Foot and Ankle Pain in a Dancer

Are you a dance parent who is wondering what it will cost your daughter in the long run if she continues to work through foot and ankle pain?

We are now at the start of full competition season and unfortunately this is the time of the year where most dancers start to complain of pain that has been building up during the season and has increased with the push to finish and perfect choreography. In this article I will provide you with a brief overview of the most common dance related foot conditions that could be causing your pain.

Dance requires a combination of strength, power, endurance, flexibility, balance, and control in order to enable dancers to perform with such athleticism and artistry. The most common area to suffer dance related injuries is the foot and ankle. The reason for this is simple in that dancers put a lot of pounding through their feet whether it is through pointe shoes that require weight bearing through joints in the foot that were not designed tot be weight bearing joints or they are constantly pounding on their feet during tap dancing (my favorite form of dance).




The foot and ankle is made up of 26 bones all connected to each other by joints. There are ligaments that stabilize the joints and then there are many different muscles that muscle work in a coordinated fashion to allow you to plié or relevé with ease!


The first step to getting rid of chronic foot and ankle pain is to seek out a medical professional that specializes in working with dancers.  Understanding the biomechanics of dance as well as the demands of the “sport” is critical the decision making process of what to modify in class when you are recovering from your injury. A medical professional will help properly diagnosis your condition, however, the the key to fixing your problem is determining the root cause of why your pain started in the first place.  In the foot and ankle and especially with dancers, it usually comes down to either a mobility or stability issue at the ankle or the hip region.  For the remainder of this article, I will provide you with a brief overview of the most common dance related foot conditions that could be causing your pain. It is beyond the scope of this article to provide an in depth analysis regarding the diagnosis, prognosis, and proper treatment of each of these conditions. Please seek out a local medical provider to receive proper management of your pain.


Common Dance Related Foot Conditions



  1. Ankle and Midfoot Sprains
  2. Ankle tendonitis
  3. Sesamoid Pain
  4. Stress Fractures



The most common injury by far suffered by dancers is an ankle sprain or midfoot sprain. The ankle sprain is accompanied by pain on the outside of the ankle in a higher location than the midfoot sprain which is associated with pain on the outside part of your foot. This always occurs as the result of an injury in which you roll your ankle during landing from a leap or coming out of a turn. The keys to proper management is ruling out a fracture of your ankle by using the Ottawa Ankle Rules

Ankle Sprain Mechanism of Injury


Inside Ankle and Back of Heel Pain
Outside Ankle Pain

Ankle tendonitis or the more appropriate term would be tendinopathy as we know that not all tendon problems that cause pain have active inflammation and hence ice and rest may not be the best treatment. The three most common tendons to cause pain in a dancer is the posterior tibial tendon (inside ankle pain), peroneal/ fibularis tendon (outside ankle pain), and the achilles tendon (back of the heel pain). These conditions are pretty true to their anatomy as pain location will help determine which you have. These injuries are usually the result of overuse and poor footwear, improper training ramp up before a competition, and muscle imbalances (either tightness or weakness) in the ankle and hip regions.



Stress fractures result in consistent progressive pain that builds up over time and is worse with weight bearing activities (dance!) but feels better when you are sitting or lying. This is a sign that you have ramped up your training too quickly and your bone is not strong enough to handle the increased load. These are important to diagnosis because they can create weakening of the bone and could result in full fractures with increased stress and load. Early detection is key to preventing excessive time lost out of the classroom.


Sesamoid pain results in pain on the bottom of the first toe and is very common in dancers due to the amount of time they spend in relevé. This is a chonic condition due to inflammation of the two pea sized bones located in the tendon under the ball of the foot in the big toe. Correct diagnosis is key to determining if you have a fracture of the bone, tendon problem (turf toe), or inflammation of the bone (sesamoiditis).

Sesamoid bone in foot
Sesamoid Pain Under Ball of Foot

In this article I provided you with a brief overview of the most common dance related foot conditions that could be causing your pain. The keys to preventing and treating foot and ankle pain in a dancer is determining the proper diagnosis and then finding out what the root cause is that is contributing to your condition. Your problem may be a mobility or stability problem and will require specific exercises to address those areas in order to fix your current problem or prevent it from coming back.  Stay tuned for future posts relating to specific foot and ankle mobility and stability exercises you can do to keep you happy and healthy dancing doing what you love! Click here to go directly to my YouTube channel with dedicated playlist to all things dancer health and wellness related.


Are you a dance parent who is wondering what it will cost your daughter in the long run if she continues to work through the pain?

Have you seen other medical providers in the past that just tell you to stop dancing?


We have a unique treatment approach that focuses on solving these problems with our clients.

Our goal is to help keep your dancer active while recovering from injury by staying in the studio and guiding them in ways to modify their training, rather than eliminating dance!

We combine manual hands-on techniques with guided supervised exercises to help your dancer get stronger, pain-free, and perform at their peak level to get them back in the classroom and on the stage.


The SPARK Physical Therapy Commitment

No long waits or multiple trips to providers’ offices every week. We see your dancer either onsite at your studio or in the comfort of your home when it is convenient with your schedule.

One on one for a full hour with your doctor of physical therapy, every visit.

We provide your dancer with a customized plan specifically designed for them, based off their unique injury and goals.

Full transparency in what you pay. You will never get a bill from us a couple of months after your visit.

Access and availability to you! Have a question about your dancer’s pain or exercise program? Get an answer from your therapist directly.

If you’re in the Wallingford, CT area and are a dancer that has been dealing with injuries we can help. We’d love to chat for a few minutes and see if you are a good fit for what we do. Fill in the contact request and we’ll set up a free 10-minute phone consultation with a doctor of physical therapy

Thank you for taking the time to read,



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“I don’t have enough words to express my gratitude towards Duane Scotti and the Spark Healthy Runner program. When I started working with Duane, I had been dealing with chronic shin splints/posterior tibialis tendinitis for almost a year.

I had worked with multiple other coaches and physical therapists with little success and was at the point of almost giving up on my love for running. Duane is so kind, thoughtful and knowledgeable as both a physical therapist and running coach. Our first virtual meeting lasted two hours because he was so meticulous in his assessment. His strength and running program is progressive and created so that you can continue to build strength and mileage as you heal. His strength program is unique, effective, and fun.

Additionally, his warm-up routine is awesome and includes drills that over time have made me a more efficient runner. His training platform is easy to use, and he is always readily available to chat when problems or questions arise.

Over four months of working with Duane, I have built back to five days a week of running and am almost back up to my pre-injury weekly mileage and long run distance. Whenever I have flare ups or setbacks, Duane reassures me and makes necessary adjustments so that I can continue to progress in my running journey. I have had so much success with him so far that I have signed on for four more months so that he can help me to continue getting stronger as I train for the Dopey challenge in Disney World.

If you are struggling with a running injury and are feeling hopeless, you have to reach out to Duane Scotti. Of course, you will have to put in a lot of hard work, but with Duane by your side, you will be able to achieve your goals and more. Thank you Spark Healthy Runner for bringing the spark back to my running!”

Dipti Pandya

You can teach an old dog new tricks!!!  I have never considered myself a runner and I knew I needed to be smart about it because I am no spring chicken. Spark preached getting strong and healthy to be injury free and they practice what they preach.  I am soooo glad I made the investment in me!  I finished my half marathon last weekend and couldn’t be any happier!  The program fed me all the steps I needed to essentially learn how to run long distance, build strength, nutrition help, a forum of other runners and probably most important was the 1:1 coaching.  I had no idea how to tackle training for a 1/2 marathon and this program broke all of it down, had it individualized for me and we tweaked as we went to make sure I was staying healthy and strong.  I had so many questions the week prior to my race and Coach Cat was always there for me and answering all the questions and issues I had-and believe me there were a lot!  The biggest benefit I think I got was the strength. I am strong and fit. But most important was what I gained emotionally.  I built confidence and strength I didn’t know I had, even at my age.  Honestly could not have done this without Spark Healthy Runners!

Gina J.

My Healthy Runner journey started after I had battled bilateral achilles pain for a few months and was frustrated how it affected my running. As soon as I talked to Duane I knew I had made the right decision. His positivity, enthusiasm and genuine care are infectious. The training plan that was tailored to me included specific exercises to rehab my injury and I was so excited that I didn’t have to stop running. It took patience to only run slow for a few weeks but I trusted the process and it got me me to where I am now: running pain free. We made adjustments to the plan throughout whenever needed having someone in your corner that is always there with guidance and support throughout the process was invaluable.

I just ran my second half marathon, both with Duane’s coaching, and PR’d by over 9 minutes! I got all choked up in the last mile when I realized that I felt strong and could still kick it up a notch.

I’m so thankful for the Healthy Runner program, community and the entire coaching team for all the support!

Katja L.

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