dr. sinkoe

Toenail Injuries in the Dancer by Dr. Sinkoe – Ingrown Nail/Infection

February 23, 2012 by 4dancers

An ingrown nail is usually referred to any condition whereby inflammation of the surrounding skin of the toenail is present. A “true” ingrown nail occurs when the nail does ingrow into the surrounding nail fold. This may result after the individual has lost the nail and the nail regrows abnormal. A chronically bruised and lost nail may result in an ingrown nail. This occurs because the nail root, nail matrix, has been injured and the nail is now “programmed” to ingrow abnormally.

However, the majority of the time, the “ingrown nail” results after the nail is cut too short within the nail grooves. Bleeding will occur resulting in a granuloma. A granuloma appears as reddish tissue within the nail groove. Granulomas attract bacteria and thus a bacterial infection can develop. The granuloma grows and covers the nail border, thus appearing as an “ingrown nail”.

Signs and symptoms: [Read more…]

Toenail Injuries in the Dancer by Dr. Sinkoe – Bruised Nail

February 16, 2012 by 4dancers

Toenail problems become a source of concern and agony for the dancer, particularly the ballerina on pointe. Toenails function to improve our tactile (pressure) sensation and to act as a support structure for the toe. This can be helpful for the dancer on pointe. However, because there is a lot of pressure on the nail while on pointe, bruising of the nail can result.

The underlying nail bed is highly vascularized. The nail plate is adhered to the nail bed via small ligaments. Repetitive microtrauma to the nail plate can injure the ligaments resulting in shear stress to the nail bed. A small amount of bleeding occurs under the nail. As the bleeding continues, the nail plate can elevate, producing calloused tissue and making the nail appear thick. A portion of or the entire nail plate can be lost.

This cycle usually repeats itself over a period of time. Many ballerinas accept the fact that they have chronically bruised nails. Long term consequences of a chronically bruised nail can be chronic ingrown nail borders, a deformed nail or a fungal infection of the nail.

Causes of a bruised nail: [Read more…]

Treatment of Warts in the Dancer By Dr. Sinkoe

February 9, 2012 by 4dancers

Warts are a virus which infects the outer layer of the skin. They are considered opportunistic and will enter the skin via a small wound or under a callous or blister. Thick calloused tissue grows over the developing wart and is painful. The surrounding area may also feel swollen due to the immunological response of the skin, reacting to a “foreign body”. Warts may occur as a single lesion or may be clustered forming several warts.

Causes in dancers: [Read more…]

Blisters And Corns Between Toes (Interdigital Lesions) by Dr. Sinkoe

January 26, 2012 by 4dancers

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 4^th and 5^th toes. The 5^th toe usually curls and abuts against the 4^th 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: [Read more…]

“The Perfect Arch” by Dr. Sinkoe

January 19, 2012 by 4dancers

Today we bring you the first in a series of articles for 4dancers by Dr. Sinkoe, a podiatrist from Georgia who works with the Atlanta Ballet. He was kind enough to share some thoughts on the best ways to help strengthen and improve your arch. Look for additional information from Dr. Sinkoe this month and next month on subjects such as warts and bruised toenails...

Dancers are always looking for ways to obtain that “perfect arch”. Every foot is genetically designed differently and not everybody will be able to achieve that “perfect arch”. Stretching and flexibility exercises are always helpful. However, I caution those that are attempting to achieve this position with the use of spring-loaded devices or placing their foot under the couch or other furniture to try to stretch the ligaments at the top of the foot. The midfoot joints are supported by strong ligaments and will allow the bones of the midfoot to only glide up and down. Attempting to make the midfoot joints act as hinge joints will injure the ligaments. If the ligaments are overstressed they can become weakened which can result in a sprained ligament or a subluxed joint.

The most effective method to strengthen the arch is to strengthen the foot muscles which stabilize the toes. These muscles are located on the bottom of the foot. Exercises to contract these muscles will flex the arch, giving you a dome appearance, thus the name “doming exercises”. Strong foot muscles will also reduce the incidence of tendonitis and metatarsal stress fractures. Experienced dancers will learn to use these muscles to stabilize themselves on pointe rather than depending on the pointe shoe to do the work.

Exercises for foot strength: [Read more…]

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