August 14, 2008

Pronated versus flat feet

Greetings!
It was so wonderful to meet some of you last weekend in New York at the Javitts Center! Yea to Dance Teacher magazine for putting on a wonderful conference! This sunday I'll be in Brockport, NY for the Dance Rochester workshop.

Onto the question of the week...

My daughter has danced for 10 years and had hoped to start pointe this year. Her teacher says she cannot start point due to the fact that she tends to roll her ankles inward, it seems as though she is flat footed. I took her to an orthopedic specialist who said it was a common problem and not severe enough to do anything about it. He said everyone is built differently and people should not be so critical! Is this a problem that should cause her to delay pointe classes or should we look for a new dance instructor?

Believe it or not – I'm going to side with the dance teacher. She caught your daughter pronating her feet, which is rolling in on the arches. That is a different situation from having flat feet. When you have flat feet it means there is no visual instep. Someone with flat feet can be a very strong dancer, they simply won't look like they have as high of an arch as most people. This is a structural issue, not a functional. Asians and African Americans, for example, have more of a genetic tendency towards structural flat feet.


This image is of pronated feet - these are not flat - rather they are rolling in. If you look at flat feet from the back the heel and heel bone would be straight, not curved towards the floor.







From the side you can see that a flat foot has little or no space between the arch and the floor.







Pronated feet, on the other hand, means the weight is not being evenly divided on the foot and there is more weight on the inner border of the feet. If left unattended, that is a problem and concern for a dancer. You want to see the weight evenly divided between the pads of the big toe, little toe and heel.

Your doctor isn't the first one who thinks that pronation is something the average youngster will grow out of. What they don't understand is the challenge of turnout and standing in first position to pronation. The child who is primarily in sneakers (with an arch support) and running around or involved in sports is using their legs primarily in a parallel stance. I can't tell you how many young dancers I have seen who begin pronating because they are over turning out their feet. Ballet is a wonderful activity - and I love dance – and – pronation is a problem that needs to be addressed as early as possible.

What I would suggest for your daughter, if she really wants to go on pointe this year – she is going to have to prove to the teacher she can stand in first position (or any other position for that matter) without rolling in her arches. It will take first and foremost awareness on her part of when she is rolling in.

If she is in the habit of wearing flip flops – she needs to temporarily stop. They are not good for growing feet with the exception of walking from the car to the beach. Speaking of beaches – walking on the sand barefoot is a wonderful strengthening for the feet and the calves!

She can practice balancing on one foot while tossing a ball back and forth between her hands – again – not allowing herself to roll in, and maintaining good alignment as she is doing so.

She can focus on strengthening the foot and calf muscles. You can find useful exercises in my Tune Up Your Turnout book – as well as in many other useful dance books. Lisa Howell has written a fantastic ebook called the Perfect Pointe Manual. You can check it out at www.theperfectpointebook.com/PerfectPointeBook/?hop=home2php&gclid=CJDJtNvyjZUCFRKLxwody1etfw

Your doctor isn't stupid for not knowing how to guide you in this situation – I think he/she just doesn't have the insight into the specific challenges for dancers. I remember taking my son to the doctors after he twisted his ankle pretty badly when he was 8. My doctor said I didn't need to give him an anti-inflammatory or ice or do rehab – that he was active and would work his way out of it. I needed the doctor to rule out anything more significant – which is what you needed to do with your daughter. But after I got that information I went to work with icing and then doing some rehab with my son. Some fun things like each of us standing on one foot and tossing a ball back and forth to each other and slowly increasing the distance. It helped his joints relearn where center is because as soon as you have an injury or a dysfunctional pattern, the body compensates.

With continued guidance and some extra work on your daughter's part – I'm sure she'll be ready for pointe work in no time!

Warm regards,

Deborah

"Education is the key to injury prevention"