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Professional ballet dancer with stress fractures in both feet

Now 22, this ballerina has been a patient of mine for 8 years and has seen me for lots of ballet-related injuries. She's already been a member of the corps de ballet of two of the top metropolitan ballet companies in the USA. She reduced her dance schedule to get an undergraduate degree at Princeton, then resumed dancing as a guest soloist in a big-city production of The Nutcracker. Unfortunately, the combination of her rather rapid return to elite-level dance and being given more roles to perform in this production than any of the other dancers led to stress fractures in each foot, which ended her personal Nutcracker season. Through removable walking casts, physical therapy, bone stimulator machines, and an incredibly short rest time, she now after only 4-1/2 weeks appears clinically ready to resume relevé in preparation for return to dance in 10 days, after we have our follow-up MRI.

Amongst the things we discussed today was how she should approach her relevés. As her stress fractures were at the bases of her metatarsals, which occur especially in pas de bourrée en pointe, I advised her to do her rudimentary ballet barre as she would in a flat, not pointe class, but use a dead pair of pointe shoes, rather than ballet slippers, for added support. If the stress fractures had occurred in mid-metatarsal shaft, I would have advised her to take a pointe barre.

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