I have been struggling with severe plantar fasciitis for several years. When I'm moving between flat and demi-pointe, I experience a painful tearing sensation in my instep. I've been to my family physician, two podiatrists and three orthopedic surgeons, and have taken a year off to heal. Will I ever be able to dance without this pain? —Dallas
I've had plantar fasciitis, too, but your condition sounds extreme. Typically, the plantar fascia—a thick band of tissue that originates at the heel bone and runs underneath the foot—becomes inflamed, causing pain in and around the heel. According to Dr. Frank Sinkoe, a podiatrist who works with Atlanta Ballet, underlying muscle and postural imbalances throughout the foot, leg and hip, combined with overexertion, are often the causes of inflammation. It's usually treated with a stretching and strengthening program, orthotics, medications and physical therapy. Extreme cases may need cortisone injections and, in very rare cases, surgery.
It's also possible that you've been misdiagnosed. According to Sinkoe, Baxter's neuritis, a compression of nerves in the heel, is often mistaken for plantar fasciitis because of its symptoms and location. The treatment, however, is different. (One sign you may have Baxter's neuritis is if you have trouble curling your little toe in a podiatric assessment.)
You've seen a wide range of doctors, but do any of them have extensive experience treating dancers? This is key to getting a correct diagnosis and proper treatment. "Certain muscle groups are going to be tighter on dancers than on a regular person or even a runner," says Sinkoe, citing the hip flexors, lateral hamstrings and gastroc soleus muscles. "You shouldn't just treat the heel—you have to treat the whole kinetic chain." If possible, call a company or large dance school for recommendations of nearby dance medicine specialists. Since your case is so extreme, it may be worth traveling outside your area for a consultation.
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