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Plaza Column - View article
Written by : Max M Ali MD
Date : 11-22-2004
Title : Dancer's Health/Stress Fracture
     
Article: Dancing Tid-bits Issue #205, Thursday, November 18, 2004

Today's Topic: Dancer's Health/Stress Fracture



Case Presentation: This the case of a 39 year old Caucasian, female dance teacher who enjoys dancing specially teaching International Style Ballroom. She has been complaining of some pain for a couple weeks in her right foot in the forepart. Pain comes and goes but more recently it has been persistent. As she finishes a series of Slow Fox-trot teaching sessions, the pain seems almost unbearable to the point that she cannot demonstrate the "Rise and fall" of a Feather Step. She has a professional competition coming up the following week. Her colleague who is another dance teacher at the studio, happens to walk by and notices her pain and agony. He happens to be physician and part time dance instructor. Both of them talk a little and he examines her; he finds very localized tenderness (quite extreme) and a little swelling in the second metatarsal bone. He had never seen a stress fracture before but suddenly he recalls this word 'stress fracture'. There is no history of any obvious injury but the findings and circumstances are so typical that he makes a provisional diagnosis of stress fracture and advises her to go and see a doctor in the morning and get some X-rays taken and sure enough the diagnosis is confirmed next day and she undergoes casting in a soft cast and is advised no dancing for 6 weeks. How devastating, you can understand. She cannot believe it and it is incomprehensible for to believe that she has a fracture and she has been dancing for a whole month with a painful foot.



What is Second Metatarsal Bone: This is the bone in the middle of your foot next to the big toe.



Why this bone fractures: As you indulge in ballroom dances specially the swing dances this part of the foot takes hell of a beating. The inner half of the foot is more involved and bears most of the weight. This is exaggerated with the rise and fall specially of slower dances as fox-trot and waltz. The causation of stress fracture is not clearly understood and is perhaps wear and tear. Don't worry, the cause of most diseases is not well understood anyway.



Final Outcome: After initial period of frustration and limping in a cast, she makes full recovery. However it is about 3 months or so that she could not compete or do any aggressive dancing.



What, if it was not diagnosed and treated? Chances are it will become so painful that she will definitely seek help and a late diagnosis will be made. If she did compete at that time she will be quite miserable and not be able to finish her program. However occasionally stress fractures will resolve themselves and will heal without any treatment.



This is an actual case presentation and I thought of sharing this with all of you. If this happened at this studio, it can happen some place else. With Best Wishes, Max