The Gilded Serpent presents...
When the Choo Choos
Give you The Foot Blues
By Jawahare BA, RRT
February 1999

"Ouch, my aching feet", such a familiar complaint of we, the biped hominids. Our feet are often neglected and abused. Foot problems are quite common among dancers, especialy ballet dancers who wear pointe shoes.

Foot trouble for Middle Eastern dancers can come from dancing barefoot or from doing repetitive steps during dance practice that put strain on one area of the foot (eg. choo choos).

General foot pain can be a symptom of a variety of health problems, including diabetes (neuropathy), flat arches, tight shoes ( bunions and corns) and even viruses (plantar warts). In this article I will address a foot condition called plantar fasciitis.

The plantar fascia is a fibrous sheath of tissue that runs along the bottom of the foot from the heel to the toes. Inflammation and pain, particularly in front of the heel bone charactarize plantar fasciitis. It is generally worse after a long period of rest, such as upon awakening in the morning. It often occurs as a consequense of abnormal bone structure or excessive stretching in this area of the foot. Injury to the plantar fascia is also associated with heel spurs ( bony tooth shaped attatchments on the heel bone). Athletes and people with unusually low or high arches are especially susceptible to plantar fascitis. Pain can be exacerbated by poorly fitting shoes, tight calf muscles, obesity and by running up or down hills.

The primary treatment for acute plantar fasciitis is rest and applications of ice to reduce inflammation. In a pinch, a bag of frozen peas will work ; just don't eat the peas afterwards, OK? Rub the ice along the bottoms of the feet in 15-20 minutes intervals 4 times a day. When the pain is severe and interferes with walking, try to reduce weight bearing activities as much as possible. Try to rest the feet and ask your doctor about taking a non-steroidal anti-inflammatory (Motrin) and be sure to take it with food as this class of medicine can irritate the stomach. To prevent recurring and chronic plantar fasciitis, stretch the calf muscles well before and after exercise. Focus on aerobic exercise that is non weight bearing, such as swimming or biking. Wear shoes that support the arches and that flex more towards the ball of the foot rather than at the middle of the arch. Don't wear high heels because the can cause shortening of the achilles tendon. Try to refrain from walking barefoot. You don't need to wear your tennis shoes in the shower, but give your feet the rest and support they need for recovery. Get some shoe inserts at a drug or sporting goods store to help stabilize the foot and prevent the ankles from turning inward ( pronation). Cloth athletic tape can also be wrapped around the foot as an arch support.

For more serious structural foot problems, or if home treatment is not effective after a period of several months, consult a podiatrist. The doctor will evaluate your foot problem carefully. A foot exam can include observation of walking gait, mobilization tests, MRI and x-rays. Most podiatrists initially take a conservative approach when treating plantar fascitis. Depending on the duration and severity of the condition, these can include the measures outlined earlier as well as cortisone shots, ultrasound, night splints and physical therapy. Most patients respond quite well to this approach. Sometimes the doctor will order custom-made shoe inserts called orthotics. The doctor takes a plaster cast of the foot and sends it off to a company that makes the orthotics out of plastic. As a last resort, podiatrists can perform foot surgery that corrects plantar fascitis by severing part of the ligament that is causing the painful tugging on the heel bone.

A final note on prevention of this debilitating foot problem: be kind to your feet and give up the marathon sessions of choo choos for more gentle forms of dance practice.

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