Sever's Disease & Plantar Fasciitis in Irish Dance

If you are an Irish dancer, then you have probably heard the words “plantar fasciitis” or “Sever’s disease.” Both of these injuries are common in Irish dancers and can be very painful, but the good news is that there is a lot you can do right now to prevent them!

SEVER'S DISEASE

Let’s first dive into Sever’s disease. Sever’s isn’t really a disease, like the name suggests, but it is a condition that affects younger dancers, around ages 8-11, who are currently going through a growth spurt. During this time, the bones are growing faster than the muscle and tendon can keep up with. The muscle ends up getting really tight and it pulls very strongly on the bone. In the case of Sever’s, it’s the calf muscle that becomes really tight and the Achilles tendon ends up pulling on the heel bone, which is called the calcaneus.

Common symptoms of Sever’s includes:

• Severe heel pain

• Tight calves

• Swelling and inflammation at the heel and into the bottom of the foot

• Tenderness at the Achilles tendon

• Pain with standing, walking, and jumping

To help prevent Sever’s from happening in the first place, it's important to stretch your calf muscles (the gastrocnemius and the soleus) to keep it loose.

Here is one of my favorite stretches that uses a lacrosse ball or tennis ball:

Place the ball under the big toe. Make sure that the ball of the foot is touching the floor. Go into a lunge stretch. Hold for 30 seconds.

Another way to prevent or treat Sever's is to massage the calf muscle to keep it loose. This can be done by a massage therapist, or even your friend or parent who has been trained on the basics. You can also do massage on your own by using a lacrosse ball or tennis ball:

Sit on the floor and place the ball under the calf. You can use your leg to roll the ball around to find tight and tender areas in the muscle. Hold static pressure for about 30 seconds in each spot. You can also gently roll back and forth.

With Sever's disease, once you stop growing, your muscles will have time to catch up to your bone growth and any symptoms will go away. It is a condition that you recover from 100%! Furthermore, dancers who have finished growing don't have to worry about Sever's becoming an issue.

If you are currently experiencing symptoms, it is extremely important to avoid lots of jumping, standing, and walking. If you continue to put stress on the calf muscle and therefore the bone, you can cause permanent damage to the growth plate which affects the bone growth long term.

PLANTAR FASCIITIS

Now let’s switch gears to plantar fasciitis. It is a condition where the plantar fascia, the connective tissue at the bottom of your foot, is inflamed.

Symptoms are very similar to Sever’s:

• Pain with walking, standing, and jumping.

• Swelling at the bottom of the foot and into the Achilles tendon.

• Pain is along the arch of the foot and into the bottom of the heel.

Plantar fasciitis is typically caused by overuse, or when your amount of dancing and exercising increases very quickly in a short period of time, and there isn’t enough rest time. The plantar fascia gets overstretched and irritated and, at first, will require some rest time for the swelling to subside and the pain to decrease.

This is also a good time to gently massage and work the plantar fascia to bring blood flow to the area to assist with healing. Rolling out the foot with a lacrosse ball or tennis ball is a quick and easy way to do so:

You can roll out your feet throughout the day, but the most important time to do so is before you put any weight on your feet in the morning. Before getting out of bed, take some time to roll out the feet while sitting on the edge of your bed. When the plantar fascia is inflamed, it can get really tight at rest, like when you are sleeping at night. If you stand immediately after a full night’s sleep without stretching first, it can put lots of pressure on the plantar fascia all at once and cause more inflammation.

Once most of the severe pain has diminished, it is time to exercise the intrinsic muscles that are within the foot.

Here is one great exercise to start with to train the muscles in the foot:

Starting with the foot flexed, flex the big toe to reach towards the floor. Keep the little toes as relaxed as possible. Perform 15 repetitions. Then keep the big toe relaxed and flex the four little toes towards the floor. Perform 15 repetitions.

All of these exercises and stretches are also great at preventing both of these issues. They are great additions to Irish dance training and can be done as cool down exercises after class.

Being proactive is key, but if you are experiencing symptoms that appear like Sever’s Disease or plantar fasciitis and they are not going away or even worsening, definitely seek out a medical provider for help. Seeing a physical therapist, especially one who specializes in treating dancers, is a great place to start.

Dr. Nina Geromel is a Doctor of Physical Therapy and certified Athletic Trainer. Nina started dancing ballet at the age of two and a half and hasn't stopped since. Through her education, she completed a three year internship with Milwaukee Ballet as a student Athletic Trainer and currently treats dancers in Milwaukee, WI. Nina is also known as "The Pointe Doc" and provides online education to dancers seeking to start pointe. Her mission is to help dancers start strong, stay injury-free, and enjoy the process of achieving the goal of dancing on pointe, all while having fun! You can follow her on Instagram at @thepointedoc for more tips on keeping your feet strong and healthy.