Today we welcome back Dr. Sinkoe with some information on something that plagues many dancers–blisters and corns between the toes–also known as “interdigital lesions”…
Corns and blisters between toes can be painful for a dancer. Pain is usually noticed with wearing all closed in shoes. In dance, the ballerina will have pain in pointe shoes, particularly when in demi-pointe. The most common location is between the 4th and 5th toes. The 5th toe usually curls and abuts against the 4th toe. The lesion may initially appear and feel soft but will harden over time. The softer lesion is usually a blister which will develop a callous. Dancers often attempt treatment with applying medicated pads which contain salicylic acid. This medication can injure the skin and result in a more painful lesion.
Treatment:
- Remove pressure from the painful lesion: medical grade lambs wool, gel pads or other spacers will assist in separating the toes and relieve pressure
- Clean the webspace well with soap and water
- Dry the webspace with a tissue
- Apply Betadine (iodine) solution or alcohol, as an antiseptic, at least twice daily
- Soak your feet in Epsom salt water with white vinegar twice daily
- Do not attempt to remove the skin as this will provide assess to bacteria.
- If redness or swelling is seen, notify your physician as this may indicate a bacterial infection
Prevention:
- Reduce moisture between toes: Dry flaky skin between toes suggest a fungal infection (athletes feet). Dry the toes well after a shower with a tissue. Apply white vinegar to the webspace twice daily. Apply anti-fungal powder between the toes.
- Properly fit pointe shoes: Longer toes require a longer vamp. Your toes will elongate as you grow and therefore your vamp will need to be longer. In addition, you may require a different shaped box as your feet change in size and shape. Rather than always ordering your pointe shoes on line, have a periodic evaluation by your pointe shoe fitter for appropriate sizing and fitting.
- Sickling: This will place excessive pressure to the outside of your foot pressing your 5th toe against your 4th toe. Have your dance instructor evaluate this as a possible cause.
- Knuckling of the toes: Knuckling of the toes will curl the toes, resulting in more friction between the toes. This can result when having difficulty in going up to pointe. The shank of the pointe shoe may need to be evaluated and/ or appropriate exercises/ technical changes need to be addressed.
BIO: Frank Sinkoe, DPM is a native of Atlanta, Georgia who has been practicing podiatry in Atlanta for 23 years. He has a general practice in podiatry and a subspeciality in dance medicine. Dr. Sinkoe serves as the podiatrist for the Atlanta Ballet and is a member of the International Association for Dance Medicine and Science (IADMS). He is married with two children. Reach him at 404-329-5050 or by e-mail at doctorfrank (at) bellsouth.net
As a podiatrist I can tell you that we see many patients in clinic with the corns , dancers, gymnasts and runners tend to be more prone to the inter digital and plantar corns. What you must not do is use corn plasters! We see so many patients in clinic that use a corn plaster and burn healthy skin, the salicylic acid tends to spread over the corn. It also makes it very difficult to remove with a scalpel as its hard to find the root of the corn. Apart from correctly fitted shoes some dancers over pronate as they move which means they turn their ankles in too much, this can lead to corns. So its important that any biomechanical problem is addressed.