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Q & A.

My foot hurts when I point it and releve! I just came back after a three-week break and pushed too hard in dance class. Every part of my body's sore and tight, which is no big deal. But my foot keeps feeling floppy and painful. It's been more than a week. Do I need to see a doctor?


Morristown, NJ

Yes! There was a time when all pain arising from releve was often mistakenly labeled tendonitis. Now we know that sudden onset of pain and weakness in this area can also occur when the small cube-shaped bone on the outside of your mid-foot shifts. This problem, known as "cuboid subluxation," will dramatically improve when snapped back in place. Ignore it and you could be limping around for months. See an orthopedist who works with dancers or athletes to find out what's going on. If your problem proves to be a subluxed cuboid, your doctor will probably refer you to a physical therapist who can help you treat it with a strengthening regimen.

Do naps make up for getting six hours of sleep a night? I try to fall asleep by 11 P.M. but it hardly ever happens. Staying up late feels right for me.

Night Owl

Boston, MA

I hate to say it, but naps can be a sign of sleep deprivation. While they can help you stay alert, they don't permit you to enter the deep stages of sleep that allow your body to release human growth hormone. This is essential for your body to recover from physical stress and injury. Naps can also make it harder to fall asleep at bedtime--and dancers need at least eight hours of sleep a night. By getting only six hours, you are more likely to experience memory problems, dramatic increases in appetite, and chronic fatigue that weakens muscles. Yet many people's natural circadian rhythms--the way our body responds to the 24-hour cycle--don't make nighttime feel like sleep-time. So what can you do? Make it easier to drift off to sleep with absolute quiet or soothing music, a cool room (avoid spicy meals that raise your body temperature), darkness, and pleasant thoughts. Try it for a week. The results may surprise you!

Yesterday my knee joint popped in and out for the third time this year during ballet class. I'm 17, and I've always been super flexible and it was never a concern. This time, my knee hurt so much I had to leave class. Why should it bother me so much this time?


Bronxville, NY

Most dancers are born with some tight joints and some loose ones. Years of pointe work and turning out can accentuate hypermobility in the ankle and knees, making them more prone to injury. Dancers who are very hypermobile tend to have further injuries due to a condition called Benign Joint Hypermobility Syndrome (BJHS) that affects as many as 15 percent of dance professionals. Red flags for BJHS include being able to touch your thumb to your forearm, bend your little finger more than 90 degrees, or hyperextend your knees or elbows. BJHS can also cause joint pain or allow joints to sublux (pop in and out) or completely dislocate. Minor symptoms may include loose, stretchy skin, abnormal scarring, drooping eyelids, and hernias. Whether you have the syndrome or just a hypermobile knee, you should be on a regular physical therapy program to help stabilize your joints. In your case, you may also need to work on your turnout and placement. Remember that forcing your legs to turn out below the knee rather than from the hip can exacerbate knee subluxation. Meanwhile, please avoid popping, cracking, or overstretching hypermobile joints.

Is an arthoscope the best way to tell if I have arthritis in my hip? It's been hurting for several years. I understand that they use a small instrument to look inside and I'll be able to walk out of surgery the same day.

Painful Hips

St. Petersburg, FL

Hip pain can be due to early arthritis, a torn labrum (the cartilage around the socket), or a combination of both. Arthritis usually causes pain and loss of motion. In contrast, a torn labrum just hurts and can happen at any age, including your teens. The best tests to pick up these problems are a bone scan (for arthritis) and an MRI (for both problems). A doctor would only use the arthroscope to fix a torn labrum. Consult a doctor to determine the right procedure, and it's always good to get a second opinion from an orthopedist who specializes in dance medicine.

SEND YOUR QUESTIONS TO Dr. Linda Hamilton, 2000 Broadway, PH2C, New York, NY 10023. Order her book for $13.90 at (800.33.DANCE).

Former New York City Ballet dancer Linda Hamilton, Ph.D., is a lecturer, a psychologist in private practice, and the author of ADVICE FOR DANCERS (Jossey-Bass). She has been offering advice to DANCE MAGAZINE readers since 1992.
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Author:Hamilton, Linda
Publication:Dance Magazine
Geographic Code:1USA
Date:Oct 1, 2008
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