By Marisa Wilson (Dance Physiotherapist at Connective Healthcare)
Commencing training en pointe is a very exciting time for the young dancer; however, if not approached with caution, it can potentially be a significant injury risk.
I remember when I was a young dancer, I couldn’t wait to get my little toes nested beautifully in a pair of pointe shoes! I thought I’d feel like a graceful swan, gliding across the stage with ease, in my perfect shiny pointe shoes. Oh it would be a dream come true!! …. But was it? NO! In reality, I ended up being a limping and injured swan with bleeding toes who kept rolling their ankles en pointe. Why? Because I wasn’t ready to commence pointe training yet. I was still too young (skeletally immature), had weak ankles and calves, and my intrinsic foot muscles were not strong enough to enable me to keep my toes long and straight when en pointe.
Dancers of today are so lucky with the recent developments in dance medicine and dance safety. In my day, pre-pointe assessments were not readily available to dancers. Today, we recognise how important it is that dancers are assessed by qualified health professionals and equipped with the necessary tools to ensure their journey en pointe is safe and considered.
Below is a list of questions all young dancers (and their parents) are burning to know…..
A pre-pointe assessment evaluates the dancer’s readiness to commence training en pointe. The assessment considers age, training history, pointe range, foot/ankle control, intrinsic foot & calf strength, pelvic/core control, and ballet technique.
The assessment generally lasts 30-45 minutes and is carried about by a qualified health professional (usually a Physiotherapist) who has a thorough understanding of ballet technique.
In the initial pre-pointe assessment, the physiotherapist will typically take a brief history to understand your training load, previous injuries, and your goals . Your therapist will then take a few measurements (e.g. pointe range, calf length, turnout range etc.) and have a look at a few ballet movements (e.g. demi plie, rises, etc.).
NO! The good news is, there is no ‘pass/fail’ or marks assigned to a pre-pointe assessment. Pre-pointe assessments are usually relaxed and interactive. They are nothing like your dreaded ballet exams! The assessment IS designed to help you prepare for future success and reduce the risk of injury. The assessment is NOT designed to focus on negatives or to stop you from training en pointe. Your Physiotherapist wants to get you en pointe as much as you do!
Finding the areas which need improvement from your pre-pointe assessment is a real positive! This is because learning about your body and getting on top of any weakness before commencing pointe will help you to reduce the risk of injury and you will therefore enjoy your pointe training much more. Trust me…. pointe isn’t as enjoyable when your toes are riddled with blisters and your ankles are sore! OUCH!
After the assessment, the dancer is typically prescribed exercises to boost the areas within the assessment that require improvement to ensure safety en pointe. These are often exercises to improve intrinsic foot strength, ankle alignment, and calf endurance. It is recommended that these exercises are practised daily, or every 2nd day, depending on your physiotherapists instructions.
The dancer is usually re-assessed 3-6 weeks after completing their tailored exercise program.
It is important to wear something fitting (i.e. leotard and tights) so that the physiotherapist can see all your muscles. Please ensure you have bare feet to ensure so that the physiotherapist can have visual access to your toes and feet. Ballet shoes are not required.
You should aim to book your assessment at least 2 months before your ballet class is due to commence pointe-work. This will give you enough time to complete the required pre-pointe exercises and gain the necessary strength to commence pointe safely. .
It is very rare for dancers to be approved for pointe under 12 years of age. This is because the body is too skeletally immature and will not be able to withstand the demands in which pointe training places upon the growing body.
You may still have a pre-pointe assessment at age 11 (you can get a headstart of your exercises!); however, it is recommended to commence pointe training from the age of 12.
In most cases, the young dancer will need to work on several items prior to getting their pointe shoes. Typically, dancers need to improve their intrinsic foot strength as this is not something that is generally covered in your everyday dance training. Often there are other elements within the assessment which need improvement too (i.e. ankle control and calf endurance).
Most dancers will need to follow their initial assessment with a subsequent exercise-based session for the physiotherapist to prescribe the dancer a tailored home exercise program. Thereafter, the dancer is typically reviewed again in approximately 4-6 weeks to assess whether they are progressing in the right direction. If the dancer shows improvement in the areas the assessment showed were lacking, then the dancer will most likely be awarded their pointe licence on their review session.
Sometimes dancers may need another few weeks (another session) to further progress their strength. This is nothing to worry about. Physiotherapists want to ensure that your body is ready, and you are safe, before commencing your pointe journey.
Before running off to purchase your pointe shoes, you must confirm that your dance teacher also approves your readiness to commence pointe training. It is important that your dance teacher has the final say as they see you in the context of class training on a regular basis.
Once approved by your teacher, you can book an appointment with the dance store (i.e. Bloch) of your choice (or your teachers preference) for a pointe shoe fitting.
In most cases, yes! However, there may be some restrictions to adhere to at the start of your training.
Not every dancer is blessed with the ideal 180deg pointe range. Having less than 180deg means that it is harder to get right up onto the block of your pointe shoes without unwanted compensations in the knees or pelvis.
If you have less than 175deg pointe range (many dancers do), then your physiotherapist will work more closely with you to ensure those unwanted compensations are minimised and you can still train en pointe safely.
YES! Your exercises are not designed to just get you onto pointe, they are designed to MAINTAIN your pointe training.
Fun fact: the Australian Ballet dancers still do 35 single leg calf rises at the barre everyday! They also do their physiotherapist-prescribed intrinsic foot exercises as part of their daily routine.
The pre-pointe journey should be an enjoyable and memorable one! Have fun with it! It’s such a wonderful time in the dancers career.
I’ll leave you with my top tips for starting pointe work!
Book a pre-pointe assessment 2-3 months prior to commencing.
Do your home exercises as prescribed!! They really do help!
Keep up your pre-pointe exercises into the future.
Begin your pointe journey slowly but surely -- you only get one body! Do it correctly!