[Changes in the skeleton of the middle foot caused by professional classical dancing].

UNLABELLED

On half and three-quarter points, the most frequent foot positions in dance, the metatarsals form an extension of the lower leg. In 54% of 56 professional male and female dancers whose feet were examined, this extraordinary stress leads to pronounced thickening of the cortex of the second metatarsal and in 6%, of the third metatarsal as well. There are no symptoms. Hypertrophy of the bone occurs in response to the additional stress imposed by dancing. Dancing on points is not the triggering factor, since male and female dancers are equally affected.

COMPLICATIONS

Under intensive stress of dancing, pain can develop in the medial portion of Lisfrans joint and endanger the dancer's career. Skeletal scintigraphy in such cases reveals increased metabolism of the bone at the base of the second metatarsal as well as in the cuneiforme intermedium. The development of this overstress on the second ray is favored by the following factors: Primarily by the congenital pes cavus which makes correct stressing of the foot in dancing impossible; a relatively long second metatarsal, or possibly the third metatarsal as well; - by an excessively large antetorsion angle of the neck of the femur, which makes correct positioning of the foot in the five positions of classical dance impossible; - by overstressing the half-points position in teaching, or by unfavorable training conditions, especially floors that are too hard. No treatment of these painful complications is possible if they are caused by anatomical factors. In other cases, several month's rest, changing ballet technique, and improved conditions regarding the ballet floor can result in an improvement. Even then, relapses are not infrequent, however.