more internal rotation at the knee (13.2° ± 5.2° versus 6.9° ± 4.9°; P = .024).

CONCLUSION: Dancers with AT demonstrate increased peak transverse and frontal plane kinematics when performing the takeoff of a saut de chat. These larger displacements may be either causative or compensatory factors in the development of AT.
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NewsBot · Oct 12, 2012

The prevalence and clinical significance of sonographic tendon abnormalities in asymptomatic ballet dancers: a 24-month longitudinal study
Jules Comin, Jill L Cook, Peter Malliaras, Moira McCormack, Michelle Calleja, Andrew Clarke4, David Connell
Br J Sports Med doi:10.1136/bjsports-2012-091303

Introduction Sonographic abnormalities of the achilles and patellar tendons are common findings in athletes, and tendinopathy is a common cause of pain and disability in athletes. However, it is unclear whether the sonographic changes are pathological or adaptive, or if they predict future injury.

We undertook a cohort study to determine what sonographic features of the achilles and patellar tendons are consistent with changes as a result of ballet training, and which may be predictive of future development of disabling tendon symptoms.

Methods The achilles and patellar tendons of 79 (35 male, 44 female) professional ballet dancers (members of the English Royal Ballet) were examined with ultrasound, measuring proximal and distal tendon diameters and assessing for the presence of hypoechoic change, intratendon defects, calcification and neovascularity. All subjects were followed for 24 months for the development of patellar tendon or achilles-related pain or injury severe enough to require time off from dancing.

Results Sonographic abnormalities were common among dancers, both male and female, and in both achilles and patellar tendons. Disabling tendon-related symptoms developed in 10 dancers and 14 tendons: 7 achilles (3 right, 4 left) and 7 patellar (2 right, 5 left). The presence of moderate or severe hypoechoic defects was weakly predictive for the development of future disabling tendon symptoms (p=0.0381); there was no correlation between any of the other sonographic abnormalities and the development of symptoms.

There was no relationship between achilles or patellar tendons’ diameter, either proximal or distal, with an increased likelihood of developing tendon-related disability.

Conclusion The presence of sonographic abnormalities is common in ballet dancers, but only the presence of focal hypoechoic changes predicts the development of future tendon-related disability. This suggests that screening of asymptomatic individuals may be of use in identifying those who are at higher risk of developing tendon-related disability, which may in turn allow targeted modifications of training or other preventative regimens.
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