How do they occur, are they genetic, what is the treatment? Answers to these questions and more from Dance Specialist Physio Debra Crookshanks, DANCEtrain's in-house physio.

HOW DOES COLLAPSING ARCHES OCCUR?
There are four arches in each foot but we are most familiar with the inside or medial arch which runs from under the big toe back to the heel. Our arches are formed by the bones in our foot (there are 24 bones in each foot) and held firm yet flexible by many ligaments and muscles.

The arches ‘collapse’ when the muscles in the sole of the foot are weak and cannot maintain the bones in the correct position eg the dancer has had a period of rapid growth when the bones grow quickly and the muscles are not able to maintain strength, or the dancer has not been trained to work through the feet correctly allowing the muscles to strengthen.
 
If the dancer does not hold the turnout from the hips and instead turns out from the knees or the ankle this will cause the foot to roll onto the inside arch straining the ligaments and weakening the muscles in the arch, giving the appearance of a collapsed arch.

DO BOTH ARCHES COLLAPSE AT THE SAME TIME?
No both arches do not necessarily collapse at the same time however the dancer who cheats their turnout may appear to ‘roll’ both ankles giving the appearance of both arches collapsed.
 
IF THERE IS A GENETIC PREDISPOSITION TO THIS TYPE OF INJURY ARE THERE ANY PREVENTATIVE EXERCISES THE DANCER SHOULD DO?
A dancer may be born with a certain foot type called ‘pes planus’ (latin for foot + flat), where there is no functional medial arch ie.the inside of the foot touches the ground. This dancer must work hard to strengthen the muscles in the arch and sole of the foot to compensate for this. There are many good exercises a dancer can do to strengthen these muscles:

i) for very young students or those with very flat, weak arches picking up marbles and placing them in a saucer, or picking up a small towel with the toes, or drawing a small towel toward you which has a weight placed on it with the toes are good beginner exercises.

ii) place the foot flat on the floor weight evenly through the heel, the middle of the foot and the 2nd & 3rd toes – flatten the toes into the floor to ‘dome’ the inside arch, repeat 10 times.

iii) sit on the floor with the foot in the demipointe position - using a light resistance band (yellow, red, orange) put the band around the big toe only-point the toe (no clawing) 10 times into the band; then place the band around all the toes and ball of the foot and repeat the exercise pointing all the toes 10 times – slowly, with control; keeping the band around the ball of the foot work the foot through demipointe to pointe return to demipointe and back to a flat position (NO SICKLING OR FISHING) 3 x 10 times so 30 in total.

iv) dancers may also be shown exercises using the balance boards or rotational discs - dance physiotherapists will have this equipment in their rooms for dancers to use. (www.dancephysio.com.au)
 
4. Once the arches have collapsed, what does treatment consist of, recovery time and are there any exercises that will help?

Treatment includes an assessment of why the arches have collapsed in the first place eg ‘pes planus’, weak muscles or faulty technique. If poor alignment or cheating the turnout is the cause the dancer is helped to improve turnout flexibility & strength to allow improved alignment and correct weight placement through the middle of the foot. Once alignment is correct the dancer is shown exercises to strengthen the muscles which support the arch. The dancer may also be shown how to strap the foot & arch to support the foot as the muscles become stronger. Recovery time varies depending on how long the arches have been under strain, how weak the muscles are and how diligent the dancer is with the strengthening exercises.

Remember dancing longer & stronger is all about you caring for YOU.

Debra