INTRODUCTION

Orthopedic surgeon and musician, Dr. A.B.M. (Boni) Rietveld, MD, PhD, BA (music) shares his popular poster presentation on Sesamoid & Harlequin dance floor scraps. Rietveld, a past President of IADMS, originally presented the poster at the IADMS conference in Basel, Switzerland in 2014 yet it still remains one of the most popular presentations from all past conferences. 

A novel approach to orthotics using dance floor scrapes is introduced: The use of dance floor scraps as insoles or orthotics taped under dancers’ feet to relieve local pressure, stabilize irregularities or improve function. 

BACKGROUND

Installing a dance floor, large quantities of vinyl often remain as a waste product. However, they can also be unexpectedly good for dancers; this thin and flexible material can be placed in dancing shoes as orthotics, or can be taped to the foot. 

Most of these leftovers are thrown away; some are recycled by cutting them into beer coasters, mouse pads, or placements. 

When purchased commercially, the vinyl comes in several thicknesses. In our clinic material of 1mm (Reversible/Duo), 2mm (Cascade), 3mm (Studio) and 8mm (Allegro) is used. 

The scraps are available in large quantities at very little cost, the material is easy to cut, and its surface has a “natural feel” for the dancer. 

SOME POSSIBLE INDICATIONS

For dance floor beer-coaster with cut-out:

Any local tenderness under the sole of the foot, due to e.g.:

• Medial (or lateral) “sesamoiditis” (avascular necrosis) improves with a metatarsal insole cut out under the medial (or lateral) sesamoid. 
• Plantar impingement at the base of the big toe after an extension osteotomy for hallux rigidus becomes symptom-free with a one mm metatarsal insole cut out under the base of the phalanx.
• Stone bruises, plantar calluses, warts, heel spurs, etc.
• Stabilize balance in a “Greek foot” with a 1-3mm pad under the first MTP-joint bilaterally.

Heel lift indications

1. Leg length discrepancy (pelvic dysbalance etc.) 
2. Limited and /or painful demi-plié due to any condition, like:
3. Anterior ankle impingement, e.g., in cavus feet
4. Retrocalcaneal bursitis, “pump bump”
5. Posttraumatic
6. Sinus tarsi syndrome (avoid “valgus ex equino”) 
7. Short Achilles tendon 

TECHNIQUE OF PREPARING DANCE-ORTHOTICS:

26-year-old amateur dancer with lateral “sesamoiditis”. Relief with coaster with cut-out under lateral sesamoid. (Reference images)

1. Marking point of maximum tenderness 
2. Testing with different coasters 
3. Make hole in inlay 
4. Check effect 

DISCLOSURES:

A.B.M. Rietveld has no financial disclosures that would be a potential conflict of interest with this poster. Although no financial support was received, the vinyl scraps were provided for free by Harlequin Europe SA. The heel lifts are made by Penders orthopedic shoemakers as a non-profit project (production costs only). For both firms it is a sign of corporate social responsibility.   

About A.B.M. Rietveld

Dr. Boni Rietveld (August 7^th, 1952, Rotterdam, The Netherlands) is a graduate of the Royal Conservatoire for Music in The Hague (trumpet, 1976), of Leiden University (MD, 1978, PhD, 2017) and a board-certified orthopaedic surgeon (Leiden, 1987).

After specializing in dancers’ and musicians’ injuries, a.o. in 1982/83 with William G. Hamilton †, M.D., orthopaedic surgeon of the New York City Ballet Company, Dr. Rietveld devoted his professional life full time to Performing Arts Medicine, as a clinician, teacher, researcher, and as director in the international organizational Performing Arts Medicine field. He is the founder of the Dutch Medical Centre for Dancers and Musicians (MCDM), which celebrated its 25^th jubilee on April 1^st, 2018 in The Hague Medical Centre (HMC) and where he worked till October 1^st, 2018. 

His doctoral thesis ‘Performing Arts Medicine with a focus on Relevé in Dancers’ (2017) can be found online via Leiden University Libraries: http://hdl.handle.net/1887/58767 . He is honorary president and founder of the Dutch Performing Arts Medicine Association (NVDMG), past president (2007-2009) of the International Association for Dance Medicine & Science (IADMS), and was a board member of the Performing Arts Medicine Association (PAMA) (2018-2022). 

Dr. Rietveld published regularly in medical scientific and popular magazines, is editorial board-member of two scientific journals: JDMS (Journal for Dance-Medicine and Science), and MPPA (Medical Problems of Performing Artists), and he is the author of chapter 9 ‘Dancers- and musicians-injuries’ in ‘Orthopaedics and Traumatology. The essential guide’ (2021, ISBN 978-90-368-26372. See: https://www.bsl.nl/shop/orthopaedics-and-traumatology-9789036826372). 

In 2015, Dr. Rietveld was awarded a high royal honor of merit, ‘Officier in de Orde van Oranje-Nassau’, for his tireless efforts to improve healthcare for dancers and musicians, both nationally and internationally.

Since Dr. Rietveld retired from clinical work in 2018, he still is active as an expert in the Performing Arts Medicine field, both for dance companies and orchestras, and in private practice, as independent advisor, counselor and teacher. Dr. Rietveld performs and records regularly as a trumpeter, both classical music with his organ-duo-partner Jaap Stork since 1978, and with his old-style jazz band, which recently celebrated its 50^th anniversary. He loves endurance-sports (running and cycling), is married to Marijke Nederveen, has two children (Boni and Sophia) and six grandchildren.

For more information: 

Medical Centre for Dancers and Musicians (MCDM):  https://www.haaglandenmc.nl 

Dutch Performing Arts Medicine Association (NVDMG): www.nvdmg.org

International Association for Dance Medicine & Science (IADMS): www.iadms.org     

Performing Arts Medicine Association (PAMA): www.artsmed.org