Q: I am a 32 years old ballet dancer with recurrent lower leg pain and clicking. I have had various niggles with this area for a long time, mainly due to extremely tight calves. But this is affecting from where my achilles inserts into the calf to my metatarsals. When I rise onto the balls of my feet and then lower and bend my knees there is a cracking noise in my achilles area. This happens every single time I do this. I also feel a tightness in my metatarsal and arch area when I rise, and when I am there for some time coming down to flat feet is very painful. I have naturally weak metatarsals as they are very flexible, and my second toe is longer than the big toe. Could I have dropped a second metatarsal? Dropped arches run in my family also, could this be the problem? When I jump I feel a tightness and mild pain in my achilles near the heel. If I rub my calf there is a lot of pain on the outside section of the muscle. As a very busy person I often find myself neglecting my aches and pains and as a dancer you are always told to push on regardless.

A:The problems narrated by you are often reported by professional ballet dancers and relate to overuse. There is a possibility of various injuries including ligament ruptures, dislocations, pressure building up in the leg (compartment syndrome) or stress fractures (cracks in bones because of repeated injury). It is imperative that you take rest and see a doctor who may ask for imaging studies like an MR scan. You may be helped by strapping or some of the methods used by physiotherapists. Subsequently, depending on the condition, gradual return to activity is permitted - perhaps beginning with dancing in a swimming pool.