Dancing en Pointe – A Ballerina’s Hard-Working Foot

In Foot Facts by Alnoor Ladhani, Chiropodist

Dancing en pointe is an important discipline in ballet. Dancers begin pointe training at varying stages of their careers. However, when the dancer begins their pointe training does not always correlate with suitable maturity of the muscles, tissues, and bones used in techniques.

Where the dancer has not adequately matured, or bones and tissues are weak, there is increased risk from dancing en pointe. Due to the position that the dancer adopts during en pointe dance (supporting all their weight on extended feet), studying the effects of the dance technique is notoriously difficult.


MRI Protocol

When a ballet dancer is in the pointe position, it has been observed in all studies that the tibia, talus, and calcaneus converge. Through the use of MR imaging – whether the dancer is in a standing scanner or lying down – the position of the bones when in pointe remain the same.

A study using an MRI protocol was carried out using six dancers. These dancers were all university level, with average ballet dancing experience of 13 years. The average for en pointe dancing in the same sample group was seven years. For these dancers, survey data revealed minor ankle and foot pain throughout their careers.

As it stands, MRI scanning provides the International Association for Dance Medicine & Science the most useful data in determining the effects of pointe positions in ballet. However, the IADMS can only draw conclusions from correlations relating to current MRI scanning abilities.

Mapping of T2/T1ρ MRI Signals

The mapping of T2/T1ρ MRI signals may allow for a more thorough and conclusive investigation into en pointe related injury. Specifically, this scanning technique could lead to direct diagnosis of ankle osteoarthritis caused by en pointe dancing. The scan uses stronger imaging which, researchers agree, will likely allow for the detection of proteoglycans in key areas of the cartilage.

The importance of MR imaging cannot be understated. Researchers are able to observe the position of the ankles and feet. The data collected from these studies can then be used to aid teachers and dancers in adapting pointe positions which are less likely to result in injury.

Dance Teachers and Parents

While researchers and the IADMS continue to work towards gaining more useful data from studies, teachers and parents have a part to play, too. A good ballet teacher will constantly assess her students. Although most students will want to dive right into pointe work, it is the job of the teacher to evaluate each student’s readiness.

For young students, especially, en pointe dancing escalates the risk of injury or permanent conditions of the ankles or feet. The bones and tissues must be mature and strong, before the teacher even considers beginning en pointe training. Relying on study data, combined with the teaching of proper technique, will help ballet teachers protect students from unnecessary injury.

Parents must also remain vigilant. Most ballet teachers are well aware of the potential perils of beginning en pointe dancing when the student is not ready. However, that alone is not enough to quell the student’s enthusiasm. Some students may attempt to practice en pointe at home, without any direction from their teacher. It is the job of parents to help educate the student on the risks associated with en pointe dancing, and why they must only practice techniques as instructed by their teacher.

Early Intervention

En pointe dancing represents a sub-discipline of ballet. There are many other disciplines in ballet which impact on the bones, muscles and tissues in the ankles, feet, and legs. Until studies are able to conclusively detect potential issues, it is important that dancers attend regular appointments with a medical specialist.

Regular checkups with Step By Step will help dancers avoid injury resulting from as yet undetected conditions. We can also provide advice and recommendations on foot care, exercise, and provide medication to reduce swelling and relief pain from injury.

If you have already began or are ready to begin en pointe dancing, contact Step By Step to find out how we can help you keep your ankles and feet healthy and strong.