Are Orthotics Bad for Dancers?

A very common misconception I’ve heard is that foot orthoses (or ‘orthotics’) work similarly to ‘crutches’, ‘holding up’ the arch of the foot and thus, allow the muscles acting on the feet and ankles to weaken due to not having to work to support the arch of the foot.

If this misconception were true, there would be significant concern for their use in dancers who require a great amount of foot strength and coordination. It’s lucky that this explanation is a long way from being a true description for the goal of functional foot orthoses.

Where does the myth come from?

There are two main goals for implementing an orthotic:

1. To optimise dynamic foot function. These orthoses are designed with the goal of acting on the forces and movement patterns to make gait more efficient. These are known as functional foot orthoses or devices.

2. To accommodate deformity or offload specific areas of high pressure. These orthoses are often designed to cushion the foot, offload a specific area where a patient may be prone to ulceration or corns and/or add height to one or both sides in the case of significant, diagnosed limb length discrepancy. They do not aim to change the dynamic forces acting on joints of the feet. These are known as accommodative foot orthoses or devices.

From a podiatrist’s perspective, an accommodative devices would be the most similar to a ‘crutch-like’ device, however that description is still a misrepresentation. The important thing to note is that these devices are rarely, if ever, prescribed for dancers!

In the case of a dancer, or someone with a recent history of injury, pain or increased requirements of the feet and lower limbs, a functional foot orthotic is the go-to with the specific goal to affect dynamic foot function. So no, especially where dancers are concerned, orthotics prescribed could seldom be compared to a ‘crutch’ in any way!

Then, what can functional foot orthoses do for dancers?

Functional orthotic prescriptions in most cases are custom designed for each individual person and their needs, so the following are just a few ways they can be commonly utilised to help dancers!

• Improve forces and mechanics acting on the function of the first toe - this can decrease risk of bunions, improve pointe range, assist with building a strong demi-pointe and in some cases, decrease risk of a dancer’s fracture (stress fracture of the 2nd metatarsal bone), and/or decrease pain in the arch or the ball of the feet.

• Improve lateral ankle strength and proprioception over time - this can assist to reduce sickling, lateral ankle sprains and instability, build a strong demi-pointe, improve supported ‘fishing’ of the foot and/or decrease pain in the ankle or lateral (outside) of the feet.

• Improve the forces and mechanics acting on the toes - improves intrinsic foot strength, pointe range, extension of the foot and ankle to build those supported ‘banana’ feet, reduces likelihood of developing claw toes, hammertoes, neuromas, corns, callus, blisters and a list of other pain in the ball of the foot and toes.

Whilst functional foot orthotics would not be worn during dance activities or class, the benefits of wearing functional foot orthotics to optimise gait and the forces acting on the feet have the potential to greatly assist dancers beyond their time spent wearing functional foot orthoses in most cases. Podiatrists are the experts in assessing and prescribing functional foot orthoses for everyone’s individualised goals!

Not everyone requires functional foot orthoses, but they can assist in most cases. There are many other options a dancer could chose to assist with improvement in the feet, ankles and legs, it is just a matter of aligning each dancer’s goals with the ideal treatment plan.