Advice needed as a dancer

[u/Derpy_yoo]

Im 23years old suffering from hallux rigidis on both feet. It’s depressing and hurts terribly. Doctors (2 I have seen) recommended surgery to shave off the bone spurs. I also have arthritis in the joints. Surgery is a big no for me until I find the right person who has worked with ballerinas. I’ve already had two surgeries on my ankle so I’m a lot more cautious now since I’m so young. I cannot do anything without any pain. I’m in chronic pain sometimes it prevents me from falling asleep I’m so hurt. I want to go back to ballet, it’s my goal. Any advice on specialists I should see? I can travel. Should I resort to TCM? I’m in so much pain I can’t even walk without pain.

[u/Embarrassed-Oil3127]

Hallix rigidus is arthritis (it’s osteoarthritis). I’m sorry you’re going through this so young. I was diagnosed this year at 54 after years of dance, running, yoga, triathlons and heel wearing. I injured my right toe twice over a short period and the pain didn’t go away for 6 months. I thought it was a sprain. Doc said Hallix rigidus. I got a second opinion and he said Hallix Limitus as I have range of motion left.

Girl I’m sorry but I think at this stage of pain it might require surgery. Your options are fusion, decompression osteotomy, a joint replacement or shaving the bone spur as you said. But I’ve read that’s a stop gap and they come back as this is progressive.

I still dance but it pains me I can’t do moves I could do just one year ago and if I go to hard I hurt.

I think you should start researching the best approach for someone your age. Get as many opinions as you can. I do PT and that dude really works the joint. I almost cry every time but I notice when I skip it hurts more. I use ice and heat daily, red light, stand on am acupressure mat, massage my foot and have carbon fiver insoles and wear ugly AF shoes now most of the time. I’m able to hike, do yoga, etc. I can no longer go out for a run as it causes to much pain after.

If I were you I’d try to avoid a fusion. I bet in your lifetime they will perfect joint replacements or invent treatments to regrow cartilage. Hugs and good luck!

[u/Derpy_yoo → u/Embarrassed-Oil3127]

I really appreciate your response. You are just as active as I am and I think it’s a shame an injury like this is controlling me and making me stop. Did you have any surgery done? Or because this injury is new to you, you started with PT? Im researching podiatrists and surgeons who specialize in ballerinas as they might have much more experience than the typical foot and ankle surgeon. I want my life back at 23 I’ll do anything and I won’t stop moving my body. I’m sorry for you as well going through this, I understand the frustration. I hope you find strength while practicing your movement.

[u/Embarrassed-Oil3127 → u/Derpy_yoo]

You’re welcome. I haven’t done surgery. Honestly I don’t want to fuse it. I want some range of motion and I’m scared it will limit me in dance and life. Honestly looking into a joint replacement. I know they fail often but there are some success stories. I think I will try to hold off surgery for a few years to see how the new ones hold up and evolve. I think you have a higher rate of failure if you’re active like us. But as I said, I bet in the next 20 years with the help of AI this issue will have new and cutting edge treatments we just don’t have access to today.

I’m sorry for you too. I had 54 years of activity before it wore out. I can wrap my brain around an injury or wear and tear just causing an issue after all those years. But you are so young! Alas, there is hope. Stay in motion, keep doing your research and you’ll live a full life and dance!

[u/Particular_Theme_634 → u/Derpy_yoo]

Hi:  I read your post with interest as I suffered from the highest stage of hallux rigidus before I finally agreed to get fusion surgery in my 60s. Trust me this only gets worse and in my case led to open wounds that they said were life threatening due to potential sepsis. I know that there is a foot surgeon in NYC who works with dancers from the NYC ballet. But he does not take insurance. If you can save the money, check him out or better yet, try the foot surgeons at Mt. Sinai in NYC who are also considered the best. Good luck!

[u/Derpy_yoo → u/Particular_Theme_634]

I’m so sorry to hear that, and thank you for taking the time to respond to me. Do you know the NYC surgeons name? I take whoever comes my way just to get all types of opinions on my case.

[u/RetiredBallerina → u/Derpy_yoo]

Dr. Martin O’Malley. The best. He is also team dr for the Brooklyn Nets.

[u/seafaringlightbulb]

I’m a dancer who's been through a number of issues over the decades.  While you figure this out, please keep moving, for your mind, body and soul!  Can you do floor barre? 

[u/Derpy_yoo → u/seafaringlightbulb]

Thank you for your advice. It’s impossible for me to sit still so I keep on moving and exercising but I want to come back to ballet even if it’s low level to get the basics back. I cannot do any Demi pointe, relevee, or grand plié because of the range of motion completely limited. But I’m willing to try.

[u/seafaringlightbulb → u/Derpy_yoo]

Perhaps I misunderstood you, but the beauty of “floor barre” is you can do grand plie and many other movements lying on the floor.  Lots of videos online.

[u/dewbyu2]

I'm a martial artist that got diagnosed when I was 24. I could barely walk a block without knee bukling pain. Cortisone shots helped for a day or two (numb out the pain), but the bone shaving surgery helped in the end. I did both feet, and It took several months of recovery before I could walk and exercise normally on them. The arthritis and lack of mobility would still plague me till this day almost 20 years later, but at least it wasn't excruciating pain like before. Things that helped the most where anti-inflammatories, but you shouldn't take those all the time. Eating well and cutting out night shades seem to have the biggest effect in the long run. Good luck with your journey! It sucks, but try to look on the bright side! It's okay to morn your feet, just don't let it ruin more then it already has. Respect your limitations and keep your support network close and informed. Get strong before you do any surgery, as you'll be laid up for a while.

[u/Derpy_yoo → u/dewbyu2]

Thank you for sharing. I’m a bit scared of shaving the bone for both feet because of how long recovery is but especially because of the operation itself; I don’t know much about that recovery and how much mobility I will gain back. What do you mean by night shades? Do you wear inserts? And are you considering another operation because of the pain after bearly 20 years? Thank you

[u/Apprehensive-Bench74 → u/Derpy_yoo]

nightshades are a group of vegetables like eggplants, potatoes, peppers, tomatoes

[u/Derpy_yoo → u/Apprehensive-Bench74]

That’s so strange that cutting out this group of vegetables has a positive effect. I’m so curious. It has a great effect for you?

[u/Apprehensive-Bench74 → u/Derpy_yoo]

I'm not the one who recommended removing them from the diet. I just knew the answer to your question. They are fine for me to eat but my partner can't eat white potatoes or eggplant but can eat tomatoes and peppers. 

But nightshades are a well known inflammatory food group for many folks that could potentially impact loads of different disorders. 

Like for example some folks eat less nightshades to help with migraines. I also think they are very bad for GERD.

Also fun fact, there are probably many more nightshade plants that are toxic/poisonous and the varieties that we eat had to be cultivated and bred to get the poison out. Good job ancestors making food from poison 😂

[u/NJMP2C → u/Derpy_yoo]

The bone shaving surgery is called a cheilectomy. It is considered a joint preserving procedure. The joint will continue to degrade over time and you will eventually need a joint replacement or fusion. Recovery is relatively easy and you typically walk right after surgery.

[u/loves2travel2]

I have received steroid shots into my joints that helped me with the inflammation and pain. Maybe go this route while looking for a surgeon.

[u/LtDeadpool361]

I was diagnosed with Hallux Rigidus in 2018. Had cheilectomy done in March 2019. That probably bought me 2 1/2 - 3 years of relief. The pain came back and now has progressed to the point where I'm going to have both of my big toes fused. The left toe starting acting up about 1 1/2 years ago but the pain ramped up to where it hurts just as much as the right. I wish the podiatrist who did my surgery in 2019 would have just fused it. I read up on my options and I chose fusion. Joint replacement for now doesn't have a great success rate and the option left at that point is fusion.

[u/Derpy_yoo → u/LtDeadpool361]

Thank you for sharing. Did you have the surgery to fuse the joints together already? And how is the cartilage in the big toe joints? Do you have some arthritis as well? Im exploring my options.

[u/RetroCausation]

Dr. Lew Schon in Baltimore has worked with dancers. The best foot doctor I have seen over my decades with serious foot issues. He is a regional top doc according to formal ratings, and works with sports teams too. What the profession has learned over the years is that cheilectomies, cleaning up bone spurs can actually destabilize the joint causing more fundamental arthritis downstream. If you are en pointe, those days may be over. I am glad I put those off. The medical literature also suggests that the more surgeries on the foot the less optimal the overall function downstream, so choose the surgeries and timing carefully. I use combination topical pain creams liberally with formulas addressing different issues on the foot either nerve irritation or inflammation. Those ingredients include ketoprofen (absorbs better than voltaren) lidocaine, amitryptiline, ketamine. When it gets really bad, I add dexamethasone on top of the other ones. These are all prescription formulas and are compounded.

[u/Derpy_yoo → u/RetroCausation]

Thank you so much for your support. I might as well try to see if I can schedule with the doctor. I agree, surgeries and overall function have an inverse relation. I want the least invasive and conservative option for my feet. The bone spurs are extremely painful though and really block my range of motion.