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Common Foot Injuries in Pointe Work

Starting as a ballet dancer, Marisa discovered flamenco in her 40s. Now retired, she enjoys sharing her knowledge of all things dance.

Our feet work very hard in ballet—possibly harder than any other dance style. Dancing on the tips of our toes is not natural! Foor injuries are inevitable—though most, thankfully, are minor. This article looks at some of them, including:

  • Blisters
  • Corns
  • Bruised Toenails
  • Sesamoid Fractures
ballet-injuries

Blisters

Blisters are caused by friction—your foot is moving inside the shoe and rubbing up and down against a seam or wrinkle.

Prevention

If you are getting blisters, they will tend to be in the same place every time—work out what your skin is rubbing against, and you can work out a way to prevent it from happening again. Get into a routine of putting toe tape or moleskin over those areas before class.

It's always better to wear your ouch pouches (or other toe pads) under your tights, not over (convertible tights makes that easier to do).

Treatment

There is no treatment other than patience—cover the blister and wait for it to get better. Never pop a blister, as it may become infected.

Dancing with blisters (especially on pointe) is horrible! I find moleskin and band-aids are less than useless to stop the pain. Although they're more expensive, the only thing I've found that helps are Compeed's Blister Care Cushions. They are thin enough that they won't interfere with your usual padding, and it's surprising how well they cushion the blister. Tip: if you can wipe the area with alcohol before putting one on, it will stay in place for days.

Warning: The video below recommends soaking your feet in methylated spirit. I don't recommend that because it's extremely drying on your skin. You don't want leathery old feet! Instead, buy surgical spirit and dab it generously on your toes only, two or three times a week.

Corns

Corns can be "hard" or "soft". A hard corn is what it sounds like—a little hard nub, like a corn kernel, often on the outside of the little toe. It's a kind of callus and is nature's way of protecting your delicate skin from constant friction. Unfortunately, the hard center of the corn can be painful to dance on, so it's worth taking steps to prevent them from developing. If you feel a corn starting, see if you can stop your foot rubbing against the shoe (by adding tape, changing your padding, or perhaps by trying a different shoe).

A soft corn, on the other hand, lives between toes, where it feeds off moisture. It looks grayish-white. They're most often caused by pressure due to a shoe that is too narrow in the box.

Treatment

Corns can be surgically removed, but it's always better for dancers to avoid any kind of surgery on their feet, even if it's minor! For that reason, it's best to act early to prevent corns from getting worse.

For soft corns, a visit to a pointe shoe fitter should be your first step, as your current shoe may be too narrow. Always make sure you dry well between your toes after a shower and after class, and wear spacers between the affected toes while dancing.

For hard corns, you can buy special corn plasters which contain salicylic acid. The acid gently softens the corn. Most plasters have a cushioning effect, too, which makes the corn less painful.

Bruised Toenails

A bruised toenail will likely look black and blue.

It may help to understand why your nail is blue and black—it's actually clotted blood under the nail. If you can disperse the blood, it will reduce the pressure and pain. The most effective way to do that is arnica: You'll find arnica creams in most health food stores, but if you can track down some arnica tincture (a watery liquid), it's even better. Saturate a piece of cotton wool or dressing with the arnica and bandage it to your toe. Change the dressing at least once a day.

Ice Packs

Ice the toe for 10 minutes, 3 times a day.

A Cautionary Tale

Bruised toenails are painful, but they are usually minor, and the worst will be over in a couple of weeks (though if your toenail falls off, as it can do, it will take a while to grow back). If the nail continues to be black and blue and painful, don't be like Catherine and persist through it:

Bruised Toenails

How do you heal bruised toenails? My big toenail is all blue and black; it has been this way for a month and has not gotten any better. I have a show in three weeks, and the many hops on pointe cause extreme pain. Desperate for anything I can do to help it!

— Catherine P

Ouch, Catherine, I'm so sorry this has happened to you, especially so close to a performance! I can't offer a magic solution.

The pain from a bruised nail should be manageable with a couple of aspirins and a gel toe sleeve. As yours is hurting more than that and has been for some time, it may be infected. That could be serious, so see your doctor ASAP, please.

I hate to tell you this, but it is likely that your toenail will fall off. It's best to keep it bandaged or taped all the time, just in case.

If you have a good pointe shoe fitter locally, it would be worth paying them a visit and asking for their advice. Maybe to get you through your upcoming performance, you could wear a shoe a half size larger on that foot, with some extra padding. You can also apply an anaesthetic cream like Anbesol.

How to Prevent Bruised Toenails

Have your shoes properly fitted. Have your shoes properly fitted. Have your shoes properly fitted.

I know, I know, sometimes that's easier said than done. Maybe the fitter at your local ballet store isn't properly qualified, or maybe your local store doesn't even have a pointe shoe fitter. Maybe you live miles from the nearest shop. If that's the case, then at least try to educate yourself on how a pointe shoe should fit, what your foot shape is, etc. This article explains what you need to know.

People often say to me, "Oh, but I've been wearing this brand and size of shoes for years, and it's never been a problem before." That's probably why you're having a problem! Feet don't stop growing once you're an adult; they continue to change shape. So it is important to check the fit of your shoes once every year or so, even if you're over 20.

Sesamoid Fracture

Before you panic—no, sesamoid fractures are not an everyday occurrence in pointe work! However, it happens often enough that it deserves a mention.

If you know you have a sesamoid fracture, then you have already seen a doctor and been diagnosed. It goes without saying that you should follow medical advice, but this question may be helpful to you:

My daughter is almost 14 and has been dancing since she was two. Unfortunately, she fractured her sesamoid bone in the ball of her foot and had to have it removed eight months ago.

She has been out of dance for a year and a half and has lost a lot of leg and foot strength. She recently went back to dance but only takes ballet, tap and jazz. She is still having some pain by the end of class; her doctor can't explain why seeing that the fractured bone is gone. Why is this happening?

— Concerned Mom

I'm so sorry to hear this happened to your daughter.

Sesamoid injuries are all too common in dancers because the sesamoid bones take a lot of pressure in dancing. However, most doctors go to great lengths to avoid surgery—I've known dancers persevere for up to 18 months rather than go under the knife, and for a good reason.

Even though the sesamoid bones are tiny, they are weight-bearing and serve an important purpose in dance. Losing one affects the ability to get up on demi-pointe—which wouldn't be a problem for an ordinary person but is a real problem for a dancer.

Because your daughter has lost an important weight-bearing bone, she'll need to learn how to compensate for that—and she won't be able to work that out for herself. So I think it's vital for you to consult a physiotherapist—and not just an ordinary one, but one who's qualified in treating ballet dancers.

It's also important to identify how she got the injury in the first place—it's often caused by incorrect technique such as sickling or forced turnout. Fix the underlying faulty technique, and she may find things easier and avoid further problems.

References

Dr Blake on Sesamoid Fracture

Dance.net Q & A

Our Health Network

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2020 Marisa Wright

Comments

Marisa Wright (author) from Melbourne, Australia on May 23, 2020:

Ballet takes a lot of patience and determination even if you do have the right body type!

Farrah Young from Lagos, Nigeria on May 23, 2020:

Ballet dancers look beautiful when they dance. I never knew they went through this much pain! Guess I'll appreciate them a lot more henceforth.

I tried ballet several years as I love the gracefullness and skill with which they move, but I had to give up after a few tries when it became evident ballet wasn't in my genes.