Ballet dancers are highly susceptible to developing arthritic
ankles, according to a new study.
The study used magnetic resonance imaging (MRI) to view the
ankles of 11 female dancers with the National Ballet of Canada and
determined that all of them had some findings of arthritis in the
joints of their ankles.
While painful ankles are nothing new to dancers, the study
suggested that problems could be prevented if young girls, notably
preteens, waited to go ``on pointe'' until they were older and
professional ballerinas rested more between performances. ``On
pointe'' refers to dancers standing on the tips of their toes using
special shoes.
``Dancers all end up with very painful ankles,'' said head
researcher David C. Salonen, M.D., assistant professor of medical
imaging at the University of Toronto and division head of
musculoskeletal imaging at Toronto Western Hospital. ``But the
important thing here is that maybe we should look at modification
of the dance and less rigorous workouts, especially if we find that
the 'on pointe' position is something that may be leading to these
findings.'' As early as age 11 or 12, some girls begin going ``on
pointe.'' But Salonen said expanding the study should yield more
conclusive results.
``The major impact will come when we look at the rest of the
dance populations,'' said Salonen. ``This will include the male
dancers and jazz or modern dance to see if the distribution of
disease is different from what we're seeing in female ballet
dancers. Then we have scientific concern for the results we're
seeing.''
The research was presented December 1 at the 85th scientific
assembly and annual meeting of the Radiological Society of North
America in Chicago.
Two years ago at the beginning of the fall ballet season,
researchers performed MRI on both ankles of 11 female ballet
dancers. All were asymptomatic and did not complain of pain or
problems. In addition, all of the ankles were stable and had full
range of motion. But upon analyzing the MRI examinations in the 22
ankles, osteoarthritis -- caused by stress on a joint -- was detected in
10 tibiotalar, 19 talonavicular and 7 subtalar joints.
``This tells us the distribution of disease is very suspicious
for causality; that's the bottom line,'' said Salonen. ``If we
bring in the men and the distribution is different, then we've got
something that's pushing more towards causality.''
``We know that increased activity does lead to increased
susceptibility to injury and osteoarthritis,'' said Salonen. ``This
is something we're going to be faced with; in short order we're
going to see a lot of people with arthritic symptoms.''
Expanding the study would give it greater overall impact,
according to one arthritis expert.
``It's hard to know the significance of the study because they
had such a small sampling of people,'' said Dorothy Estes, M.D.,
professor of clinical medicine at the College of Physicians and
Surgeons, Columbia University in New York.
``I'm sure that all ballet dancers know that the kinds of
movements they do may cause stress to their joints,'' said Estes.
``And most ballet dancers have a pretty long career. If you want to
dance, you just do it and you know you may get arthritis because of
the usual stress. It's par for the course.''
