If you have never worked with dancers, you may not appreciate that working with dancers can be very challenging, whether it involves a 10-year-old, a professional dancer in their prime, a retired dancer, or someone who likes dancing recreationally. Perhaps surprisingly, the key to a successful treatment outcome may all come down to the dancer’s “long big toe flexor,” or “Flexor Hallucis Longus” (FHL). This muscle is responsible for many common dance moves, such as rising up onto their toes (relevé), and probably the most overlooked muscle responsible for several musculoskeletal complaints and injuries. Tendonitis of this muscle is so common among dancers that it is commonly known as “Dancer’s Tendonitis!”
During and following the COVID-19 pandemic, there was a significant shortage and backorder of pointe shoes, making dancers wear their shoes too long, dancing on “dead shoes,” and overusing the FHL. Dry needling the FHL can make all the difference in regaining range of motion, especially when combined with education, myofascial release (roller or ball), and stretching the muscle.
“The PTs at the Ballet can always predict FHL issues when the company is working on a Balanchine piece or other choreography involving multiple small jumps without letting their heels touch the ground,” says Mandy Blackmon, Medical Director of the Atlanta Ballet and Myopain Seminars Dry Needling Instructor. “We joke that we should just line the dancers up before each performance and needle their FHLs…..”
Mandy Blackmon, PT, DPT, OCS, CMTPT/DN
Photo by Nihal Demirci Erenay on Unsplash
