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Your Question.....	Our Expert says........
2 weeks ago I fractured the growth plate on my 5th metatarsal. The orthopedic said 2 weeks is a magic number for growth plates. I have rested but it still hurts a little when I press on that bone. I am going to see him again but just wanted a 2nd opinion. I am training for Worlds and want to get back to practice but don't want to get hurt so I can't dance at Worlds. Any advice, guidance or rules of thumb?	The growth plate is an important area of your long bone responsible for normal development in terms of lengthening the bone itself during normal growth. A fracture here can prevent the bone from growing longer, but this is not always the case and you should get your orthopaedic consultant to give an opinion on this if they have not already. A few factors come to mind in terms of guidance - your age is important in terms of how much growth you have left to do - a short fifth metatarsal is not the end of the world but can mean you overload the metatarsal next to it if is significantly shorter. Generally speaking you can overcome this with a simple insole or orthotic device if your foot should be painful when loaded - eg walking / dancing - and you should seek the opinion of a Podiatrist for this. I'm sure it will settle down and you will continue your training soon. Best of luck
I practice around 2 - 3 hours a day, with 7 hours school, and half an hour cycling a day. And, I seem to sleep for 14 hours as well! The thing is a have school I don't have time to have this amount of sleep, is there anything I could do apart from cutting down of practice because I really need it to learn new steps in time for competitons and really can't afford to miss any practice! Also, you said you shouldn't stretch or cool down. However whenever I don't do this at the end my legs ache the next day and I do a correct warm up. What am I doing wrong?	I think your problem is quite a common one, you are obviously a very dedicated dancer, but you think the more practise you put in the better. Unfortunately, this is not the case, as it sounds as though you are over training, your legs aching the next day and the fact that you feel as though you sleep for 14 hours could be symptoms of this (stretching afterwards will not effect your leg symptoms, you need to interpret 'heavy legs' in a different way i.e. possibly over training). You need time to recover from the dancing as your body responds to the training in your rest periods, if you don't get a day or two off per week from exercise, your body will respond with sub - maximal performances and maybe become injured, but you may interpret these poor performances as a need to train harder - DON'T. Practise should be aimed at quality of practise not quantity, set your self realistic goals for each session for your overall aim and give yourself enough time in the lead up to the major competitons to achieve them, but be disciplined to take your rest days - you will benefit as a result. REST MORE PRACTISE LESS!
My daughter injured a muscle in her hip region a couple of weeks ago. Its only a real problem when she jumps wearing soft shoes. Can you recommend any exercises to help this ?	Who has assessed your Daughter's hip problem and diagnosed it as a muscle injury? Assuming it is a damaged muscle, then the healing time for this could be up to 4 weeks or more and continuing to dance with it may not be advisable. Since your Daughter only feels the pain in her light shoes it highlights the need to have her dancing technique assessed to see what it is about her light dancing that irritates her hip problem. It is also important that it is established how the injury developed in the first instance to optimise healing and prevent reoccurrence - seek the advice of a physiotherapist that specialises in assessing movement dysfunction
whilst dancing daughter was en pointe,she fell over and sprained her ankle....it is now much better but still gives her slight pain...how long should she stop dancing for to enable it to get better ?	Always get sprained ankles assessed by a Physiotherapist, as allowing 'Mother Nature' to heal it on its own will only complete part of the job and this will not reduce the risk of reoccurrence. Existing pain suggests that there is still healing to occurr, but I do not know how badly it was sprained in the first instance or how long ago it was sparined to be more specific on how long it will take to heal from this point going forward. Seek the advice of a Physiotherapist on what else needs to be done to ensure a complete recovery will happen.
I have been getting pains in my calf muscles, it feels as if they are really tight and need to be stretched, when I jump I get pains right up my leg. Is there anything you can suggest to get rid of the pain?	Calf tightness can be due to several factors: 1) Are you dehydrated? You need to ensure that you are drinking enough water to allow the exersing muscle to work properly and 2) A lot of calf related symptoms are due to faulty foot mechanics, which can have existed for many years without problems, but are only now coming to light and as a result the calf maybe working too hard to compensate for these mechanics and become excessively tight - BUT STRETCHES ON THEIR OWN IS NOT THE ANSWER. See a Podiatrist for a gait (i.e. walking, running, dance) analysis and they will be able to expalin exactly what is wrong, but do not accept stretching to be the answer - it is not.
My daughter is 12 and has recently been complaining of hip pain. I have taken her to an orthopedic who established that one leg is longer than the other (3mm) causing "asymmetric loading". He thinks this may be causing her pain and is having her do a lot of ab crunches and hanging from a chin up bar. I think this has helped somewhat, but she still complains and now also has pain in her knees as well. Any further advice?	The diagnosis of a leg length discrepancy maybe part of your daughters problem, but it will be a very small part. Leg length asymmetries are very common within the population, but are not necessarily symptomatic and 3mm is very small. Assuming the orthopaedic doctor has excluded all the intrinsic(internal)causes to your daughter's hip pain, I would suggest you have your daughter's lower limb alignment and the muscles that control her hip when dancing assessed to see if they are doing what they should be. This should have been done already, as part of your daughter's original assessment - if not get it done by someone who assesses musculoskeletal injuries in this way, that may not be an orthopaedic doctor. Irish dancing causes massive impact to the joints of the lower limb and poor muscular control will not allow appropriate shock attenuation (absorption) and this could cause an overload in the hip area causing her pain. Either way 'Ab crunches and hanging from a chin up bar' will not help in the longterm and could be contributing to her knee pain in the process - SEEK ANOTHER OPINION FROM A PHYSIOTHERAPIST THAT TREATS DANCERS!
I have severe tendonitis in both my knees and a lot of excess water and inflation...I used to go a physical therapist but they only made things worse..is there anything you can suggest that might help me?	To be able to comment in detail I would need to know just what treatment you have had to date and how many opinions you have sought. However, it is important to remember that not all Physiotherapists / Orthopaedic practitioners practise in the same way and if you feel the intervention of one therapist made your problem worse you must seek a second opinion - please do not 'tar us all with the same brush'. The treatment you require will need to address why the tendons have become inflammed and not just the pathology in the tendons themselves. To do this you will need to see a Physiotherapist AND Podiatrist to have your lower limb alignment / biomechanics assessed and they will need to see you dance too - if this is not going to form part of their assessment and their treatment seems to involve only 'Ultrasound to the tendons and stretches or strengthening' then you need to seek further opinions until you find a team of clinicians who can address all the issues of improving your lower limb positioning and control, but the proper treatment will help.
how do I treat shin-splints which are really sore when I dance	'Shin splints' is a very common complaint with Irish dancers, but you have to understand that the term is a generic description for a number of possible problems that could cause pain in your shin area, it is not a diagnosis in itself. Due to the various possible causes of your shin pain it is impossible for me to tell you exactly how you should treat it, but there are several common issues that relate to all of these possible causes that I can mention.What ever the tissue in the shin area that is painful is, the resultant pain will have been caused by an excessive over load in those tissues due to repeated impact and poor shock absorption; the main culprit will lie in your feet and foot mechanics when you dance. It will also probably be due to the overactivity in the muscles that move your toes, these muscles should be relatively inactive when you dance and it is the muscles of the ankle that should be working hard, but in alot of dancers the toe muscles (which are actually located in the shin, as well as some smaller ones in the foot itself) become too dominant and overactive. This overactivity usually results due to the foot mechanics not being controlled enough, these muscles working too hard then become painful and are one cause of shin pain.However, it is important you seek the opinion of a Physiotherapist and Podiatrist to establish the exact cause of your 'shin splints' and they should be able to expalin more precisaely what I have already mentioned, but I would suspect you will benefit from some form of orthotic prescription for your shoes and heavy shoes when you dance, as well as a dance analysis of how your feet and legs are controlled when you dance. Correction of poor biomechanics (via specific exercises - NOT stretch and strengthening though) in the leg and feet will optimise your alignment and clear you of your pain. In the short term, you should not be dancing whilst you do not know what is causing your shin pain. Seek appropriate help!
I get really bad pains in my shins, knees and where the top of my leg joins my hip when I am dancing have you any advice on how I can get my joints more flexible as the pain is holding me back from dancing my best.	You need to think of your legs in two ways when you dance i.e. they should produce the shock absorption of a spring and the strength and power of a piston. Neither springs or pistons need to be more flexible to work properly; when an Irish dancer has multiple sites of pain such as yourself when dancing stretching more or becoming more flexible will definitely NOT help. You need to address not just the painful areas of pain, but WHY all of these areas are painful. Your lower limb biomechanics defintely need to be assessed and corrected with an appropriate exercise programme; you will need to see a physiotherapist and podiatrist (that are used to treating dancers) to ensure 'all bases are covered', but if someone tells you it is 'growing pains' or gives you just 'stretches and strengthening exercises' - seek another opinion, they also need to see you dance. Your pain could be due to the incorrect way your muscles control the way your legs move and attenuate shock and there is probably a foot component to this too. Not all muscles are just used to produce movement, they are also needed to produce positioning around a joint and if that does not happening correctly an activity like Irish dancing could give you pain in a number of areas.Furthermore, it is very important to remember that dancing with pain is not advisable, especially when the pain is so widespread - seek the right opinion, Irish dancing should not be a painful experience!
About 3-4 months ago, I hurt my toe falling over on it, we waited a few weeks and there was still a bump on it, so we went to the doctor, he said that it would take months to get better and that if it hurt i would need to stop dancing. It has now been 2 months since we went to the doctors and it is still sometimes sore. Is there anything i can do to help it get better quicker, the doctor said it was a callous	Often with dancers a small injury can lead to a swelling on the toe joint that becomes a problem if shoes rub on it as in your case.Your doctor diagnosed a callus - I suspect you may also have developed a bursitis - this is nothing but a bag of fluid that forms to protect the joint.I would reccomend a toe protector - check out www.silipos.com under orthopaedic foot products. They have a digital protector that is sold in strips and would make a valuable addition to any dancers kit bag!!
I have continuous pain in my knee joints and have extremly tight hamstrings which makes it very hard to extend my elevation is there anyway I can get rid of the pain?? I've been to a physio but they just told me to leave dancing. I don't want to leave as I have danced for 16 years!	Knee pain can be caused by many different reasons, but in Irish dance it will undoubtedly involve the repeated impact placed through the knees when you dance and the way you deal with the impact. Your legs will be very strong due to the time you have spent dancing, so weakness will not be an issue, but your biomechanics / leg alignment may not be good enough to absorb the shock applied to your legs when you dance and over time this has caused pain in certain areas of your knees. Biomechanical issues can be treated very effectively (by someone who knows what they are doing) with an appropriate exercise programme and podiatry assessment (your feet will also need assessing), but the correct approach will also involve assessing the way you dance and if this has not been looked at by your previous physio, make sure your second opinion involves this. Extremely tight hamstrings are also something that can be treated effectively, but just 'stretching them' is not the answer. The reason for why they have become tight needs to be established and treated, but this can be assessed when your knee pain is being looked at and should form part of your dance analysis. You need to get a second opinion from a specialist physiotherapist / podiatrist who deal with dance related injuries - it may mean you have to travel some distance to see them, but I would be very surprised if giving up dancing is the only answer. However, I would suggest you rest from dancing until the cause of your problem has been established, as 'constant' pain should not be ignored.
Do you need a balanced diet towards dancing? What foods do you eat if you do?	A balanced diet is essential for a good healthy lifestyle, made even more so when an individual takes part in exercise and trains regularly as Irish dancers do. A good diet ensures there are the correct components in the body for the body to function on i.e. In brief - Protein is needed to build muscle (e.g. found in lean meats), Carbohydrate is needed as the 'fuel' to exercise with (e.g. found in potatoes, bread, pasta) and fat (yes fat - the unsaturated kind) is needed for a secondary source of 'fuel' when the carbohydrates run out and they also ensure certain vitamins are also present in the body (e.g. found in oily fish like tuna, mackerel or trout). It is also important that a balanced diet includes drinking enough water too (see some of the previous 'ask the expert' questions on this. Detailed information on dietary needs are beyond the scope of this Q&A, but any good library will have plenty of helpful books on the subject or you could seek the advice of a dietician / nutritionalist who could tailor a diet for your individual needs.
My right foot is now in a soft cast due to an injury I sustained doing simple 3's toward the end of my softshoe class. My podiatrist told me that I have an acute tear in the ligament that extends from the ball of the foot to the heel (on which I have a spur). He told me that to relieve foot pain, oftentimes he surgically loosens this ligament, but apparently my stepping on it wrong accomplished the same thing, albeit much more painfully. He said I could dance again in about 3-4 weeks, depending on how my foot heals and after I've had some physical therapy. Two years ago, I broke my right ankle, so this is a weakened area to begin with. Is there anything that you would recommend that I do to strengthen my ankle and foot to prepare it for dancing once it's healed, and would you recommend wearing any kind of support cushioning or wraps with my shoes, at least for awhile?	Thanks for your question. It sounds as if you have ruptured the plantar fascia - this is an important structure in the foot for normal gait and so should be treated with respect in terms of the time to go back to dancing.The plantar fascia takes a great deal of load in normal gait and more so with dance training - it would be useful to ask your physical therapist to off load it with temporary appliances and / or taping initially. Be patient with this injury in respect to rehabilitation to avoid long term complications.The ankle should be assessed for range of movement - I would expect you to be able to bend your knees equally over both feet if there is no restriction.Ask your PT for further advice if this is not the case - a restricted ankle will undoubtedly load up the fascia more than an unrestricted ankle.
What muscles are used when doing a flutter in Irish Dancing?	A 'flutter or butterfly' requires considerable plyometric ability in the lower legs (as in all jumps) to achieve the elevation needed to get off the floor. Once in the air the technique is performed using the muscles of the shin (or Dorsiflexors) and those of the calf (or plantarflexors)co-ordinated in such away as to achieve the 'flutter' you are referring to, but it also requires good control around the pelvis to maintain the leg position whilst the ankle is moved at speed during the 'flutter'
I have been an Irish Dancer for over nine year's and over the past year I have had extreme pain in the arches of my feet. It feels as though the arches in my feet are levelling out with the rest of my foot and the pain is unbearable. my question is, will a foot support help my falling arches? If not then what will?	It sounds like you have a mobile type of foot that may be progressively collapsing due to the nature of your activity and the amount of training you are doing. Foot supports or orthotic devices are very useful in the controlling of this type of foot and you should seek the opinion of an experienced musculoskeletal Podiatrist who can correctly dispense them for you.
Last night I was warming up pitching at a softball game and all the sudden sonething in my leg was hurting it was like the muscle was being torn apart. At first I thought it was just a charlie horse (?) until my foot started to swell up around the toes and on the side of my foot, and today it was getting numb and tingiling. My coach thinks its my Achilles tendon but I have no idea because I can walk on it and it only kinda hurts when I get on my tippy toes and press down. Do you have any idea what it is?	It sounds like a torn calf muscle and the feeling of 'being torn apart' was probably what was happening to the fibres that make up the muscle. The fact that you are able to walk on it and even calf raise suggests it is not too severe, but it will need some treatment and a confirmation of the diagnosis, do not continue to play sport on it until a physiotherapist tells you it is OK to do so. It is also important you establish why your calf has torn (if that is what it proves to be), don't accept "they are tight you just need to stretch them" as an answer, seek a proper explanation.
I am 20 years old and have taken all kinds of different forms of dance over the years, but just recently started Irish Dance. I love it, but I got shin splints!! I never got them from any other dance and they are very painful to do soft and hard shoe dances with. What do I need to do to make them feel better so I can continue dancing?	There are several causes of 'shin splints', the term itself is a generic one to encompass all the possibilities. However, there is a common theme with shin pain and it revolves around the legs inability to attenuate shock properly. The fact that you have danced for many years does not mean you have the biomechanics required to Irish dance efficiently - this art form involves far more impact than other forms of dance and in doing Irish dance you have revealed a probable issue with your lower leg alignment and / or poor foot mechanics. Either way you need to get yourself assessed by a Physiotherapist and Podiatrist who both work with dancers and are use to analysing that type of movement and are capable of pooling their combined knowledge to set you a corrective rehab programme, but I suspect both your feet and lower leg control will need addressing. The symptoms will not just go away though, so see someone ASAP.
My 11 year old daughter who is an open level dancer injured her heel 8 weeks ago whilst practising and was told at the hospital she has torn some fibres in her Achilles tendon. Since the immediate pain stopped she has been receiving physio from a sports injury specialist and has been doing specific stretches daily. When will it be safe for her to return to her dancing at open level without risking recurrence of the injury? She has just returned to class and has been doing a small amount of dancing, just hop1,2,3's but no jumps yet. Should she just try doing her reel etc and see how she gets on?	Since your Daughter is having Physio for her injury and I do not know the specifics of her problem I think it is best you ask your questions to her treating physio, these are just the questions that they should be answering as part of her rehabilitation, you should never have to just 'try doing her Reel and see how she gets on'. The physio should have laid down specific goals your daughter must achieve before a return to dancing is contemplated.
I have been dancing for 11 years and really enjoy it but when I am doing my reel i get a pain up the back of my heel. This started as being sore only after my reel but recently it is after every dance. I am worried in case the only option is to quit dancing but I couldn't do that	Your heel pain could point to several causes, the most obvious would be an issue with your Achilles tendon, but it will need assessing properly by a physiotherapist to establish the exact diagnosis. It is important you get the assessment, as the reason as to why your heel has become painful also needs determining, rather than just establishing what tissue is painful (so see someone who deals with dance related injuries if possible). It sounds as though your problem is worsening, so I suggest you see somebody ASAP to stop the deterioration before you need a lot of treatment to cure this.
My daughter is really suffering with heel pain. The pain tends to come on after two or three dances. She does have fallen arches which I suppose isn't helping. The pain is not under the heel but at the back of the foot.Do you have any suggestions ? Thank you for your time	I think that the pain is due to a biomechanical problem and this is related to the dancing as you rightly point out, but is often irritated with general sports and even just walking.Fallen arches can cause a temporary overload of the achilles tendon and it can get sore at the back of the heel as you describe. Achilles problems will normally settle with the appropriate shoe inserts and physiotherapy.It is unlikely to go away unless the underlying cause is removed or you rest completely - which is probably out of the question.I would urge you to have a gait analysis with video performed with a foot examination - try to get the Podiatrist to ask your daughter to video Irish dance specific routines - and this should give you a solution to the problem. We can do this for you - £55 for gait analysis.
What is the best way to treat the all-too-common dancer's ailment- shin splints? I have heard ice, heat, stretch...what is your advice? Thank you!	The advice you have been given relates to treating the symptoms only once you have got the pain of 'shin splints' However, if you read some of my other responses to questions on shin splints that are posted on the Irish-dancer site, you will see that I am constantly recommending that the reason why you get shin splints must be established and treated accordingly. Irish dancers that get shin pain should have their biomechanics, lower limb and foot alignment assessed, as shin pain in part is as a result of poor shock attenuation. You need to see a physiotherapist and Podiatrist so you can get the exercise rehab programme you need and you may also need orthotics for your shoes too. Do not just treat symptoms always ask yourself why are you getting the pain and why does it reoccur?
Is is possible to completely tear(severe)your achilles tendon and not have to get surgery? Can you simply wear a cast and have the tendon regenerate?	Completely ruptured Achilles tendons would best be treated with surgery, especially if you wish to return to impact exercise e.g. running or dancing. Older patients might be managed conservatively when all aspects of surgery are considered and what the extent of the disability is post rupture. Afterall older patients may not fair as well with the trauma of under going surgery and the subsequent rehabilitation needed. Furthermore, without a surgical repair the tendon is unlikely to spontaneously reconnect and will not repair sufficient enough for the forces placed through the Achilles tendon to be dealt with properly, so if you are active and want to continue with impact sports, then consider the surgery, but I would need to know more about your specific issues before I could say for sure.Please call me if you wish to discuss the issue further.
I have a Sprained ankle is there anything I can do to get back to sports in a few day ?	In short, No. Your ankle sprain will need to be assessed to establish the extent of the sprain and what should be done to optimise its recovery. Ankle sprains are extremely common, but rarely treated thoroughly, if at all. Sufferers are often correct in their own diagnosis, but let 'Mother Nature' take care of the repair, this on its own will never complete the repair process properly - see a Physiotherapist ASAP. Returning to sport just because the pain has gone is also very common, but the damaged tissue will never be completely recovered within a week or two, minimum time scales will be four weeks or so at least and you should also seek whether there is anything that can be done to prevent further sprains in the future too.
I am training full time at dance colllege and have suffered with a bad left knee which enables me to kneel at times. I have been treated by various physios who have told me to strengthen my thigh muscle to support my knee. I have recently had problems with my left shin which has now left a pain in my ankle. I have been to a physio who have said my back is fine but i'm not sure what is triggering these injuries down my left side. Is there anything I can do to help myself? Please answer at your earliest convenience. Thank you	As a full time dance student there is no way your legs are going to be weak and therefore your knee pain can not be due to this either. The solution is NOT to strengthen your legs further, but to understand the cause as to why your knee and now your shin have become symptomatic As you will see by my responses to other questions asked through this website, without exception, all dance related injuries will have a biomechanical component i.e. your legs need to attenuate shock properly when you move and that relies upon your lower limb alignment to be good enough to deal with that shock.Your hips, knees and feet all need to function correctly and line up over one another if optimal shock attenuation is to occur. However, most dancer’s alignment is not good enough for the repeated shock attenuation needed with dancing and therefore injuries develop. The fact that you have a left knee and now left shin pain could simply be that your left leg alignment and control is not as good as on the right, but both areas are easily corrected with the right treatment approach. Poor biomechanics are treated with exercise, but those exercises are not to ‘strengthen’ anything; they are designed to ensure all the correct muscles needed in dancing are working properly and relate to improving the overall control and alignment of your legs in general.You will need your feet assessed by a podiatrist too. I wouldn’t give up on Physiotherapy, but I would seek another opinion, but see a Physio that works with a Podiatrist so you can get an integrated rehab programme; one where your dancing is assessed and where your whole leg including your feet are addressed. Remember, if the therapist you are seeing talks in terms of weakness, then they don’t know what they are talking about and seek another opinion from someone who actually understands what it takes to correct faulty biomechanics and movement patterns. Call me if you want further advice. 020 7702 1112 (in UK). Good luck!
is it possible that my 8 year old has pains in her knees and a clicking sensation from her irish dancing, if so what can we do?	It is very possible that your daughter's knee pain and clicking has been brought on by her Irish dancing. However, it must be pointed out that it will not be the act of dancing that has caused her symptoms, but more the way she dances and whether her leg alignment and biomechanics is able to deal with the shock attenuation needed. I would strongly suggest you get your Daughter assessed by a Physiotherapist and Podiatrist, both who work together and deal with dance related injuries to give you more information and an accurate diagnosis. Make sure you are happy with the explanation and a plan of action is in place as to what is needed and over what time frame the recovery will take place. If the Physio tries to tell you that your Daughter's symptoms are due to lack of strength and she needs to strengthen and stretch her legs - SEEK ANOTHER OPINION. Correction of dance related injuries is NEVER that simple.
Sometimes I get pains in my knees after I have danced and I also Scoliosis on the top of my spine by 15 deg and my Achilles tendons are also short and my ankles fall in and Iwant to know if that was causing the pain in my knees if not what	It sounds to me that you have several issues with your Achilles tendons and feet that could indeed be contributing to your knee pain post dancing. Your scoliosis has probably less to do with your knee pain, but I would suggest you see a physiotherapist and Podiatrist use to treating dance related injuries and they will be able to confirm your thoughts and direct the best way you can correct the problems causing your symptoms
my daughter has recently complained of numbness in the top of her legs (front)when she is practising her heavies. no pain and only when dancing fine when walking immediately afterwards.should I go to a physio first or my gp.	Since your Daughter's problem seem specific to dancing only at this stage, I think it is a reasonably safe assumption that her problem is a musculoskeletal one and therefore I would go straight to the Physiotherapist rather than the GP.
I am 11yrs old open dancer for the past few days I have sxperienced severe pain in my left side of leg please can you help I want to compete in nationals end July	I'm not really in a position to offer you any specific advice as I would need to assess your leg in person and you have not given me much advice to go on. However, due to the severity of the pain you say you are experiencing and your desire to dance at the Nationals, you should see a physiotherapist ASAP to have a definitive diagnosis made. Once done, you will know what to do about the injury and whether you should have some treatment and whether you should be dancing on the leg at present.