Oh, Toenail Woes! Prevent and Treat Common Nail Injuries

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Few problems are as painful and unsightly as a battered toenail. Sarah Chisholm, a dancer with Ballet Arizona, knows this well. She has suffered from chronic bruised and ingrown nails throughout much of her career. “It's hard to focus on your work when you're always worrying about how much your feet hurt," she says. “You don't get to think about the joy that comes from dancing."

Dancers spend hours crammed into sweaty shoes, making them great candidates for ingrown nails, bruising and nail fungus. Though these aren't usually threatening enough to force someone to take time off, they can cause days, weeks or even months of painful distraction. Many nail problems can be prevented by taking small precautions.


Bruised Toenails

A bruised nail might last several months, and the condition can be extremely painful. Often caused by stubbing the toe or knuckling over on pointe, the nail shifts over its bed where many blood vessels meet, causing bleeding under the nail. Long toenails and tight shoes or pointe shoe boxes that don't match a dancer's foot type can also put excessive pressure on the toes.

After bruising, ice the foot to soothe the pain. And regularly clean the area to prevent infection. “The dried blood under the nail bed is a breeding ground for bacteria," says podiatrist Dr. Thomas Novella, who works with New York City dancers.

The nail may eventually loosen or fall off, but keep it intact as long as possible. “Band-Aid or tape it in place until a new nail begins to grow," says Novella. Toenails grow just 1–2 millimeters per month, so it can take up to a year for a new one to fully form.

While growing a new nail, Chisholm applies 2nd Skin, a jelly-like adhesive that can be cut to size. “I stick it on my toenail, and it acts as a buffer," she says. “It's very cooling and helps with impact."

Ingrown Toenails

Ingrown toenails are common in young dancers, whose nail plates have not yet strengthened, and those with nails that curve side to side. Chronic bruising can also damage nail beds enough so they grow back incorrectly, says Atlanta Ballet podiatrist Dr. Frank Sinkoe. “If it's disrupted, it can cause an abnormality," he says. Trim the nail to match the toe's shape to help prevent ingrowns; be careful not to cut too far into the corners.

To soften the nail as it grows out, soak the foot in an Epsom salt and warm water bath. Resist the urge to pick; it could cause infection. If the pain is unbearable or there is swelling, redness and increased skin temperature, see a podiatrist. If it's not infected, they can pack cotton deep under the nail. “This helps guide the skin away from the nail as it grows," says Novella. In chronic cases, podiatrists can permanently remove the sides of the nail as a preventive measure.

Toenail Fungus

Fungal toenails are rarely painful, but they're extremely unsightly and hard to treat. The nails are yellowed, thick and crumbly, and the surrounding skin is red and scaly. They often have a yeasty odor and powdery debris.

Novella says to seek help after noticing symptoms because “addressing fungus early will help a lot in the long run." To diagnose the fungus, a podiatrist sends a snippet of the nail to a lab, and if confirmed, may suggest topical creams. Oral medications are most effective, but they can cause serious side effects like liver damage.

To prevent toenail fungus, change socks frequently and dry out dance shoes and toe pads. “Funghi is Italian for mushrooms. And where do mushrooms like to grow? Moist, dark places, like under logs—or inside sweaty shoes," says Novella. He adds that the condition is contagious, so students should avoid sharing shoes, socks and nail clippers.

Music
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Securing the correct music licensing for your studio is an important step in creating a financially sound business. "Music licensing is something studio owners seem to either embrace or ignore completely," says Clint Salter, CEO and founder of the Dance Studio Owners Association. While it may seem like it's a situation in which it's easier to ask for forgiveness rather than permission—that is, to wait until you're approached by a music-rights organization before purchasing a license—Salter disagrees, citing Peloton, the exercise company that produces streaming at-home workouts. In February, Peloton settled a music-licensing suit with the National Music Publishers' Association out-of-court for an undisclosed amount. Originally, NMPA had sought $300 million in damages from Peloton. "It can get extremely expensive," says Salter. "It's not worth it for a studio to get caught up in that."

As you continue to explore a hybrid online/in-person version of your class schedule, it's crucial that your music licenses include coverage for livestreamed instruction—which comes with its own particular requirements. Here are some answers to frequently asked questions about music licensing—in both normal times and COVID times—as well as some safe music bets that won't pose any issues.

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Of course, there's no easy answer, and no perfect approach. As social justice advocate David King emphasized at a recent interactive webinar, "Cultivating Racial Equity in the Classroom," this work is never-ending. The event, hosted by Dancewave (which just launched a new racial-equity curriculum) was a good starting point, though, and offered some helpful takeaways for dance educators committed to racial justice.

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According to onstageblog.com, out of the 30 top-ranked college dance programs in the U.S., tap dance is offered at 19 of them, but only one school requires majors to take more than a beginner course—Oklahoma City University. Many prestigious dance programs, like the ones at NYU Tisch School of the Arts and SUNY Purchase, don't offer a single course in tap dance.

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