General Dance Discussion > Podiatrist Says: Hallux Limitus

Discussion in 'General Dance Discussion' started by demoiselle, Oct 10, 2014.

  1. demoiselle

    demoiselle Active Member

    So, I finally took myself to the podiatrist, as I should have ages ago, and the diagnosis for my sharp, occasional toe pain is Hallux Limitus, probably stage one. Basically, at some point I injured my big toe (perhaps due to inappropriate shoes) and since then, I've gotten a bit of bone deposit.

    The solution is to NEVER wear heels, always wear orthodics, either in tennis shoes or other, non-heeled shoes. The injury/problem predates me taking up dance, and the podiatrist sees no reason that I shouldn't be able to continue dancing, so long as I wear the orthodics in my dance sneakers. I'm glad about that.

    I do have some feelings of disappointment and chagrin, though. My problem isn't severe YET, and I gather that if I wear proper footwear, I'll be OK, but I'm struggling a bit with the fact that I won't have many footwear options *for the rest of my life*. I'm only 34!

    So, goodbye to all the Argentine Tango partners who will look at my dance sneakers or possibly other flat dance shoes and choose not to partner with me. And I guess, goodbye to any hope of someday choosing to enter competitions (right?) or possibly showcases.

    Hopefully, as I move on to more advanced levels, teachers will find a way to work around my footwear and won't try to convince me to wear heels to dance.

    Has anyone else here had a like diagnosis? Have you managed to keep dancing with orthodics in your shoes? I'm going to follow the doctor's advice, since I gather had I waited a couple more years, I might have ended up in constant pain instead of occasional.

    Comforting words would be appreciated.
     
  2. leee

    leee Well-Known Member

    I'm sorry to hear that, but as your doctor mentioned, it's not the end of your dance world! My flat feet (and an early pair of ballroom shoes that were too small) have left me with painful bunions, but I always wear my (custom) orthotics when I dance, going on a couple years now. Of course, I'm dancing swing pretty exclusively now, in which case flats/sneakers are perfectly acceptable. Just make sure that there's some kind of shank or support beneath the orthotic (yes: support for the support) and you'll be able to dance without pain.
     
    demoiselle likes this.
  3. Steve Pastor

    Steve Pastor Moderator Staff Member

    Those of us who have been around for a while know that you don't always get what you see; And sometimes you might.

    From my perspective, if you resist the temptation to dance on your toes (read, with your heels noticeably off the ground, or, heels down but unweighted) and keep a nice "straight line" from heel to head, you will look like you are "grounded" and very possibly a good partner for someone who knows how valuable that can be.
    Maybe you'll find that only the better guys will dance with you.

    Congratulate yourself on being smart enough to have the situation evaluated.

    And maybe i shouldn't even go here but...
    You MIGHT find that you can allow yourself SOME time dancing in "inappropriate" shoes without making things worse. Listen to your feet! if you have ANY discomfort, change shoes. IF you try.

    I've had various foot, ankle, etc problems over the years, and they've all gotten better, to the point where they go away, once I take appropriate measures; which might include rest or not doing certain things any more, or using a different technique.
    I've been using SuperFeet insoles in all my shoes for.. can't remember how long.

    You might want to spend some time looking for articles like this one.
    http://www.podiatrytoday.com/when-patients-insist-wearing-high-heels
     
    demoiselle likes this.
  4. demoiselle

    demoiselle Active Member

    Thank you for the comments! I'll go read the article. I can't help but feel a bit short-changed that I have developed a foot problem. I don't even wear heels or dress shoes. For years, I wore just the kind of shoes that you are supposed to for good support. But I had to go to a conference and got two pairs of dressier flats, and during that conference is when the problem first started.
     
  5. Steve Pastor

    Steve Pastor Moderator Staff Member

    Well, I bought Keen shoes for the extra big toe box, and now I have maybe a corn on my one toe that wasn't there last year. Or maybe it was the mountaineering boots I wore while training for and climbing volcanoes this summer. No discomfort, just looks kind of awful. Keeping it padded, and wearing my Teva sandals a lot, and will have it evaluated when I get my yearly physical in a month or two.
    Just another day in the life.
     
  6. Loki

    Loki Well-Known Member

    Not comforting, however...

    I know three follows who let hallux or hallux-like conditions go too long or ignored the docs and danced in "bad" shoes. They all wound up having surgery. The good news is the surgery helped a lot, although in one case the damage was so severe that her foot will never be 100% and her recovery was long.

    The takeaways are that you got to your doc early, the damage is not as severe as it could be and you need to monitor the condition and follow your doc's advice.
     
  7. demoiselle

    demoiselle Active Member

    That is my plan--take care of my feet! I won't ever get a new set, and I'd prefer not to have to have surgery. I don't think it'll actually be a big change for me, since I never have worn heels much, or even shoes that are significantly different from the ones I'll "have" to wear now. It's more of a reluctance to admit that I *can't* have that option anymore than it actually being a big change.

    Though heels seem to be such a "thing" in dancing, it does make me a bit sorry that I won't be able to wear "appropriate" shoes for different styles. I could try to "get away" with it from time to time, but the pain when I do have it is sharp enough that I don't want to mess around. I've never gotten it while dancing (in my flat shoes), and hopefully I never will.
     
  8. dncergrl

    dncergrl Active Member

    I have this condition. Had surgery on one foot about 5 years ago and should have had it decades earlier. Other foot is probably due in next 2 years. I put off surgery until the pain was so bad, I could not tolerate wearing socks and I had to wear rocker sole shoes all the time. Now, after surgery, I can wear 2" heels but it hurts. I really have to use my heels time sparingly. I realize I am damaging my toe joints, but… I would advise seeing a physiotherapist. My toe joint get jammed, which contributes to the pain and the growth of bone. I learned how to distend it and give the joint more space. I also ice regularly and use ibuprofen. By the way, my right foot is not 100% but it is miles better than the way it was. Only frustration is when pro complains "Why can't you balance? why you falling over"? All I can think is, "Honey, get back to me in 30 years". By the way, if you do have surgery, the key to a successful outcome is to stay off your feet for 6 weeks with your foot elevated above your heart, like on a couch. The people I know who did not do this and only rested when their foot hurt, had a much worse outcome than I did. Personally dancing in flats is better than not dancing at all. It is possible to get soft orthotics for heels, but they never worked that great for me. I also use Jill's Gels and rig up my own orthotic-like contraption in my shoes.
     
  9. jfm

    jfm Active Member

    i have it, podiatrist said the same thing to me. I spent two years miserable thinking I could never wear my heeled dance shoes again, but you know what? I took a risk and discovered that after wearing the orthotics and switching down to 6.5 cm/7cm heels for 4 hours of dancing a week I have almost no pain and i don't believe the bone deposits have gotten bigger.
    As long as the weight is on the ball of your foot not the toes/toe joints the heels don't seem to have an effect on it if it's only a few hours.
     
  10. demoiselle

    demoiselle Active Member

    Thank you both for your feedback! After having let a few days pass, I have realized that this really isn't going to be a problem for me. Like many sad things in life, this is about letting go of a fantasy rather than reality. I don't dance in heels as it is, and considering how little I like wearing them, I probably wasn't going to start dancing in heels any time soon.

    I'm really lucky. Nothing really has to change. I don't need to cut back on my dancing. I'll just have to wear orthotics in my same old shoes, which I already like, once I get them.

    Worth it. And a good reenforcement for my previous plan to focus on becoming a good social dancer/fun person to dance with rather than a performer.
     
    tancos and raindance like this.
  11. Steve Pastor

    Steve Pastor Moderator Staff Member

    Like

    (just in case I can't like my post of your quote!)
     
  12. demoiselle

    demoiselle Active Member

    Since other people have said they have this condition, and new visitors to the forum may search, I will keep updating this post with information about my experience as time passes.

    On Monday, I'll be getting my x-rays and cast for orthodics.
     
    novemberecho likes this.
  13. novemberecho

    novemberecho Member

    dncerglr, would you be willing to talk to me more about your surgery (here or pm)? I have hallux rigidus in both feet and have been referred for surgery (not necessarily immediately), but I'm afraid it will end dancing for me. It's been hard to find personal accounts of the surgery & recovery, specifically in athletic people who want to return to activity, and even more difficult to find accounts from dancers. I have a million questions. :)
     
  14. demoiselle

    demoiselle Active Member

    Novemberecho, I will let dncergrl answer your question. I'd be glad to hear what she has to say.

    My update is that on Monday I went back to the podiatrist to get my xrays and have casts of my feet made for the orthodics. The good news is that apparently I have caught the condition before there has been much damage! There was no arthritis in my joints. In about four weeks I will get the inserts for my shoes. I'm not to use them dancing until I've gotten very used to them in my normal, day-to-day activity.

    Now that I know what kind of shoes I need to wear, I'm managing to avoid those that were causing problems. No pain.
     
    novemberecho likes this.
  15. dncergrl

    dncergrl Active Member

    November, I am more than happy to tell you my story, although each person is unique. I consulted with 2 podiatrists and 2 orthopaedic surgeons before deciding who to go with. In the end, I chose the guy who really respected that I wanted to dance and worked with me. The others were ready to pat me on the head, fuse the joint and tell me to return to my knitting. Post surgery, my foot was better than before but not good as new. I'll take it. It is important to let the bones heal fully and then work on range of motion after the surgery even though it hurts. But nothing and I mean nothing is going to stop me from dancing. I know people that dance in wheelchairs and with hip replacements. I danced in gawd ugly, velcro, rocker sole sandals at my most painful pre-surgery. And someday I may have to return to them. There are lots of ways to compensate for wonky feet. So it is all workable. And I highly suggest finding a physio that knows about feet. My pod said I didn't need it, but it helped immensely and now he knows the good it can do and he gives me advice about which foot muscles to work on to support the joints. He was just unaware how PT could help at first. Don't despair. PS We can talk if you like….
     
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  16. Steve Pastor

    Steve Pastor Moderator Staff Member

    I have to say that reading this is kind of inspirational. When I look through Dance and Dance Spirit magazine, they often have information about injuries and other physical problems , and who would be the appropriate professionals to go to for treatment. So, it's good to read about it actually happening.
     
  17. dncergrl

    dncergrl Active Member

    I could literally not dance like I do, without my team of physiotherapists, podiatrist and massage therapist but key, are my physios. Even if they start out not knowing about the requirements of a dancer, if they are keen they learn, they do and it is a question of working together with them and building a relationship and so they can learn your body. I have to say, they tell me I am one of their few patients who actually does the exercises they prescribe, so it is a two way street. I don't want to confess to how old I am but I have gone through my share of injuries and overuse effects as well as coping with the wear and tear of time. But I adore my team. I have also ditched some duds along the way, but the gems are out there.
     
  18. Steve Pastor

    Steve Pastor Moderator Staff Member

    Me neither.
     
  19. leee

    leee Well-Known Member

    Me three.
     
  20. novemberecho

    novemberecho Member

    thank you!
    so glad you get this, so I can skip the 'dance is my oxygen' bit.

    I am no spring chicken but fairly young for the severity of arthritic problems I'm having (told by one orthopedist that my knee joint looked 20+ years older than my actual age after an arthroscopic surgery a few years ago).
    Arthritis has resulted in bone spurs on top of both big toe joints and greatly reduced range of motion.
    In the past four years I've seen 4 different ortho foot/ankle specialists, & a podiatrist who works with a local ballet company. I have stopped wearing heels completely, except for in dance, but I wear low heels (1.5" in both practice and court shoes) with custom made orthotics. Sometimes I wear the rubber soled dance sneakers but they're not conducive to proper technique/footwork (I only dance competitively).
    The concensus among all these doctors is, there are limited things I can do for pain management (doing them all) and eventually I'll need surgery. One of them quite directly said, "You can keep dancing as long as you can tolerate the pain. When you can no longer tolerate the pain, you can either stop dancing, or have surgery."
    So many concerns about the surgery though; at top are the recovery time (up to a year for full recovery?) and what state my foot (feet) will be in after that. I know from prior surgury they will never be "the same."
    And now with the questions:)

    What kind of surgery did you have? (options I've looked at are cheilectomy, replacement, or fusion - the cheilectomy is the only one I'm really considering at this point).

    Are you seeing a PT as part of post-op treatment, or some other reason? Luckily I know an exceptional PT in my area but I've only ever seen her for post-op or specific injury treatment. I'm not even sure what I'd ask her for help with in this case.

    Sounds like you consider your surgery a success. Would you make the same decision to do it again? Would you do anything differently?

    Did you, or would you, consider having both feet done at the same time? I've had at least one doc recommend against that, but when I think in terms of recovery time, 1 year sounds a lot better than 2.

    Do you expect your surgery to be a long term or permanent solution? I ask this because I've been told in my case, it will not. They say if I have it I may get 5-10 good years of foot use (if I'm lucky), but the condition will return, since there's no cure for arthritis, and eventually I will end up back where I am now or worse (naturally dancing like I am speeds up the deterioration).

    there might be more... :)
     
    Last edited: Oct 24, 2014

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