Dancers continuously point their toes (plantarflexion) and this is especially true for ballet dancers. Dancing en pointe puts the full weight of the body on the foot while in the plantarflexed position. Repeatedly doing so can cause the structures of the ankle to condense, resulting in Talar Compression Syndrome. Although most common in ballet dancers, the demi-pointe position used in other types of dance can have the same effect and also contribute to the development of Talar Compression Syndrome.
Causes & Symptoms:
Talar Compression Syndrome is characterized by pain and tenderness in the posteriolateral ankle (outer portion of the ankle toward the back of the body). It may result in an impingement of Stieda’s process, a long protrusion of the talus bone in the posterior ankle. Some individuals do not possess this process on the talus at all, and others have a small ossicle attached to the talus by fibrous tissue. This ossicle and fibrous tissue are called the Os Trigonum, and individuals with Talar Compression may develop Os Trigonum Impingement Syndrome as a secondary condition. Talar Compression Syndrome has often been misdiagnosed as Peroneal Tendosynovitis. To tell the difference, the physician should check for pain and swelling over the peroneal tendon, which are not present in Talar Compression Syndrome.
Conservative treatments range from anti-inflammatory drugs and physical therapy, to coriticosteroid injections and/or a plaster cast for 3-4 weeks. If ineffective, surgical removal of the Os Trigonum or Stieda’s process can provide relief of Talar Compression.
A study of 6 dancers who all received surgical intervention for Talar Compression participated in a follow-up study seven years after surgery. All six dancers got no relief from conservative treatment and opted for surgury. In this case, all six dancers returned to dancing and were asymptomatic seven years later.
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