Dancing Feet that Ache – Dr. T. M. Sunil

Dancers, like any other professionals engaged in strenuous physical activity, suffer from aches and pains. This article answers some of the most frequently asked questions on the subject. The author Dr. T. M. Sunil, is an Orthopaedic, Hand & Micro Surgeon at the M. S. Ramaiah Medical College Hospital, Bangalore.

Who are susceptible & what are the common aches and pains that afflict dancers?

Dancers particularly those who practice and perform for long hours are more prone to develop aches and pains. The most common areas affected are, the knees, the feet and the shins. Some may complain of a generalized ache of the entire lower limb. Pain in the lower back is also a frequent complaint.

Why should dancing predispose to leg problems?

Most traditional Indian dances require the dancers to stamp their feet hard on the ground and that too, quite often. This automatically means that the feet receive a lot of pounding in the course of a performance. A fact to consider here is the amount of force passing through the feet during each such thump. Even during normal walking, a force equal to about 3 times our body weight passes through the feet with each step. This means, for an average Indian who weighs about 50 Kg, each simple step of waking subjects the feet to about 150 Kg of force. Activities like running, jumping or dancing, can increase this force to as much as 6 times the body weight or up to 300 Kg! No doubt dancers develop aches and pains.

Does dancing barefoot on hard floors predispose to problems?

Yes! If one considers the above facts, it becomes obvious that shoes or any form of footwear can provide a certain cushioning effect, reducing the impact on feet. Unfortunately, all Indian dances require the dancer to remain barefoot. This is further compounded by the fact that the traditional Indian dancing floor is the hard stone floor of a temple or the concrete floor of a stage. Only rarely are floors paneled with wood, which can help reduce impact forces.

If a dancer’s limbs have started aching has she developed arthritis?

No! Every ache and pain in our limbs is not arthritis. By definition, arthritis is an inflammation of a joint. It is caused by infection, deposition of some crystals, immune related disorders, etc. Dancing or any form of activity cannot cause arthritis. However, in a person already afflicted by an arthritic disorder, dancing may worsen symptoms.

Why does the knee characteristically ache in traditional India dancers?

One of the main reasons contributing to knee pain is the bent posture of knees during a performance; particularly the ‘aramandi’ position. A partly bent knee causes a considerable amount of pressure to build up behind the kneecap. This causes stress on the joint leading to pain.

Why does the whole limb ache after prolonged performance?

All movements of our limbs are brought about by the action of muscles. These muscles are obviously in constant use during a dance performance. A dance performance in our country usually does not provide for much rest between each dance item. This means the dancers muscles are called upon to act continuously without much provision for recuperation. This leads to a build up of certain chemical substances within them. These chemicals are responsible for producing pain. This is what we commonly call fatigue pains.

Why do some dancers get tremors when trying to stand still in a particular posture?

This requires a bit of understanding about how our body works. As is obvious, every movement in our body is complemented by the ability to perform its reverse movement also. For example, just as we can bend the elbow, we can also straighten it. Just as we can raise our feet, we can also lower it. Just as we can spread our fingers, we can also bring them together. Opposing groups of muscles brings about these opposing movements in any joint. If we have to bend our elbow, one group of muscles (i.e., the flexors – or benders of the elbow) actively pulls the elbow into the bent posture while the opposing muscle group relaxes (the extensors – or straighteners). Similarly, the reverse action of straightening the elbow requires the extensors to pull while the flexors relax. These muscle groups continue to pull on the joint till the joint is fully bent (flexed) or fully straight (extended).

If one has to hold any part of the body still in any particular posture, it requires both the opposing muscles to be pulling at the same time with equal force in opposite directions. In other words, if the elbow has to be held still in a half bent position, the benders (flexors) and straighteners (extensors) have to pull in unison in opposite directions with equal force. This has to occur simultaneously and in perfect co-ordination for the joint to remain absolutely still. Often this does not occur. One group pulls a little more for a fraction of a second followed immediately by the opposing group pulling the joint in the other direction. This sets off a rapid to and fro movement of the joint that we appreciate as tremors.

Fatigue, excitement, tension, stress or a combination of these is likely to increase the chances of tremors developing. In some people this can be quite pronounced.

Can one prevent these tremors?

Yes and no. While regular practice and a calm demeanor can certainly reduce the chance of tremors, there is no guarantee that they will not occur.

What measures can help prevent or reduce all the above problems?

It is essential to adequately warm up before a performance. This improves circulation to the limbs and in a way gears the limb up for the prolonged activity that will follow. Certain simple muscle strengthening exercises (isometric) help in building muscle tone and make them tolerate stresses better. Isotonic exercises improve stamina. And permit prolonged activity without much fatigue.

Adequate hydration (i.e., drinking adequate water) helps reduce muscle fatigue and cramps. However it is important not to drink too much during a performance or it may lead to colicky abdominal pain; commonly called stomach cramps. It is important for the professional dancer to eat healthy and wholesome food. A balanced nutritious diet keeps the body fit. Of course nothing can match regular and well-planned practice as this conditions your body for the entire performance.