We have all sat and watched a beautiful ballerina or an Olympic gymnast perform, and applauded at the end of the performance. But how many of us have paused to consider the demands dancing places on their feet and the possible injuries dancers may develop during such performance or long hours of practice.

Dancing is excellent exercise for the whole body. If you love dancing for exercise -- from ballet, hip hop, salsa, calypso, Zumba, gymnastics or any other forms of aerobic dance -- you must know dancing places significant physical demands on the feet and ankle and increases your child's risk of injury. In addition, the type of footwear or lack of correct footwear used during the dance can also put the feet at risk for injury. The various positions and steps performed during the dance routine put pressure on different parts of the foot and cause injuries to these parts of the feet. For example, ballet dancers have added risk of foot and ankle injury because of specific positions such as "en pointe" and "demi-pointe", which can add stress to the toes and ball of the feet.

The most common injuries seen in dancers may include:

Dancer's fracture or fifth metatarsal fracture: This is often the result of landing awkwardly on the outer side of the foot or twisting of the ankle.

Lateral ankle sprain: A common injury among all athletes. This may happen from landing awkwardly after a jump or twisting the ankle especially on uneven surfaces.

Bunions (Hallux Valgus): These do not usually develop because of dancing, but may be made worse by wearing tight fitting shoes and irritation to the big toe joint.

Stress fractures: These may result from too much dancing or dancing for too long, which causes stress and weakens the bones. This most commonly happens in the second metatarsal and may cause pain and swelling.

Ankle impingement syndrome: This cause pain to front or back of the ankle related to bone pinching the soft tissue when the ankle is pointed in one direction or the other. Over time this can progress to arthritis to the ankle joint.

Trigger toe or tenosynovitis: This results when a tendon cannot glide within its canal causing it to get stuck. This prevents the big toe from being able to move freely up and down and sometimes getting stuck in one position.

Sesamoiditis, hallux rigidus, plantar fasciitis and Achilles tendonitis: These are common injuries to the foot seen with overuse and repetitive trauma that occur while dancing.

All forms of dance place unique stresses on the foot and ankle. While the level of participation varies from recreational to professional, dance remains one of the most physically demanding activities on the musculoskeletal system and especially the feet. The hours of practice in dance may improve strength, flexibility, and balance. But sometimes overuse or chronic injury can occur.

Tips to prevent dance injuries:
Don't be extreme: Start your dance routine slowly and gradually, and increase the frequency, intensity and the duration of your exercise to avoid dance-related injuries and to safely and effectively partake in dance fitness. You may need to take a beginner's class before heading to the advanced. Start by taking one or two classes a week instead of one class every day.

Take the time to warm up: Always stretch gently and warm up for a few minutes before a dance class by doing light exercise. This will allow your muscles to loosen and warm-up and be better prepared for the workout. You can also get to the gym a few minutes early and do some cardio, like walking on the treadmill, running on the elliptical or riding the stationary bike to get your body ready to boogie down.

Cool down too: It is just as important to cool down after a workout as it is to warm up before. Your muscles will recover faster, reduce your risk of injury and you will feel better. This will prevent lactic acid build-up and any unnecessary injuries that might occur from tight muscles if you just walk out of the class and head on with the rest of your day."

Focus on proper technique: Proper technique is a vital ingredient in preventing dance-related injuries. Turning your body the wrong direction or holding a position incorrectly can instantly lead to injuries -- pulled muscles, strains, sprains and even fractures. It is important to listen to your body. If something doesn't feel right or if you have pain don't do it. Paying attention to your dance instructor to learn proper dance moves as well as ask questions about how to do the moves can be a big help.

Wear proper footwear: Before you start a dance-fitness class, ask the dance instructor for the footwear recommendations. You might be able to get away with using your regular running shoes for a while, but if you plan on dancing often, it is best to invest in the correct footwear to prevent injuries.

Cross train: Most dance routines will give you a full-body workout, but doing only one type of workout puts you at risk for overuse injury. Many injuries can be prevented with improved posture, flexibility and strength. Instead of doing only dance classes every week, a couple days of week add a strength training class, a Pilates class or another type of cardiovascular workout to exercise the muscles you don't use regularly with dance, and allow the dance muscles to rest in between workouts. Not only will you reduce your risk of injury, but you will also get fit faster and avoid burnout.

If you're hurt or injured, here's what to do: If you do get a dance-related injury, it is important to take a rest from dance class and start on the road to recovery. It is best to follow the PRICE (protect the injured area, rest from activity and dance, ice, compression bandage or wrap, and elevate an injury to decrease swelling) approach to prevent further injury and help with healing.

If pain and swelling persist, it may be time to see the podiatrist for an evaluation and treatment of any injury that is present. Early diagnosis and treatment of injuries helps to prevent long-term complications and allows a safe return to your dance routine. Specific stretching and strengthening exercise or physical therapy may also be recommended.

o For more information email foothealth242@gmail.com or visit www.apma.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820, or Lucayan Medical Centre on East Sunrise Highway, Freeport Grand Bahama, telephone 373-7400.

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