Top

Achilles Tendinopathy in Dancers

Achilles Tendinopathy in Dancers

What is Achilles Tendinopathy?

Achilles tendinopathy is pain that occurs in the large Achilles tendon, located at the back of the ankle. The Achilles tendon is the point of attachment for the calf muscles to the heel of the foot, and it is important in any activity that requires shock absorption or power generation through the foot and ankle. For dancers, it is essential for demi-pointe, pointe, and jumping exercises.

What causes Achilles Tendinopathy? What are common symptoms?

Achilles tendinopathy often occurs when the foot and ankle experience excessive loading, such as a sudden increase in training volume. This increase can come from getting back on pointe after a long break or starting harder jumping combinations. It can also be impacted by the floor you are dancing on. It can occur ‘out of the blue’ or suddenly during an activity.

Common symptoms include:

• Pain when touching or squeezing the Achilles tendon.
• Pain when rising up onto demi-pointe or pointe.
• Pain during jumping exercises.

How can Physiotherapy help my Achilles Tendinopathy?

Physiotherapy can help to treat both the direct causes of your pain, as well as contributing factors to why it may have developed in the first place. Your physiotherapist may use manual therapies such as massage to the muscles of your calf and joint mobilizations to the bones in the foot and ankle, or modalities such as acupuncture/dry needling. They will investigate the underlying causes of your pain, including how you move through your feet when you rise up and how you are controlling your turnout, to ensure that once resolved, the risk of pain redevelopment is reduced. You will be given a tailored exercise program to help strengthen the muscles contributing to your symptoms and get you back to your regular volume of dancing. Tendons are sensitive to loading, so your physiotherapist will help you determine how much you should push the Achilles tendon to promote healing without overloading it. This will mean reducing the amount of relevé, pointe, and jumping exercises you do for a time, so you can gradually build back up without causing pain in your Achilles.

How can Massage Therapy help my Achilles Tendinopathy?

Massage therapy can also be used to treat both the direct and indirect causes of your Achilles tendinopathy pain. Your registered massage therapist will work on a broader area of muscles contributing to your symptoms, helping to reduce tightness through the calf, hips, and lower back that may be contributing to your pain. Registered massage therapists are also skilled in various neuromobilization techniques which may be underlying your ankle pain and thus, an important component to your recovery. They will communicate with your physiotherapist to ensure both members of your team are working together to help you get back to your normal.

How can Sports Medicine/Physiatry help my Achilles Tendinopathy?

In most cases, the conservative management described above is extremely effective in helping you to overcome the symptoms of your Achilles tendinopathy and get back to dancing pain-free. However, in some cases you may need to see a sports medicine physician. Your sports medicine physician will be able to order imaging such as an ultrasound or x-ray to determine if there is anything that is slowing down the healing process. For younger dancers, if the Achilles pain is associated with heel pain, your sports medicine physician can help you rule in/out Sever’s disease, a condition which affects the growth plate in the calcaneus (the heel bone). They can also perform provide medications both oral and topical, or nitric oxide patches to help with your recovery.

How long does it take to for me to recover from my Achilles Tendinopathy?

For someone with an Achilles tendinopathy, it typically takes around 3-6months until they feel that they are ‘back to normal’. In some cases, however, it can take more than a year. It is a long process, BUT if you commit to your journey, you will have the strategies to not only manage your pain in the short term, but self-manage any recurrences of this pain down the road.

What are the best exercises to help with my Achilles Tendinopathy?

To get started with some exercises to help you recover from your Achilles tendinopathy, check out the Achilles Tendinopathy Home Exercise Program. Please keep in mind that these exercises were designed as a place to start to address your symptoms. These exercises should not be performed or continued if they cause or increase your pain in any way. Using these exercises for self-management of your symptoms does not replace the value of being assessed by a Health Professional. If you find you need help, let a Strive Health Professional help you, book your time today!

What can I do to treat Achilles Tendinopathy at home and in the studio?

• Avoid doing the things that aggravate your symptoms.

• in dance class, avoid pointe work and jumping for a time until your pain has decreased. For relevé exercises, only do a volume that does not bring on your pain (that may be 1-2 exercises or that may be none at the start).

• Self-massage or foam rolling to the muscles of your calf frequently throughout class.

• Sometimes, when the Achilles is acute enough that even walking bothers it, a small heel cup or lift can be used in your running shoes when outside of the studio to ensure that your regular activities in the day aren’t aggravating your pain so much that you are too sore to dance by the time you are in class.

Not Sure If Physiotherapy Is Right for You?

We are here to help! Call us at (416) 486-4776 to book a free 10-minute phone consultation with Danna Epstein Marcus, a Physiotherapist who has a passion for working with dancers because she was one!   Schedule a time to chat with her to find out if Physiotherapy is right for you.

What is Achilles Tendinopathy?

Achilles tendinopathy is pain that occurs in the large Achilles tendon, located at the back of the ankle. The Achilles tendon is the point of attachment for the calf muscles to the heel of the foot, and it is important in any activity that requires shock absorption or power generation through the foot and ankle. For dancers, it is essential for demi-pointe, pointe, and jumping exercises.

What causes Achilles Tendinopathy? What are common symptoms?

Achilles tendinopathy often occurs when the foot and ankle experience excessive loading, such as a sudden increase in training volume. This increase can come from getting back on pointe after a long break or starting harder jumping combinations. It can also be impacted by the floor you are dancing on. It can occur ‘out of the blue’ or suddenly during an activity.

Common symptoms include:

• Pain when touching or squeezing the Achilles tendon.
• Pain when rising up onto demi-pointe or pointe.
• Pain during jumping exercises.

How can Physiotherapy help my Achilles Tendinopathy?

Physiotherapy can help to treat both the direct causes of your pain, as well as contributing factors to why it may have developed in the first place. Your physiotherapist may use manual therapies such as massage to the muscles of your calf and joint mobilizations to the bones in the foot and ankle, or modalities such as acupuncture/dry needling. They will investigate the underlying causes of your pain, including how you move through your feet when you rise up and how you are controlling your turnout, to ensure that once resolved, the risk of pain redevelopment is reduced. You will be given a tailored exercise program to help strengthen the muscles contributing to your symptoms and get you back to your regular volume of dancing. Tendons are sensitive to loading, so your physiotherapist will help you determine how much you should push the Achilles tendon to promote healing without overloading it. This will mean reducing the amount of relevé, pointe, and jumping exercises you do for a time, so you can gradually build back up without causing pain in your Achilles.

How can Massage Therapy help my Achilles Tendinopathy?

Massage therapy can also be used to treat both the direct and indirect causes of your Achilles tendinopathy pain. Your registered massage therapist will work on a broader area of muscles contributing to your symptoms, helping to reduce tightness through the calf, hips, and lower back that may be contributing to your pain. Registered massage therapists are also skilled in various neuromobilization techniques which may be underlying your ankle pain and thus, an important component to your recovery. They will communicate with your physiotherapist to ensure both members of your team are working together to help you get back to your normal.

How can Sports Medicine/Physiatry help my Achilles Tendinopathy?

In most cases, the conservative management described above is extremely effective in helping you to overcome the symptoms of your Achilles tendinopathy and get back to dancing pain-free. However, in some cases you may need to see a sports medicine physician. Your sports medicine physician will be able to order imaging such as an ultrasound or x-ray to determine if there is anything that is slowing down the healing process. For younger dancers, if the Achilles pain is associated with heel pain, your sports medicine physician can help you rule in/out Sever’s disease, a condition which affects the growth plate in the calcaneus (the heel bone). They can also perform provide medications both oral and topical, or nitric oxide patches to help with your recovery.

How long does it take to for me to recover from my Achilles Tendinopathy?

For someone with an Achilles tendinopathy, it typically takes around 3-6months until they feel that they are ‘back to normal’. In some cases, however, it can take more than a year. It is a long process, BUT if you commit to your journey, you will have the strategies to not only manage your pain in the short term, but self-manage any recurrences of this pain down the road.

What are the best exercises to help with my Achilles Tendinopathy?

To get started with some exercises to help you recover from your Achilles tendinopathy, check out the Achilles Tendinopathy Home Exercise Program. Please keep in mind that these exercises were designed as a place to start to address your symptoms. These exercises should not be performed or continued if they cause or increase your pain in any way. Using these exercises for self-management of your symptoms does not replace the value of being assessed by a Health Professional. If you find you need help, let a Strive Health Professional help you, book your time today!

What can I do to treat Achilles Tendinopathy at home and in the studio?

• Avoid doing the things that aggravate your symptoms.

• in dance class, avoid pointe work and jumping for a time until your pain has decreased. For relevé exercises, only do a volume that does not bring on your pain (that may be 1-2 exercises or that may be none at the start).

• Self-massage or foam rolling to the muscles of your calf frequently throughout class.

• Sometimes, when the Achilles is acute enough that even walking bothers it, a small heel cup or lift can be used in your running shoes when outside of the studio to ensure that your regular activities in the day aren’t aggravating your pain so much that you are too sore to dance by the time you are in class.

Not Sure If Physiotherapy Is Right for You?

We are here to help! Call us at (416) 486-4776 to book a free 10-minute phone consultation with Danna Epstein Marcus, a Physiotherapist who has a passion for working with dancers because she was one!   Schedule a time to chat with her to find out if Physiotherapy is right for you.

Portrait of Danna Epstein Marcus

Danna Epstein Marcus

BHSc, MScPT, Dip.Manip.PT
FCAMPT
Registered Physiotherapist

Registered Physiotherapist

Danna Epstein Marcus has formal training in dance including ballet, pointe, jazz, lyrical, and tap. She has extensive training in dance rehabilitation in areas including pre-season and pre-pointe assessments, assessment and treatment of dance injuries and hypermobility disorders, establishing safe warm up and stretching routines, dance specific exercise rehabilitation including core stability, strategies to improve turn out, arabesque, développé, and other dance specific techniques. She is a member of Healthy Dancer Canada.

Learn more about Danna

Have a question about Patellofemoral Pain Syndrome in Dancers?

Ask Danna