Having high arches is seen as an asset in many dance styles. As a dancer with normal arches (boring!), I followed the advice of every “improve your feet with __!” article I could find: exercises, “massaging” the soles of my feet with a golfball (ouch), and, of course, the beloved foot stretcher. I have learned that “improve your feet with __!” can mean many things. Before PT school, I always interpreted it as “improve the way your feet look with __!”, because the article was targeted at dancers, and dance is an art form that thrives on aesthetics. Everyone is asking “how can I improve the aesthetics of my feet?” when we really should be asking “CAN I improve the aesthetics of my feet?”
This post will cover the different types of foot arches and what physical changes are possible with the foot that can improve dance aesthetics. Let’s start by taking a peek at the anatomy of the foot. There are 26 bones, 107 ligaments, 33 joints, and 29 muscles and tendons that make up the structure of a typical foot9. Ligaments connect bones to other bones, which form joints, while tendons connect muscles to bones. Located at the bottom of the foot is also the plantar fascia, a thick band of connective tissue that runs from the heel bone to the toes. Let’s take a look at the bones and arches of the feet.
The foot has multiple arches: the primary ones are the transverse arch and the medial longitudinal arch (MLA); these provide stability and mobility5. The MLA is the arch we dancers are referring to when dishing out compliments – “your feet are AMAZING!” You’ll notice in my drawings that I’ve made especially sure to identify the navicular bone – this bone is a key player in determining the height of the MLA5. Without the navicular bone, the entire arch collapses. The surrounding bones, ligaments, and muscles assist in maintaining the structure of the MLA5 .
In dancers with normally arched feet, known as “pes rectus” in PT, the MLA provides a springy and elastic connection between the heel and the ball of the foot, allowing for shock absorption – for example, when landing from a jump in dance5. Since the MLA is a prime shock absorber, the height of your arch affects how the body absorbs forces in other joints and muscles – especially those of the ankle, knee, hip, and lower back3. You can think of this arch as an adaptable and supportive base for the body5.
In dancers with highly arched feet, formally known as “pes cavus”, the MLA does not have the same springiness and elasticity. While aesthetically pleasing in dance, these feet are often described as being “rigid” and “non-shock absorbent”3. High arched feet also have a reduced contact area with the ground – peep those footprints below. As a result, these feet are more at risk of developing metatarsalgia (pain in the ball of the foot) and plantar fasciitis (pain from inflammation in the plantar fascia), a tightened Achilles tendon, and claw toes. This is because of the unequal distribution of weight through the feet caused by high arches3, 5. Overall, those with high arches are 60% more likely to experience a higher incidence of foot pain in comparison to those with normal arched feet3.
In dancers with lower arches or “flat” feet, a.k.a. “pes planus”, again the MLA does not provide the same springiness and elasticity as those with normal arches. Those with flat feet have decreased ligamentous support which causes the navicular bone to drop, losing the domed appearance of the arch. On a positive note, having decreased ligamentous support allows for the foot to be flexible and adaptable to ground surfaces5. Since the arch is lower, there is more surface area in contact with the ground, reducing a person’s risk of developing pain in their feet. A common theme seen in those with flat feet is the foot appearing to “roll in” which is formally termed “pronation”. While these dancers may experience fewer occurrences of pain, they are still at an increased risk of injury compared to dancers with normal arches. The flexible flat foot requires more muscle activation to propel the body through space. As a result, the 29 muscles relating to the foot and ankle are working overtime and may fatigue much faster than those with a normal or high arched foot. These individuals are less likely to complain of their feet hurting, and more likely to complain of their feet being tired5.
So, CAN I improve the aesthetics of my feet? – In short, it depends. When it comes to foot aesthetics in dance, the foot arch and how much range of motion the ankle has when pointing the foot are considered. It is not possible to increase the height of an arch with training, stretching, massage, devices, etc. The arch height is determined by genes, but can change if a person has an underlying health condition or experiences trauma to their foot (no, this does not include pointe shoes…) But, a dancer may be a candidate for improving their ankle range of motion when they point, a.k.a. “plantarflex”. One way to assess if more plantar flexion is achievable is the Pencil Test4.
Pencil Test
- Sit on the ground with your legs extended in front
- Point your foot and have someone place a pencil on top of your ankle joint
- If the pencil lays flat, then maximum plantar flexion has been achieved. If the pencil lays at an angle, a greater range of motion may be achievable by stretching the foot in a pointed position. Hold the stretch for no longer than 30 to 60 seconds. Holding a static stretch any longer than 60 seconds does not correlate to a range of motion gain, but it does correlate to an increased risk of injury2.
What about the exercises stating they improve the foot arch? Two main exercises, the “Towel Scrunch” and the “Short Foot Exercise” have been proposed to help lift the navicular bone by strengthening the muscles located on the bottom of the foot and connecting to the MLA. These exercises have been debunked by research. One study measured the navicular bone height of 30 healthy participants (15 males and 15 females) that were divided into three groups: the control group, the towel scrunch group, and the short foot exercise group. Baseline measurements were taken of the navicular bone height in all of the participants, as well as their ability to maintain balance on one leg while standing still and while moving. Participants completed 100 repetitions daily of their assigned exercise for four weeks. At the end of the trial, the navicular bone height and the balance exercises were reassessed. No participants from any of the three groups experienced significant changes in navicular bone height. Those participants in the groups that were assigned exercises did, however, experience an improved ability to balance on one leg, with those in the Short Foot Exercise group showing the greatest improvements7. Other studies have found similar results8.
Can dancers without high arches have a successful professional ballet career? Absolutely! Research that is dance-specific is seriously lacking compared to other sports (are you surprised? I’m not!). I did come across a Polish study comparing the foot arches of 44 elite professional ballet dancers to the arches of 44 medical students with no prior dance training. The purpose of the study was to see if ballet training causes a change in the biomechanics and neuromuscular control of dancers’ feet. The study measured the arch heights of the participants’ feet. Surprisingly, they found only 9% of the 44 professional dancers to have higher arches, 81% to have normal arches, and 10% to have lower arches6.
The study proposes the reason there are fewer dancers with higher arched feet than anticipated is a result of that foot type not being able to sustain the technical requirements of ballet. For example, being en pointe generates a force of 10 times the dancers’ body weight, and grand jumps such as a grand jete, sissonne ouverte, and grand pas de chat generate a force of four to nine times a dancer’s body weight. Over time as a high arched foot loses its flexibility and becomes more rigid, these dancers are at an increased risk of sprained ankles and stress fractures. The decreased ability to absorb forces through the joints may result in a shortened performance career6.
They also did not find a correlation between arch height and years of training, determining that ballet does not alter foot arch heights. Meanwhile, the researchers did find an increase in neuromuscular control in all foot types compared to the non-dancers6.
DISCLAIMER: I am not a Physical Therapist (yet), so I can’t be your physical therapist – I can’t offer advice that directly relates to your foot since I am not physically examining your feet. But, I will share some general recommendations. The following is NOT medical advice – it’s just my opinion.
Taken with a grain of salt… For those with high arches, consider stretching the calf muscles and strengthening the ankle everters a.k.a. the muscles responsible for “winging” in ballet. This helps to balance and support the ankle and MLA in high arches2. For those with low arches, an emphasis should be placed on the foot and ankle muscle strengthening to improve muscle endurance and decrease the rate of fatigue – hello theraband exercises!2 I recommend stretching and strengthening exercises be completed at the end of your dance day. Since both high and low arches are poor shock absorbers, dancers with these types of feet should be mindful of the floor they are training on. In a perfect world, every studio would have sprung floors to help absorb shock and decrease injury rates, but I know some studios aren’t able to invest in such a (necessary) luxury. Taking time to dynamically warm up feet, ankles, knees, hips, and back before dancing will help to lower the predisposed risk of injury. I also think setting time aside – yes, even during performance season – is important to take care of your feet. This may include self-massaging the soles of your feet, gently stretching your toes out, and rolling your ankles around while seated to move some of the inflammation out of the area.
I hope this post brings insight on how to reduce your injury risk for dancers with high and low arches. If you are like me, you get frustrated about how your feet don’t have the desired “perfect point” aesthetic, try redirecting that energy into something you can control in your dance training such as – working on your artistry, and musicality, performance presence, etc. There is so much to explore within dance movement!
One last -fun fact- relating to foot arches: during pregnancy, many people experience their shoe size permanently increasing. This is due to the position of the navicular bone changing in response to pregnancy hormones to help ligaments become lax to prep for delivery. The increase in body mass during pregnancy combined with the lax ligaments causes a shift in the center of pressure through the feet and results in the navicular bone dropping in height. Feet don’t “grow bigger” during pregnancy, arches just become flatter- increasing the total length of the feet1. If they’re dancers, pregnant individuals should be re-fitted for dance shoes during and after a pregnancy 🙂
In the medical world, we refer to the key takeaways of a topic as “Clinical Pearls.” For funsies we can call these “Studio Diamonds.”
Studio Diamonds
- The foot arch height is based on genetics and cannot be altered through exercises, stretches, or the foot stretcher
- There are three categories of foot arches: high, normal, and low
- Dancers with high arched feet are more likely to experience their feet being in pain, while dancers with low arched feet are more likely to experience their feet feeling tired
- A dancer can use the Pencil Test to screen for the potential range of motion increase from stretching their ankles in the pointed position. Static stretching (holding a stretch position) should be limited to 60s max. Anything greater than the 60s may result in tissue failure and injury.
- The “Towel Scrunch” and “Short Foot Exercise” are beneficial exercises for improving neuromuscular control of the muscles located on the bottom of the foot
- Regardless of your arch type, you can have a successful dance career!
Lastly, if you experience pain when you dance please consult a licensed physical therapist or your healthcare provider.
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References
- Awad et al. Effect of Arch Support on Prevention of Foot Pain During Pregnancy. The Medical Journal of Cairo University. Volume 87, Issue 2. March 2019. DOI:10.21608/MJCU.2019.52708
- Behm DG, Chaouachi A. A review of the acute effects of static and dynamic stretching on performance. European Journal of Applied Physiology. November 2011. DOI 10.1007/s00421-011-1879-2.
- Burns et al. The effect of pes cavus on foot pain and plantar pressure. Journal of Clinical Biomechanics. March 2005. doi:10.1016/j.clinbiomech.2005.03.006
- Currey et al. Performing Arts Medicine. Physical Medicine and Rehabilitation Clinics of North America. Volume 31, Issue 4. November 2020. https://doi.org/10.1016/j.pmr.2020.08.001
- Franco A. Pes Cavus and Pes Planus: Analyses and Treatment. Physical Therapy and Rehabilitation Journal. May 1987. https://doi.org/10.1093/ptj/67.5.688.
- Gorwa J, Michnik R, Nowakowska-Lipiec K. In Pursuit of the Perfect Dancer’s Ballet Foot. The Footprints, Stabilometric, Pedobarographic Parameters of Professional Dancers. Biology Journal. May 2021. https://www.mdpi.com/2079-7737/10/5/435.
- Lynn S, Padilla R, Tsang K. Differences in Static- and Dynamic Task Performance After 4 Weeks of Intrinsic-Foot-Muscle Training: The Short-Foot Exercise Versus the Towel-Curl Exercise. Journal of Sport Rehabilitation. November 2012. DOI: 10.1123/jsr.21.4.327
- Mulligan E, Cook P. Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic function. Manual Therapy Journal. February 2013. http://dx.doi.org/10.1016/j.math.2013.02.007
- Riegger C. Anatomy of the Ankle and Foot. Journal of Physical Therapy. Volume 68, Issue 12. December 1988. https://doi.org/10.1093/ptj/68.12.1802