To prevent injury to dancers feet, pointe shoes have to be fitted correctly and fit the dancer’s foot as accurately as possible.
Both demi pointe and pointe shoes need to be fitted as snug as possible. Our feet are not naturally designed for pointe work, and in fact, the bones in our toes are among the smallest in the body. When we dance on pointe, the foot’s natural three-point support system is completely compromised, so the show must take over and provide that critical support.
It is therefore very important to find the correct shape, style, and size of the shoe for the dancer, making sure there is no room to slide around in the shoe. Our shoes come in three different styles, half sizes and 5 different widths, as well as 5 different shank strengths. If we do not have the correct shoe in stock we can order it for you.
Fitting
As a young dancer grows, it may be necessary to replace the pointe shoes each term. The shoes will need to be refitted periodically until the dancer’s feet settle into a consistent size and shape.
Life Of The Shoes
The support of the pointe shoe largely depends on how well the dancer care for them. Regularly drying the shoes will help them last much longer. Our pointe shoes are made entirely from natural materials, and if left in a plastic bag at the bottom of the dance bag, they will deteriorate and rot.
Dancing In Broken Shoes
It is crucial to replace your pointe shoes as soon as the support through the metatarsal heads is lost, or if your toes are pushing into the bottom of the shoe’s box. Continuing to wear broken shoes can lead to hairline fractures, which may not show up on an X-ray until 6 weeks after the damage occurs. Therefore, replace your shoes as soon as the support diminishes, or stop dancing on pointe until you can get a new pair.
Authored by Georgina Barr, Barrina Podiatry and Esther Juon, Juon Pointe
Many countries, New Zealand included, are funding adolescent pre-professional sporting programmes in high schools with increasing regularity. Dance however is still considered by many to be purely an art form and those who participate within it are artists without the dual title of athletes.
This then leads to a lack of appropriate medical care of dancers and subsequently poorly managed dance-related injuries.
Commob scenario: two 12 year old girls have ankle injuries. One plays football and the other dances. The football player is told to rehabilitate effectively. The dancer is told to stop dancing.
Common scenario: two 16 year old girls have hip injuries. One plays netball and the other dances. The netball player is assessed and given exercises based on her sport. The dancer is not assessed in turnout positions.
Is dance at fault? Or is how we view dance the issue?
Considering so many young people in New Zealand engage in many forms of dance, surely there is a better option?
One of the most challenging forms of dance is the practice of classical ballet on pointe. The form originated in the early 1800s and has progressed through the decades with increasing popularity and equally increasing difficulty. It is now seen as a social rite of passage for many young ballet dancers.
General belief states that reaching 12 years of age is the main pre-requisite to beginning to dance on pointe. Unfortunately, there is no robust body of medical evidence to suggest that age is the most important and definitive factor. The result is the guideline is to treat all dancers the same, despite individual growth and development issues, and this typically leads to preventable lower limb injuries and feet with significant structural changes, such as bunions in dancers as young as 13 years old.
Global research is currently looking at the benefits if dance schools incorporating medically-based pre-pointe assessments into their curriculum to ensure dancers are properly managed. Assessment criteria includes testing strength (of the feet, ankles, legs and core), flexibility (of joints as well as muscles) and proprioception (awareness of the nosy within space) to effectively define an individual dance student’s readiness for pointe work.
Such simple but effective testing outcomes view the dancer as an individual and allow the guidelines to fit the dancer and not the other way around. Such easily replicable testing outcomes for example include appropriate joint range of motion for the ankle. With the leg extended, a straight line from the inside of the shin to the inside of the ankle bone and to the ball of foot when pointed should achieve a range close to 180 degrees. Any lack of range, or conversely excessive range, forces compensations on other areas of the body and can lead to ankle, knee and hip injuries. Likewise, the ball of the foot range needs to be 90 degrees to ensure a proper ‘demi pointe’ position. Any limitation here forces the ankle into malalignment as is transitions from demi pointe to full pointe and the can lead to preventable ankle injuries.
Despite the logic of such measurements and their associated outcomes, we line in a world where more is better and flexibility often over-rides strength. Instead we need to protect young dancers from injury. Not many will achieve success in the commercial dance world but safe guarding against lifelong pain and disability should be the first priority.
In this way such images (A) can be a thing of the past in a 13 year old.
These photos of feet, in a non-weight bearing pointe posture and standing ‘on pointe’ do not present feet with appropriate intrinsic foot muscle strength and so the feet are sinking into the pointe shoe which then in turn cannot support the dancer’s weight.
Internal foot muscle strength (as well as general body conditioning) should be the focus for all pre-pointe and pointe dancers.
Toe movement and strength involves a mix of activating muscles from inside and outside the foot. When the intrinsic (inside) toe muscles are ignored for the larger stronger extrinsic muscles, the foot is ‘pointed’ with the external lower calf muscles only and this makes a ‘fist’ with the foot which leads to curled toes. This way of pointing bends all the joints in the toes as well as the ball of foot joints. When put on pointe the toe joints then have to beat all the body weight and they distort under the pressure. The foot ends up sitting in the end of the shoe with the toes carrying the weight.
The most unrecognised fact of dancing en pointe is that the weight of the body should not be forced onto the toes but instead dispersed from the metatarsal heads (ball of the foot) through the shoe and into the floor. If the dancer does not have strong enough feet then no pointe shoe will effectively support them.
A number of Canterbury dance schools are growing an increasing knowledge of dance bio-mechanics and they are incorporating a mix of pre-pointe strength training programmes and assessments into their repertoire to ensure that the dancer is safe. The result is a dancer with stronger feet and lower limbs and a clearer knowledge of their body, which allows them to better self-manage future injury potentials.
This is a much better outcome than (A)!
But despite the various Canterbury region dance school initiatives, how does New Zealand fare in this changing landscape? Are we being left behind on the global scene? There are many medical professionals actively involved in dance medicine in New Zealand, but are they being under-utilised? The social construct of the under-funded arts is outdates and serves no function but to undermine the needs of those it professes to celebrate – the dancers.
The change in being initiated from the bottom, today’s young dancers are better medically-managed than any previous generation. But where do we stand on the international scene? Are we to always look abroad for best practice? Why, with so many in this country making changes?
New Zealand is constantly and consistently making progress in dance medicine and we have the opportunity to lead the way in simple by effective techniques to protect our young dancers from injuries.
The question is – what happens to the 12 year old who has an ankle injury and dances?
Is she to be valued as highly as the football playing child?
