How can I exercise my feet for better pointework?
Dance specialist Dr. Lisa Schoene recommends this set of exercises to every dancer on pointe.
Equipment: RP Exercise Bands (knotted into loop at end), small towel, cushion, chair/ stool
Time required: Five minutes for each set, after you have learned the exercises.
General principles: Keep your movement slow and controlled, in both directions of each exercise. (To understand why this is important, see Q&A below.) Keep the toes extended in a relaxed way (neither flexed nor strongly pointed) throughout exercises 1-4. This focuses the impact on the targeted muscles. Start with one set of eight to ten repetitions of each exercise, on each foot. As your feet strengthen and you learn the exercise, increase to two or three sets. Remember to balance these exercises, like any strength training, with gentle stretching.
1. Dorsiflexion (flexing the foot upward) Sit with legs extended forward, one foot resting on top of the other. Wrap band as shown, with the end hanging loose. Without flexing toes, flex the working (top) foot at ankle, slowly and smoothly, upward toward the body. Do not move other foot. Return to starting position slowly and smoothly.
Target muscle: tibialis anterior
Importance: alignment of foot and ankle; control for jumps and pointe work
2. Plantar Flexion (“pointing” the foot) Sit with legs extended forward. Wrap the band as shown, and grasp with hands. Without strongly pointing toes, slowly and smoothly extend foot into a “pointed” position (at ankle, not toes) then return to starting position.
Target muscles: gastrocnemius and soleus
Importance: strength on pointe and throughout dance technique
3. Eversion (“winging”) Sit with legs extended forward, ankles a few inches apart. Wrap band as shown and grasp with hands. With working foot slightly (not strongly) pointed, move foot smoothly outward (to an everted position). Move exactly to the side, without changing angle of foot or moving toes. Return smoothly past starting point to fully inverted position.
Target muscle: peroneus brevis
Importance: control and stability, avoidance of sickling, winging and over-pronation.
4. Inversion (“sickling”) Sit with legs extended forward, with working ankle resting on top of other ankle. Wrap band as shown and grasp with hands. With working foot slightly pointed, slowly and smoothly move inward (to an inverted position). Keep ankle extended and try not to use toes. Move exactly to the side in relationship to the ankle. Return slowly past starting point to fully everted position.
Target muscle: tibialis posterior
Importance: with eversion, essential for control and stability
5. Pointing big toe Sit with working leg extended and ankle flexed but relaxed. Wrap loop around big toe joint and grasp band with hands. Without “pointing” foot, point big toe against resistance of band. Then, allow toe to return very slowly to flexed position.
Target muscle: flexor hallucis longus (FHL)
Importance: stability on pointe, avoidance of over-pronation and bunions
6. Pointing little toes Perform as #5 but wrapping band around four little toes instead of big toe. Also try this exercise with band around individual toes.
Target muscle: flexor digitorum longus (FDL)
Importance: overall stability
7. Big toe push Use a chair or stool, with a cushion or pillow on top. Stand with working foot on cushion. Do not roll foot in or out, lift heel or change standing position. Push down into cushion with big toe joints.
Target muscle: peroneus longus
Importance: strength and control in releve, keeps big toe functional properly
8. Towel curl Place small towel on floor or exercise table and sit in front of it. Place working foot in middle of towel. Repeatedly grasp and release towel with toes, gradually moving it toward the body. (Picking up objects with toes provides similar exercise.)
Target muscles: intrinsic muscles of arch
Importance: work with longer muscles to flex and point foot, and maintain stability throughout foot
Q&A with Dr. Lisa M. Schoene
Why does the “return” part of your exercises have to be slow and controlled?
Each exercise consists of two stages: concentric and ecentric. The concentric stage is the part we consider the main movement: the “up” of a grand battement, the sitting up part of a sit up, etc. The ecentric stage is the return to the starting position, such as the return to fifth position after a grand battement. The targeted muscles remain contracted in both stages, shortening in the concentric stage and lengthening in the ecentric stage. According to Dr. Schoene, the ecentric phase is most important for building strength and control. “Dancers tend to be stronger than most other athletes in the ecentric stage,” she says. “Your silent landing from a jump is a good example of controlled ecentric movement.”
Which of the exercises are best for limiting bunions?
Exercises 5-8 target hallux valgus (bunions) most specifically. However, all the exercises work together to promote balanced strength throughout the foot and lower leg. Perform the exercises consistently as a group for the best results. With strength should come increased control and better placement. Proper placement limits over-pronation, the major cause of bunions, as well as other placement problems.
What therapy is available for dancers with bunions?
“Unfortunately, you cannot reverse the bunion deformity,” says Dr. Schoene, “but appropriate footwear and orthotics can help stop bunions from worsening, and you can alleviate the symptoms of the sore joint.” Icing, anti-inflammatory creams or an injection with Traumeel® can reduce pain in the joint, and ultrasound PT modality can help reduce the swelling, she says. Wear pointe shoes and street shoes that facilitate good alignment and don’t rub or squeeze the joint. And don’t forget orthotics for your street shoes. Orthotics are special insoles that realign the abnormally pronated arch. This helps the muscles work normally, decreasing the drift of the big toe toward the little toes.
What footwear is best for avoiding or minimizing bunions and other foot injuries?
“Street shoes are really important. When a dancer is working her feet and taking many classes per week, her feet need support and some rest!” states Dr. Schoene. Two parts of the shoe protect specifically against over-pronation: arch support and a good heel counter. (The heel counter is a component that gives shape and support to the heel area of the shoe’s upper.) A slight heel height is better than a completely flat shoe. “In a shoe with no heel at all, the foot is in its most stretched out, flattened and unsupported position, causing possible stress to the arch muscles and plantar fascia (the fibrous band that holds up the arch),” says Dr. Schoene. Gym or running shoes typically have the best arch support and heel counters, and are the right choice for significant amounts of walking. Dr. Schoene does not recommend flip-flops, which provide no support.
Dr. Lisa M. Schoene, DPM, ATC, FACFAS, is a triple board certified sports-medicine podiatrist with a specialty in dance. She treats dancers at every level, from beginners to professionals to teachers, and is an expert at evaluating pointe readiness, teaching injury prevention, and treating injuries that do occur. In addition to working with clientele including The Joffrey Ballet, Hubbard Street Dance and many other companies, studios and athletic teams, Dr. Schoene is a prolific writer, teacher and lecturer on sports and dance medicine. Based in the Chicago area, she practices at Gurnee Podiatry & Sports Medicine (www.drschoene.com).