Stress Fractures – Foot and Ankle Problems for Dancers Part 2

As we know, Irish dancing and many other activities and sports consist of constant movement including repetitive jumping and landing. When loading is increased too rapidly, it can weaken the bone and increase the risk for a stress fracture. The cause of a stress fracture can include many factors including:

• Increased training intensity (too much too soon!)
• Hard floors (during the COVID-19 pandemic, many dancers were left with no other option but to use their free space at home. Unfortunately for many, this meant that they had to practice on hard floors including concrete floors, causing injuries.)
• Low energy availability (Fatigue is a big factor. When a dancer starts to fatigue you will notice that their posture becomes worse, their movement becomes less attractive and their landings from jumps become heavier putting more stress on the body.)
• Nutritional and hormonal factors including menstrual irregularities
• Studies have shown that females suffer from stress fractures more when taking part in jumping activities compared to males.

From my experience, metatarsal stress fractures are the most common stress fracture for Irish dancers. I have also witnessed dancers experience stress fractures in other bones too including the tibia, hip and spine. A dancer who has a stress fracture would often experience pain during or after dance class. They would also perform a specific movement or activity when feeling the pain such as jumps. As symptoms progress, the pain worsens and can often cause pain when doing very light activities such as walking or even lying in bed. It is important to know too that inflammation may not be present and the pain may not be well localised. Bony areas may be painful to touch too. If you are experiencing any symptoms and if you are in doubt in any way, an MRI is recommended to make a diagnosis.

Short story: At a major competition a few years ago, a dancer was practising with friends and rolled her ankle (fortunately the day after the competition!). She came to see me at my treatment area (supervised of course!) and I assessed and treated the injury. She was delighted to be pain-free leaving my treatment area but I advised her to get an MRI to be sure. They were able to book in for an MRI a few days later and up to then she was still pain-free with no issues but the MRI showed a stress fracture was present. It wasn’t as severe as others so the healing process did not take as long but if she continued to dance and train it could have become much worse.

So what is the lesson here? Always be sure! Get an MRI.

It is important to get an accurate diagnosis to determine how much healing time is needed. The MRI is the best option to get the correct diagnosis for this reason. Casting is not always required and some dancers are asked to wear a removable boot instead. A dancers conditioning can be maintained during the healing process and there are many activities to choose from to stay active including:

• Strength training that doesn’t include putting stress on the injured area (floor work mostly)
• Yoga (obviously many exercises would have to be avoided for some time.
• Pool exercises (always a great option but make sure you proceed with caution)
• Indoor bicycle and elliptical trainer (when the injured area is ready to adapt to the stress of course!)

Please get advice from a professional before deciding to complete any kind of exercise or activity program. 

Rehabilitation will eventually include a gradual return to dance class with avoidance of specific exercises such as jumps, turns and some point work.

I hope this short blog helps. I will be posting another in a few days. If you need extra help or advice or if you would like to book in for an assessment then please feel free to message me via my website or social media channels (Irish Dancing Physical Fitness).

Thank you for reading.

Peter O’ Grady