Are You Or Your Child Looking To Commence Ballet Training "En Pointe"?

Progressing to en pointe is a big step in any dancer's journey, not only in terms of their skill development, but in the large and straining demands being placed on their bones and joints. During en pointe, up to ten times a dancer’s body weight will be carried on their toes, which must be supported with great strength, flexibility, control and technique. Leaping into en pointe training before you’re ready places you at a significant risk of injury to the foot and ankle. 

A pre-pointe assessment with our Brisbane podiatrists identifies any issues and deficiencies that must be addressed to help you progress safely through your training, help you avoid injury, and help optimise your performance. Pre-pointe assessments are now a standard requirement for many dance schools and ballet academies to provide ballet dancers a form of medical safety clearance to progress to this next step.

What Is A Pre-Pointe Assessment?

At its core, a pre-pointe assessment helps prevent dancers from getting injured by starting en pointe training before their bodies are ready. It is a comprehensive examination that will either give them the go-ahead to begin training paired with advice and additional exercises to optimise their performance, or it will advise them of what they need to do to best prepare their feet and ankles for this next step if it looks like they are physically and functionally not yet ready. Pre-pointe assessments establish a baseline of a person’s strength and mobility, and involve a physical assessment, a functional assessment, and a detailed medical, dance and injury history. 

Pre-Pointe Assessment Testing Areas

Some of the areas we look at during your pre-pointe assessment include:

Height of rise

If your height of rise is inconsistent, it may decrease your ankle stability and make you more prone to overuse injuries in the lower leg. When your height of rise is consistent, we can ascertain that the strength and endurance of your calves is sufficient to support you through en pointe training.

Quality of rise

The quality of rise is the control with which it is performed and lowered. If the heel is dropped too quickly, it can indicate poor eccentric muscular control in the calves, which is important for ideal shock absorption control when landing from jumps, as well as protecting the back of the ankle joint and Achilles tendon.

Pointe range

Insufficient or restricted point range is a common problem, being linked to not only the range of motion in the ankle but also strength to help articulate the feet well.

Turnout range

The turnout describes the available movement and strength of the hip rotator muscles. A good turnout range requires both symmetry and strength for even forces to be distributed around the hips, which greatly influences technique and leg alignment control.

Ankle alignment on rise

When rising, we should see a vertical alignment of the leg, ankle and foot. Ankles that roll either inwards or outwards may indicate muscle weakness in the lower leg and ankle, which is an injury risk.

Intrinsic muscle strength

If the toes curl or grip when rising instead of remaining straight and being firmly pressed against the floor, this likely indicates weakness in the intrinsic muscles of the foot.

Calf muscle activation

The gastrocs at the back of the calves are key to pointing and rising. Rising to demi pointe, the calf muscles should be activated early and efficiently. When they’re not, certain muscles may have to overwork instead, leading to tightness and overuse injuries. 

Pelvic stability

The pelvis should be stable and controlled, as opposed to hitching or rotating, which may indicate weakness in the glutes or core.

Ankle flexibility

When ankle flexibility is restricted, this can make it difficult to keep the heels down when landing from jumps, increasing the pressure on the surrounding joints and encouraging the ankle to roll in.

Ankle strength

The muscles and ligaments that support and stabilise the ankle must be at a good strength in order to perform their role properly and help prevent ankle injuries.

What Does A Pre-Pointe Assessment Involve?

The assessment starts with a comprehensive medical, dance and injury history. This information can also guide any additional assessments we perform to ensure that you have sufficiently recovered from any previous injuries. Next, we perform your physical and functional assessment - this is all of your range of motion, strength and stability testing. We look at your joints and muscles both in isolation, and during ballet movements and techniques. Based on the results of your assessments, we’ll compile a report, make recommendations about your suitability to begin dancing en pointe, and create an exercise plan to address the areas of weakness, inflexibility or poor control that we’ve identified. We may continue to see you periodically as your progress through your plan to reassess your progress.

How To Care For Your Feet During En-Pointe Ballet Training

• Keep your nails trimmed appropriately - not too short and straight across the nail as opposed to curving the nail down the sides, to reduce the risk of an ingrown toenail
  
• If you are prone to recurring ingrown toenails, have the troublesome nail edge permanently corrected by your podiatrist
  
• Dry your feet well after showering or any time they’re wet. Keeping our feet in shoes for prolonged periods, especially when they’re sweating, increases the risk of blisters, fungal infections and general damage to the skin
  
• Get professionally fitted for a pair of pointe shoes
  
• Air your pointe shoes well after every use
  
• Avoid tight, narrow or uncomfortable shoes outside of pointe training too - these can leave blisters and problems that compromise your training
  
• Consider which toe is your longest - for many it’s not the big toe but the second toe. Keep your toes protected as best possible to avoid the nail bruising and falling off
  
• If you develop corns or painful calluses, have them professionally removed by a podiatrist. The nature of calluses is that they develop as a direct result of pressure, so only tend to worsen on their own. If you have minor calluses that are not causing any discomfort or problems, you can leave these as a natural layer of protection for your foot
  
• If pain starts, or if you develop athlete’s foot or other foot problems, get them treated early. Generally, the faster we are able to treat a problem, the faster and simpler the treatment is.
  
• Add regular strengthening and stretching as a normal part of your every day life - it all adds up.
  

FAQs

Visit one of our Brisbane Podiatry clinics

If you would like to talk to one of our team, visit us at one of two Brisbane based locations, CBD & Newmarket.

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