Tender Tendons

By Bauman, Phillip A. | Pointe, October/November 2002 | Go to article overview

Tender Tendons


Bauman, Phillip A., Pointe


When you land from an entrechat quatre, you know not to roll your arches. But do you know what your tendons are doing? Each movement in dance requires the use of the many muscles and tendons in your foot and ANKLE. Ballet-especially pointe work-can lead to straining of the tendons. When strained repeatedly, tendons can become inflamed. This inflammation is called tendonitis.

There are many reasons why tendonitis develops. Very intense classes or rehearsals over a period of days or weeks can lead to tendonitis. Other causes include a lack of proper warmup or stretching and intense, frequently repeated movements.

Two areas in the ballet dancer's foot and ankle are particularly prone to developing tendonitis: the ACHILLES TENDON and the flexor hallucis longus tendon (FHL; see illustrations). The Achilles tendon is the largest tendon in the back of the ankle; it attaches the calf muscles to the heel bone, or calcaneus. It can become inflamed when it is repeatedly strained, as occurs in landings from jumps and the repeated and forceful pointing of the foot. Achilles tendonitis is easy to identify because the tendon is usually visibly swollen in comparison to the other ankle or other parts of the tendon and/or is tender to the touch and hurts during forceful contraction of the calf muscle against resistance, as in releve. Sometimes this kind of tendonitis is confused with posterior impingement syndrome, an inflammation caused by an extra bone located in the back of the ankle.

The FHL TENDON attaches a muscle in your lower leg, the flexor hallucis, to the bottom of a bone at the tip of the great toe called the distal phalanx. This tendon allows you to point your foot. When inflamed, the FHL is tender to the touch, and often there is associated clicking in the same area. When FHL tendonitis becomes severe, the tendon may catch, or trigger, and cause the big toe to feel as if it has become "stuck."

The Achilles tendon and FHL are located close to one another; because of this proximity, the two types of tendonitis are sometimes confused. Occasionally, a dancer will have tendonitis in both places, but more commonly only one tendon is involved. …

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