Pain on the inside of the ankle when you rise to demi-pointe or push from plié? That catching “pinch-click” at the big toe that throws off your line? If these moments are creeping into class or rehearsal, you’re not alone. Dancer’s tendonitis is common in ballet and contemporary work and can unsettle confidence as much as it unsettles your footing.
At Perfect Balance Clinic, Moorgate, we look beyond the sore spot to how you move, train, and load through the foot and ankle. Your plan calms irritation, restores smooth tendon glide, and builds strength for a steady return to barre, centre, allegro, and pointe. If you’d like a clear route that fits rehearsals and show dates, we’re here to help. Same-week appointments are often available in Moorgate.
What is Dancer’s Tendonitis?
“Dancer’s tendonitis” usually means irritation of the flexor hallucis longus (FHL) tendon. The FHL runs behind the inner ankle, under the foot, and into the big toe. It steadies you on demi-pointe, helps you point the toe, and powers take-off for jumps. Long hours on hard floors, pointe work, and fast transitions between plié and relevé can irritate the tendon and its sheath. Friction in narrow tunnels behind the inner ankle and at the back of the ankle can cause pain, clicking, or a brief lock that releases with a nudge.
You may also hear this called trigger hallux or FHL tenosynovitis. Different labels, same problem. An overworked tendon needs calm, space, and smarter loading.
Dancers Tendonitis Symptoms — Signs to Watch
- Pain behind the inner ankle that worsens with relevé, pointe, or jumping
- Clicking or “triggering” of the big toe during push-off
- Local tenderness behind the medial malleolus
- Soreness on slow plié and a gritty rub along the tendon
- Morning stiffness after heavy classes or long rehearsals
- A sense the big toe briefly locks then releases
If these sound familiar, we can check what’s going on and help you keep training without flare-ups.
Why Dancers Get It
Training load and surfaces
- Sudden spikes in classes, rehearsals, or jumping sets
- Hard floors and tired shoes that absorb less impact
- Tight schedules with little time for recovery
Technique and control
- Turnout forced from the feet rather than the hips
- Toe clawing on relevé to “find height”
- “Sickling” during line work or late-session fatigue
Mobility and strength gaps
- Stiff first-toe or ankle joints creating extra friction
- Weaker foot intrinsics, calf complex, or hip rotators
- Limited landing control during petit and grand allegro
Foot shape and alignment
- Flat foot patterns or first-ray overload that twist the tendon path
These factors stack up. Our job is to find your mix, calm the tissue, then rebuild the way you load so the problem stays quiet.
How We Assess Dancers at Moorgate
Your appointment uses dance-specific testing and looks at the whole picture.
- History linked to class schedule, choreography, and footwear
- FHL testing through its full path, not just one position
- Joint screen for the big toe, ankle, and subtalar motion
- Turnout strategy, foot control on relevé, and jump landings
- Palpation along common compression zones behind the inner ankle and at the back of the ankle
- Imaging only if it changes the plan
You leave with a clear route forward and small technique changes you can use in class the same day. If you’d like clear answers and a plan that fits your diary, our Moorgate team can help.
What Else Can It Be
A careful screen also rules out or addresses
- Posterior ankle impingement or os trigonum irritation
- Tibialis posterior tendon pain
- Sesamoid irritation under the big toe
- Hallux rigidus and first-toe joint limits
- Tarsal tunnel symptoms
- Rearfoot or forefoot bone stress
How Imaging Fits the Plan
- Diagnostic ultrasound can show tendon thickening or sheath irritation and lets us watch the tendon move
- X-ray helps identify bony drivers like an os trigonum
- MRI is kept for suspected tears or stubborn cases
Scans are suggested only when results guide the next step.
Your Treatment Plan at Perfect Balance Clinic, Moorgate
We set a plan that fits your role, rehearsal diary, and show dates. Each phase links clinic work with studio steps so progress stays steady.
Phase 1 – Settle the Pain and Calm the Tendon
In-clinic local soft-tissue care along the FHL route, gentle joint work for the ankle and big toe, supportive taping if walking or barre is sore, short-term offloads from pointe and heavy jumps.
Your take-home simple isometric holds, ice or heat based on response, and clear rules for class.
Signs you’re ready
- Pain stays around 2–3 out of 10 during and after a light class.
When these signs hold for a few sessions, a quick check-in sets the next step.
Phase 2 – Restore Smooth Tendon Glide
In-clinic tendon-glide drills and mobility for first-toe extension and ankle dorsiflexion.
Your take-home a short glide sequence to slot between barre and centre plus daily range work.
Signs you’re ready
- Full, smooth toe point without a catch.
Once this feels consistent, it’s a good time to move up. We’re here if you’d like guidance.
Phase 3 – Build Durable Strength for Class and Stage
In-clinic stepwise loading from isometrics to higher-volume calf work and heavy slow resistance, plus balance and landing drills that match your choreography.
Your take-home two brief routines for non-dance days and pre-class warm-up, plus a simple load log.
Signs you’re ready
- Twenty-five pain-free single-leg calf raises and steady single-leg landings.
At this point, a short strength review keeps progress steady.
Phase 4 – Fix the Reasons It Started
In-clinic technique tweaks so turnout starts at the hip, coaching to stop toe clawing on relevé, and advice on footwear and floors.
Your take-home cue cards for class, weekly checks of shoes and surfaces, and simple recovery habits.
Signs you’re ready
- Clean relevé without toe clawing and even load through the first ray.
If anything drifts, a brief technique tune-up brings the pattern back in line.
Phase 5 – Return-to-Dance Pathway
We map a graded path back to full performance
- Barre with modified rises
- Centre with controlled allegro
- Hops and travel with volume tracking
- Pointe re-entry with capped sets and rest windows
- Full choreo with dress-rehearsal readiness checks
If symptoms linger into the next day, we step back one level for forty-eight hours, then re-test. The aim is steady progress without yo-yo flare-ups. We can time this around rehearsals and shows so training keeps its rhythm.
Short Rehab Menu You Can Start Today
- Isometric calf holds with a strap
- Toe wave drills for gentle glide
- Light joint mobility for the big toe and ankle
- Seated then standing calf raises
- Simple balance drills on stable ground
Prevention That Fits Real Studio Life
- Build volume gradually when seasons change or rehearsals ramp up
- Rotate footwear and check fit regularly
- Add two brief strength sessions per week for feet, calves, and hips
- Keep a quick log of jumps and pointe time to spot spikes early
- Plan recovery days after show runs or exam blocks
When Are Injections or Surgery Discussed
Most dancers settle with the plan above. An injection is considered only when pain blocks progress despite careful loading. Surgery is rare and kept for stubborn cases where a tight tunnel or scarring traps the tendon and causes persistent triggering. If that path is on the table, we talk through risks, timelines, and the return plan in plain language.
Why Dancers Pick Perfect Balance Clinic – Moorgate
- Dance-literate clinicians who assess technique, not just joints
- Plans that match show calendars and school timetables
- Hands-on care plus rehab that fits between barre and centre
- Access on site to physiotherapy, osteopathy, sports therapy, sports massage, laser therapy, shockwave therapy, Pilates, gait analysis, nutrition, athlete services, corporate wellness, and acupuncture
Whether you’re preparing for exams or simply want class to feel easier, our Moorgate team can help you move with confidence.
Book Your Appointment
Finding Us in Moorgate
Perfect Balance Clinic – Moorgate
Centrally located near Moorgate and Liverpool Street stations. Easily accessible via public transport.
Please note: There is no on-site parking available at the Moorgate clinic. We recommend using public transport or nearby public car parks, such as:
- Finsbury Square Car Park
- London Wall Car Park
We offer early morning and evening appointments to accommodate your schedule.
Your Next Strong Step
If inside-ankle pain is interrupting class, rehearsal, or stage prep, you don’t have to wait it out. Quick guidance on load and technique usually settles symptoms faster and keeps your progress steady. Whether you’re building toward an exam, a run of shows, or you simply want each class to feel smoother, we’re ready to help you find your best next step at Moorgate.
Book a Consultation Today
Perfect Balance Clinic, Moorgate
