Dancer's Tendonitis: Difference between revisions

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The ankle is a crucial joint to acknowledge in the context of dance injuries because it is the connection between the leg and the foot that establishes lower limb stability. It is one of the most commonly injured body areas in dance.<ref name=":0">Rinonapoli G, Graziani M, Ceccarini P, Razzano C, Manfreda F, Caraffa A. [https://ljkzedo.ba/mgpdf/mg33/45_Rinonapoli_1201_A.pdf.pagespeed.ce.p999-Lh0ZX.pdf Epidemiology of injuries connected with dance: a critical review on epidemiology]. Med Glas (Zenica). 2020 Aug 1;17(2):256-64.</ref> Incidences of injury to the ankle-foot complex scale from 27% to 49% of total injuries in ballet, modern, flamenco, and tap dancers.<ref>Kadel NJ. [http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.613.9795&rep=rep1&type=pdf Foot and ankle injuries in dance]. Physical Medicine and Rehabilitation Clinics. 2006 Nov 1;17(4):813-26.</ref><ref>Vera AM, Barrera BD, Peterson LE, Yetter TR, Dong D, Delgado DA, McCulloch PC, Varner KE, Harris JD. [https://journals.sagepub.com/doi/full/10.1177/2325967120937643 An injury prevention program for professional ballet: A randomized controlled investigation.] Orthopaedic journal of sports medicine. 2020 Jul 28;8(7):2325967120937643.</ref> Dancer’s tendonitis is also referred to as Flexor Hallucis Longus tendonitis which is an overuse injury in which repetitive plantarflexion and dorsiflexion (pointing and flexing) of the foot results in inflammation of the FHL tendon.<ref>Rowley KM, Jarvis DN, Kurihara T, Chang YJ, Fietzer AL, Kulig K. [https://www.sciandmed.com/mppa/journalviewer.aspx?issue=1210&article=2110&action=1 Toe flexor strength, flexibility and function and flexor hallucis longus tendon morphology in dancers and non-dancers]. Medical problems of performing artists. 2015 Sep 1;30(3):152-6.</ref>  
The ankle is a crucial joint to acknowledge in the context of dance injuries because it is the connection between the leg and the foot that establishes lower limb stability. It is one of the most commonly injured body areas in dance.<ref name=":0">Rinonapoli G, Graziani M, Ceccarini P, Razzano C, Manfreda F, Caraffa A. [https://ljkzedo.ba/mgpdf/mg33/45_Rinonapoli_1201_A.pdf.pagespeed.ce.p999-Lh0ZX.pdf Epidemiology of injuries connected with dance: a critical review on epidemiology]. Med Glas (Zenica). 2020 Aug 1;17(2):256-64.</ref> Incidences of injury to the ankle-foot complex scale from 27% to 49% of total injuries in ballet, modern, flamenco, and tap dancers.<ref>Kadel NJ. [http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.613.9795&rep=rep1&type=pdf Foot and ankle injuries in dance]. Physical Medicine and Rehabilitation Clinics. 2006 Nov 1;17(4):813-26.</ref><ref>Vera AM, Barrera BD, Peterson LE, Yetter TR, Dong D, Delgado DA, McCulloch PC, Varner KE, Harris JD. [https://journals.sagepub.com/doi/full/10.1177/2325967120937643 An injury prevention program for professional ballet: A randomized controlled investigation.] Orthopaedic journal of sports medicine. 2020 Jul 28;8(7):2325967120937643.</ref> Dancer’s tendonitis is also referred to as Flexor Hallucis Longus tendonitis which is an overuse injury in which repetitive plantarflexion and dorsiflexion (pointing and flexing) of the foot results in inflammation of the FHL tendon.<ref>Rowley KM, Jarvis DN, Kurihara T, Chang YJ, Fietzer AL, Kulig K. [https://www.sciandmed.com/mppa/journalviewer.aspx?issue=1210&article=2110&action=1 Toe flexor strength, flexibility and function and flexor hallucis longus tendon morphology in dancers and non-dancers]. Medical problems of performing artists. 2015 Sep 1;30(3):152-6.</ref>  


In dancers, injury to the FHL is usually provoked by the recurrent movement caused by changing position from a plié position to a relevé position. (Plié is a French term meaning to bend, relevé, is a ballet term meaning “raised.” The term relevé explains the action when a dancer rises up on their toes).<ref>Mira NO, Marulanda AF, Pena AC, Torres DC, Orrego JC. [https://www.ingentaconnect.com/content/jmrp/jdms/2019/00000023/00000004/art00003 Study of Ballet Dancers During Cou-De-Pied Derrière with Demi-Plié to Piqué Arabesque]. Journal of Dance Medicine & Science. 2019 Dec 15;23(4):150-8.</ref> This movement of action produces a force that is ten times the dancer's body weight. Bio-mechanically, a restricted plantarflexion movement may lead to a prolonged pronated foot position when pushing off during the Propulsion Phase which can lead to FHL tendonitis.  
In dancers, injury to the FHL is usually provoked by the recurrent movement caused by changing position from a plié position to a relevé position. (Plié is a French term meaning to bend, relevé, is a ballet term meaning “raised.” The term relevé explains the action when a dancer rises up on their toes).<ref>Mira NO, Marulanda AF, Pena AC, Torres DC, Orrego JC. [https://www.ingentaconnect.com/content/jmrp/jdms/2019/00000023/00000004/art00003 Study of Ballet Dancers During Cou-De-Pied Derrière with Demi-Plié to Piqué Arabesque]. Journal of Dance Medicine & Science. 2019 Dec 15;23(4):150-8.</ref> This movement of action produces a force that is ten times the dancer's body weight. Bio-mechanically, a restricted plantarflexion movement may lead to a prolonged pronated foot position when pushing off during the Propulsion Phase which can lead to FHL tendonitis.<ref>Michelson J, Dunn L. [https://www.researchgate.net/publication/7908275_Tenosynovitis_of_the_Flexor_Hallucis_Longus_A_Clinical_Study_of_the_Spectrum_of_Presentation_and_Treatment Tenosynovitis of the flexor hallucis longus: a clinical study of the spectrum of presentation and treatment]. Foot & ankle international. 2005 Apr;26(4):291-303.</ref>


The Flexor Hallucis Longus (FHL) has been also called as the ‘Achilles of the foot’ due to its unique role controlling midfoot pronation and supination, and its physiological and mechanical properties, which permit it to act as a powerful convertor of force from the rear foot all the way through to the big toe. Due to its anatomical arrangement and its unique actions, it is a muscle-tendon unit that can often become injured in athletic populations. This is often called the ‘dancers tendonitis’ because it is so prevalent in classic ballet dancers.<ref>Hodgkins CW, Kennedy JG, O'Loughlin PF. [https://www.sciencedirect.com/science/article/abs/pii/S0278591907001093 Tendon injuries in dance]. Clinics in sports medicine. 2008 Apr 1;27(2):279-88.</ref> However, it's going to affect any sport which requires repetitive push-off and extreme plantarflexion such as swimmers, sprinters, footballers, and gymnasts. Moreover, it can also suffer damage following injury to the ankle and/ or syndesmosis caused due to its close proximity to the talus and the ankle joint.  
The Flexor Hallucis Longus (FHL) has been also called as the ‘Achilles of the foot’ due to its unique role controlling midfoot pronation and supination, and its physiological and mechanical properties, which permit it to act as a powerful convertor of force from the rear foot all the way through to the big toe. Due to its anatomical arrangement and its unique actions, it is a muscle-tendon unit that can often become injured in athletic populations. This is often called the ‘dancers tendonitis’ because it is so prevalent in classic ballet dancers.<ref>Hodgkins CW, Kennedy JG, O'Loughlin PF. [https://www.sciencedirect.com/science/article/abs/pii/S0278591907001093 Tendon injuries in dance]. Clinics in sports medicine. 2008 Apr 1;27(2):279-88.</ref> However, it's going to affect any sport which requires repetitive push-off and extreme plantarflexion such as swimmers, sprinters, footballers, and gymnasts. Moreover, it can also suffer damage following injury to the ankle and/ or syndesmosis caused due to its close proximity to the talus and the ankle joint.  

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Introduction[edit | edit source]

The ankle is a crucial joint to acknowledge in the context of dance injuries because it is the connection between the leg and the foot that establishes lower limb stability. It is one of the most commonly injured body areas in dance.[1] Incidences of injury to the ankle-foot complex scale from 27% to 49% of total injuries in ballet, modern, flamenco, and tap dancers.[2][3] Dancer’s tendonitis is also referred to as Flexor Hallucis Longus tendonitis which is an overuse injury in which repetitive plantarflexion and dorsiflexion (pointing and flexing) of the foot results in inflammation of the FHL tendon.[4]

In dancers, injury to the FHL is usually provoked by the recurrent movement caused by changing position from a plié position to a relevé position. (Plié is a French term meaning to bend, relevé, is a ballet term meaning “raised.” The term relevé explains the action when a dancer rises up on their toes).[5] This movement of action produces a force that is ten times the dancer's body weight. Bio-mechanically, a restricted plantarflexion movement may lead to a prolonged pronated foot position when pushing off during the Propulsion Phase which can lead to FHL tendonitis.[6]

The Flexor Hallucis Longus (FHL) has been also called as the ‘Achilles of the foot’ due to its unique role controlling midfoot pronation and supination, and its physiological and mechanical properties, which permit it to act as a powerful convertor of force from the rear foot all the way through to the big toe. Due to its anatomical arrangement and its unique actions, it is a muscle-tendon unit that can often become injured in athletic populations. This is often called the ‘dancers tendonitis’ because it is so prevalent in classic ballet dancers.[7] However, it's going to affect any sport which requires repetitive push-off and extreme plantarflexion such as swimmers, sprinters, footballers, and gymnasts. Moreover, it can also suffer damage following injury to the ankle and/ or syndesmosis caused due to its close proximity to the talus and the ankle joint.

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References[edit | edit source]

  1. ↑ Rinonapoli G, Graziani M, Ceccarini P, Razzano C, Manfreda F, Caraffa A. Epidemiology of injuries connected with dance: a critical review on epidemiology. Med Glas (Zenica). 2020 Aug 1;17(2):256-64.
  2. ↑ Kadel NJ. Foot and ankle injuries in dance. Physical Medicine and Rehabilitation Clinics. 2006 Nov 1;17(4):813-26.
  3. ↑ Vera AM, Barrera BD, Peterson LE, Yetter TR, Dong D, Delgado DA, McCulloch PC, Varner KE, Harris JD. An injury prevention program for professional ballet: A randomized controlled investigation. Orthopaedic journal of sports medicine. 2020 Jul 28;8(7):2325967120937643.
  4. ↑ Rowley KM, Jarvis DN, Kurihara T, Chang YJ, Fietzer AL, Kulig K. Toe flexor strength, flexibility and function and flexor hallucis longus tendon morphology in dancers and non-dancers. Medical problems of performing artists. 2015 Sep 1;30(3):152-6.
  5. ↑ Mira NO, Marulanda AF, Pena AC, Torres DC, Orrego JC. Study of Ballet Dancers During Cou-De-Pied Derrière with Demi-Plié to Piqué Arabesque. Journal of Dance Medicine & Science. 2019 Dec 15;23(4):150-8.
  6. ↑ Michelson J, Dunn L. Tenosynovitis of the flexor hallucis longus: a clinical study of the spectrum of presentation and treatment. Foot & ankle international. 2005 Apr;26(4):291-303.
  7. ↑ Hodgkins CW, Kennedy JG, O'Loughlin PF. Tendon injuries in dance. Clinics in sports medicine. 2008 Apr 1;27(2):279-88.
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