Health Secrets of a Belly Dancing Road Warrior:
Part 5, Foot, Muscle, & Joint Health

This is Part 5 of a series of articles on travel health issues for road warriors, particularly belly dancers. If you will be taking intensive dance classes at your destination or even if you just expect to spend a lot of time walking on your sightseeing excursions, use this article to help you plan ahead to avoid muscle and joint pain. Other articles in the series cover:

• Part 1, Introduction and Beginning Preparations
• Part 2, Coping with Jet Lag
• Part 3, How to Avoid Catching a Cold While Traveling
• Part 4, Stomach & Intestinal Health

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Sore muscles can detract from the fun of taking dance workshops or exploring fascinating historical sites.

Avoid Cramps, Pulled Muscles, Strains

Trying to dance with cold muscles can lead to pulled muscles, cramps, and other injuries. Here are some tips for easing muscles into exercise:

• Ballet-style legwarmers will help avoid muscle cramps when you initially begin to exercise and reduce your risk of injury.
• Warm up on your own before the workshop actually begins, because many instructors don't include warm-ups as part of their class. Insufficient warm-up can leave you vulnerable to injury.
• The latest advice from exercise physiologists is to warm up through a minimum of 5 minutes of gentle aerobic exercise such as walking briskly.
• Do not use stretches to warm up!!!
• If you don't feel free to walk around due to saving your spot in the classroom, try doing a series pliés in place. This is the ballet exercise that involves bending the knees, then straightening. Take care that your knees go directly over your toes but not beyond them.
• When using pliés to warm up, don't bend any deeper than you comfortably can - warmup is not the time to try extending your range of motion!

Avoid Muscle Fatigue

Dehydration and depleted electrolytes can cause muscles to feel weak. To avoid this, drink plenty of water, and replenish your electrolytes.

• Keep a water bottle handy, and take sips throughout the workshop.
• Try to drink at least one glass of water per hour.
• During breaks, snack on foods rich in electrolytes such as bananas, saltine crackers, etc. Electrolytes are nutrients such as potassium and sodium that help your muscles rehydrate.
• Some bottled water, such as that sold in Egypt, contains electrolytes such as sodium, potassium, etc. Check the ingredients label.
• Some people like to use sports drinks such as Gatorade to replenish electrolytes. These can be purchased in packets of powdered form for travel and added to your bottled water. Check the label, make sure the drink contains potassium or sodium.
• Avoid caffeine-containing drinks such as sodas, coffee, and tea before exercising. These actually have a dehydrating effect and can deprive your muscles of the water they need.

Dealing with Stiff Muscles

Sightseeing and dance workshops can both cause you to use your muscles in ways they are not accustomed to being used. Afterward, you'll have stiff muscles. I prefer to avoid using pain medications for stiff muscles because drugs can damage the body. Even those sold over the counter aren't necessarily completely safe. For example, in one study acetaminophen (widely sold under the brand name Tylenol) has been linked to liver damage when the extra-strength dose size is used for a few days in a row. In another study, ibuprofen (sold under the brand names Advil and Motrin) has been linked to increased risk of heart attack.

Here are some non-drug options for dealing with stiff muscles: Hot showers Massage Heating pad Placing a hot towel over the sore spot Soaking in a bathtub of hot water Scented bath salts may help encourage you to relax in the tub longer. If you normally use an ointment such as Ben Gay, Tiger Balm, or arnica to soothe stiff muscles at home, you may want to pack some for the trip.

Prevention

Exercising when you feel fatigued can cause injury. Something as simple as stepping off a curb or trying to regain your balance after being jostled in a crowd can lead to a painful sprain or even a broken bone in the foot or ankle if you are exhausted.

Here are some steps you can take to prevent sprains or breaks:

• Take care to get plenty of rest throughout your trip.
• When tired pay special attention to where you put your feet when walking over uneven surfaces, stepping off curbs, or using staircases when tired.
• If you're not used to doing much exercise all at once, multi-hour workshops can stress your feet, knees, and ankles. Two weeks before you go, begin taking glucosamine chondroitin tablets twice per day to fortify your joints for the expected activity.
• If you need braces or wraps to support a weak joint, use them.
• Constantly pay attention to your posture.
• Don't exercise when fatigued!

First Aid

In the event you do injure yourself while exercising, don't hesitate to seek expert medical assistance if you have any reason to believe a bone may be broken! Sharp, piercing pain is often a sign of a break.

For sprains, the acronym RICE is a convenient way to remember the recommended first aid: Rest. Avoid putting any weight on the injured limb for the first 24 hours (or longer) after injuring. Ice. Apply ice packs over a towel intermittently to minimize swelling, but be careful to avoid frostbite on your skin. Continue the intermittent ice routine until you're absolutely certain the risk of swelling has passed - this should be at least 24 hours, possibly longer. Compression. Wrap an elastic bandage around the injured area and elevate it to prevent the accumulation of excess fluid known as edema. Elevation. Use pillows or a footstool up elevate the injured limb.

After the initial period of using the above RICE technique to treat the sprain, try using a papaya to reduce any swelling that may have occurred. Peel off the skin, wrap the flesh of it around the injured joint, and use some sort of bandage to hold it in place.

During the first 48 hours after a sprain, avoid all of the following because they make fluid accumulation worse:

• Hot showers
• Heat rubs such as Ben Gay
• Hot packs
• Drinking alcohol
• Taking aspirin (aspirin prevents blood from clotting)

Exercise caution when using pain relief pills. Ibuprofen (Advil, Motrin) and naproxen (Alleve) can both irritate the stomach lining in some people. There have also been studies linking such anti-inflammatory drugs to increased risk of heart attacks. Although it may be fine to use such drugs to help you endure the days immediately following a fresh injury, you'll want to talk to your doctor before making a lifestyle of using them for long-term pain.

We often don't think much about foot health. But injured feet can ruin a dance-related trip. Things that can go wrong with your feet when traveling include:

• Tiredness and soreness from a day of standing around vending, sightseeing, or visiting museums.
• Cuts from the sharp edges of glass beads which fell off other people's hip scarves. One of my friends once needed to make a trip to the emergency room after performing barefoot to have the broken remains of a glass bead surgically removed from her toe.
• Pins on dressing room floors piercing your feet.
• Blisters from shoes.
• Burns caused by going barefoot on hot concrete, marble, or asphalt. At the Ahlan Wa Sahlan festival in Cairo in 2006, I made the mistake of deciding to run barefoot from a classroom to my hotel room along an outdoor path. The outdoor marble staircase had been baking in the intense, hot sunshine of Egypt, and I suffered severe burns with blisters on the soles of my feet.
• Broken bones through dance injury or misstepping on an uneven surface.
• Athletes foot.
• Being stepped on by a classmate in a workshop.

Soothing Tired Feet After a long day of vending, dance workshops, or sightseeing, these techniques can help ease tired feet: Take off shoes and socks, and spend some time barefoot. Better yet, walk barefoot across some grass. Soak in either warm water or cool water, whichever seems more appealing. Massage them with your hands. Wiggle each toe, and rub every bit of both the sole and the upper foot. Rub a soothing lotion onto them, such as peppermint foot lotion.

Sightseeing Risks

One common travel injury to avoid is blisters. Beware of wearing brand-new shoes on your trip.

• One risk is that you may ruin them from the abuse of sightseeing. I remember a teen with our tour group in Egypt one year who accidentally stepped in a large heap of camel dung wearing her beautiful new pale pink tennis shoes - creating a hideous large yellow-brown stain.
• More importantly, new shoes can cause painful blisters, which can detract from the pleasure of sight-seeing or taking dance classes. If you take shoes on your trip that you don't wear very often, it would be wise to also pack some bandages for protecting the foot in case the shoes cause blisters to appear.
• En route to your destination, wear your comfortable sightseeing shoes on the airplane. That way, if your luggage fails to arrive when you do, you'll have your comfortable shoes available to use.

Workshop Precautions

Your feet may be strong and healthy for enduring a one-hour class at home. But a 4-hour workshop in another city places extra stress on them that can lead to injury. Exposing your feet to the same floor as an army of other dancers can expose you to fungus and bacteria. Plan ahead for protecting the health of your feet.

• Wear dance shoes (Hermes sandals, dance sneakers, Scottish ghillies, or ballet slippers) to protect the feet against the many hazards that lie on a classroom floor. These hazards include:
  • Beads falling off other people's hip scarves. Beads are made of glass and often have sharp edges.
  • Athlete's foot fungus or bacteria placed on the floor by classmates.
  • Stress to soles and arches from more activity than they are accustomed to. Dance sneakers offer cushioning and arch support.
  • Some workshops are held in carpeted hotel ballrooms. Dance shoes with slick soles allow feet to pivot freely on this surface and avoid torquing the knees.
  • Some workshops are held in rooms with wooden floors that have protruding nails which can injure the feet. Shoes protect the feet from this.
• If you do go barefoot, immediately after your class, performance, or swim wash your feet with soapy water and towel dry them, taking extra care to dry between the toes.
• If recommended by your doctor, take along orthotics to use in your shoes.
• If the feet have open wounds caused by broken blisters or cuts, place bandages over the sores to protect your feet from contact with fungus and bacteria on the floor. Wear socks over the bandages for further protection.

First Aid Athlete's Foot. If you find that you have an itching, burning sensation on your feet, especially between your two littlest toes, you may have athlete's foot. You may find that the skin appears to be peeling away. Fungus flourishes in damp environments. Wash the foot frequently with soap, and dry thoroughly in the itchy area. Some people use tea tree oil to help kill the fungus and promote healing. Some people choose an anti-fungal product from the drugstore such as Lotrimin to help kill the fungus and encourage healing.

Burns. If you have walked or danced barefoot across a hot surface such as concrete or marble, your feet may be painfully burned. When hospitals treat burn patients, a significant focus is protecting the damaged skin from germs which can cause infection. Use aloe immediately to ease the sore skin. Obtain a bucket full of ice from your hotel, place a towel moistened with cool water across the top surface of the ice, and place your burned skin on top of it. Place antiseptic ointment such as Neosporin on the burned area to protect it from germs. If antiseptic ointment is not available, use honey to coat the wound. Apply twice a day. Bandage the burned area to protect it from germs and further injury. Try to choose bandages that won't stick to the healing skin. Cellophane paper is good for this. If it blisters, following the instructions below for caring for blisters.

• Blisters. These can have two different causes - friction from shoes that fit badly, or burns from walking barefoot on concrete or marble. Regardless of cause, these treatments will help:
  • If possible, don't pop blisters. The blister formed for the purpose of protecting the foot. If you pop it, that protection will be lost.
  • If the blister does pop, place antiseptic ointment such as Neosporin on the place where the skin is broken to protect against germs entering the body.
  • If antiseptic ointment is not available, use honey to coat the wound. Apply twice a day.
  • Keep the blistered area clean
  • Use bandages to protect the blister from contact with germs.
  • Avoid continuing to wear the shoes that caused the blister.
  • A couple of days after the blister forms, the outer layer of skin will start to dry out and lose its suppleness. The tightness will pull at the edges of the blister. This hurts, and creates a risk of it tearing loose to create an open wound. Keep it soft with moisturizers.
  • Don't remove the outer layer of skin until a couple of weeks after the blister has formed. It provides continued protection against the germs that cause infection, and should remain in place until a new layer of healthy skin has fully formed.

Of course, you won't take everything appearing on this checklist. Talk to your doctor about the issues described in this article, and let that guide you in which items are right for you. You won't want to take any more than necessary because it takes up space in your luggage and adds weight.

Muscle	Leg warmers Ointments such as arnica, Ben Gay, or Tiger Balm Heating pad Anti-inflammatory drugs Handheld massager
Sprains & Breaks	Elastic bandage for wrapping sprains Bag for icing injury Glucosamine chondroitin First aid advice from your doctor on what to do in case of sprain Knee or ankle braces if needed for weak joint
Feet	Soothing foot lotion Dance sneakers with padded soles Orthotics Bandages to protect blisters Antiseptic cream to put on skin if blisters break Old, comfortable shoes Athlete's foot remedy (anti-fungal cream, tea tree oil) Skin moisturizer to keep blisters soft and supple

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