How Old Is Too Old To Start Pointe Work?

The "How Old Is Too Old?" question comes up often in forums and discussion groups centred on pointe training and it is an issue that not many teachers/therapists/authors address. Technically, there is less risk to adult feet when beginning en pointe as their growth plates are fully fused. However, very few adults who have not danced for several years in their youth will possess a foot of suitable shape or strength for dancing en pointe. "The Perfect Pointe Book", a downloadable e-book designed to help girls get strong enough for pointe work, has details on exactly how to measure the range of motion in various parts of the foot and ankle required for pointe training.

The issue of flexibility is the main area that will hinder most mature students from achieving a fully pointed position of the ankle, as this often requires some gentle stretching of the ligaments that is much easier when we are young. The range possible at the ankle also depends significantly on the natural mobility of the ligaments in general. Therefore, in a 'hypermobile' individual (general laxity in all ligaments of the body), this will be easier to achieve. However, if there is a real desire to put the work in to improve this, I have seen some drastic improvements in foot and ankle range in adult clients.

The strength requirements for an older ballet student to progress onto pointe actually exceed the requirements for a young dancer. This is due to the fact that most adult dancers are significantly heavier than the average 12 year old! The dancer must be able to control the feet well for all of the tests, especially when en fondu, and during petit allegro, as the increase in body weight will create much stronger forces through the joints in the foot while jumping. Lack of control of the arch when en fondu, especially on the slightly rounded sole of a pointe shoe, will put the knees under great strain when dancing. Turnout strength, range and control are also very important areas to assess.

If an adult has been taking ballet classes for some time, and working their feet well in class, the required strength in the forefoot will not take long to develop. However, for the complete newcomer to ballet, learning how to isolate certain muscles in the feet may take some time. Our bodies develop 'motor patterns' of movements that we do regularly, and it is important for this isolated foot control to become second nature to the dancer before commencing pointe work. There are so many other things to think about while en pointe, that the dancer must be able to easily control the position of the toes in the shoe to have optimum control and therefore safety en pointe.

The co-ordination required to control the feet en pointe is something that is developed over years of dancing, and, as for any student, I would expect an adult to be dancing at least 3 classes a week for a year, and ideally regular classes for several years before considering pointe work.

All the points discussed in "The Perfect Pointe Book" should be addressed for anyone of any age (men included!) before progressing onto pointe. It gives guidelines and tests for range and strength that is so important to prevent injury. It is not impossible for an adult ballet dancer to progress onto pointe, but it will usually require a lot of work and dedication to achieve this safely.

Lisa Howell (B.Phty) is a Physical Therapist (Physiotherapist) based in Sydney, Australia, who specialises in the assessment and treatment of dancers of all ages, from young students to professional level, and teachers. She is dedicated to the education of dancers to help prevent injury, and to develop optimal performance at every level. She produces a FREE weekly dancer's newsletter with tips on all aspects of dance to help spread her knowledge around the world. To find out more about "The Perfect Pointe Book" or to receive the newsletter, go to www.theperfectpointebook.com

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Pointe vs. Weight. How heavy is too heavy to be dancing en pointe?

It is possible that a dancer who is slightly 'heavier' does has enough strength to hold their weight en pointe, however how heavy is too heavy to dance en pointe? This issue of "weight" is very common in dancing, and often girls get a distorted idea of what is normal when involved in dance for a long period of time. However it is commonly asked what is about the ideal weight for pointe work.

It is possible to be too big for pointe work, and bigger girls do need to be stronger to go en pointe due to more pressure going through the ankle ligaments. However, you do not need to be a 'stick' either! "Les Trocaderos De Monte Carlo" there are plenty of fully grown men en pointe, who I am sure will be vastly heavier than any girl.

Basically, it depends whether you carry weight as muscle or as fatty tissue, and how strong you are. If you have done all the preparation exercises in The Perfect Pointe Book, and are sure that you are doing all the tests correctly and can demonstrate your strength to you teacher. I feel it is reasonable to dance on pointe.

If you know that you could do with losing a little weight, do make sure you go about it sensibly. Starving is not the way to lose weight, and will actually often slow your metabolism down, as well as making you crave the foods you are missing. The first thing I would do is cut out all the simple sugars in your diet. (Sugar, sweets, white bread, crackers, potatoes and white rice etc). Replace them with whole grain versions as much as possible, and have fruits to satisfy you sweet cravings as much as possible.

It is often really hard at first, so maybe give yourself one day when you can have a small amount of your favourite food if it is not in the good list! This means you won't be as tempted to break your good habits on other days, and before long, you will probably not feel like the "treats" anymore!

The next is to take a look at your weekly exercise regime. How much cardio-vascular exercise do you get each week? According to the Heart Society Guidelines, at least 30 mins of aerobic activity, three times per week is essential for a healthy heart, and this is a good level to have as a baseline. When we are dancing, it is often not sustained aerobic work (although it can be very tiring) so maybe try to include some swimming, brisk walking or jogging to keep you heart rate up for the 30 mins, three times a week.

Good things take time, but do not get discouraged! This is a very health practice to get into for the rest of your life, and I promise that you will feel the benefits before long. Keep up a good intake of fresh fruits, vegetables and lean protein (eggs, tofu, fish, red meat and or chicken) and remember to drink loads of water to keep yourself hydrated!

Lisa Howell (B.Phty) is a Physical Therapist (Physiotherapist) based in Sydney, Australia, who specialises in the assessment and treatment of dancers of all ages, from young students to professional level, and teachers. She is dedicated to the education of dancers to help prevent injury, and to develop optimal performance at every level. She produces a FREE weekly dancer's newsletter with tips on all aspects of dance to help spread her knowledge around the world. To find out more about "The Perfect Pointe Book" or to receive the newsletter, go to www.theperfectpointebook.com

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Dealing with Bunions En Pointe

Many girls who start on pointe are scared that they will get bunions from doing pointe work. Pointe work will not 'cause' bunions, however if you do have a family predisposition to bunions (check out your Mother and Grandmothers feet!) then wearing ill fitting shoes (whether they are street shoes or pointe shoes) may hasten their development.

People usually say that they have a bunion if they start getting a lump out at the base of the big toe. You can get a 'pseudo' bunion by the rubbing of the pointe shoe if the wings are too short and do not come up to the level of the big toe joint, or wear a very narrow box. This causes the toes to be squashed together, and the ball of the foot sits above the box, rather than being supported within it. Often picking a shoe with longer wings and a wider box will help reduce pressure on the area, and the irritation will subside...

A 'real' bunion is when the end part of the big toe begins to angle in towards the other toes, and the knuckle of the toe (head of the first metatarsal) drifts away from the second metatarsal. The protruding piece of bone thickens and often gets red and irritated. Sometimes it may feel hot.

Several things are often present in the physical examination of a dancer with bunions.

1) Often she has quite mobile feet but tends to overturn the feet in first and fifth positions.

2) She may have good turnout range, but may not have the strength to use it in standing and when dancing.

3) If this is the case, when she is standing the rolling in of the feet puts pressure on the inner edge of the big toe and this encourages the drift towards the second toe.

4) If she has good turnout range she often walks with the feet slightly turned out, and rolls off the inner edge of the big toe, rather than pushing off from the underneath part of it.

5) The muscles that support her arch are usually too weak to support the foot, and especially the one under her big toe (Flexor Hallucis Brevis) is unable to assist the movement from demi to full pointe.

6) There is often an isolated restriction in mobility between the top end of the first metatarsal and the mid foot bones (Cuneiforms).

7) If there is reduced mobility of the big joint when attempting to go onto demi pointe, this often results in either sickling in, or sickling out en demi-pointe

8) The metatarsal of the big toe is often rotated in, and angled out away from the second metatarsal.

9) She may demonstrate poor pelvic stability, with the thigh, knee and foot rotating inwards with single knee bends in parallel.

Depending on how many of the above points are true for the dancer, she should commence a series of exercises based on turnout strength, arch control and control of the intrinsic muscles of the feet. Many exercises to target these areas are described in detail, with photos in The Perfect Pointe Book. (www.theperfectpointebook.com/index2.html)

The dancer with bunions often needs mobilization of the mid foot to help re align the toe correctly, and then taping and padding in the shoe to keep the toe in alignment. There are various taping techniques that can be used to help the dancer with bunions. Many people use toe separators, and this may help prevent the big toe from crossing the second toe, however it does not solve the real problem. It is preferable to tape under the head of the first metatarsal, before drawing the tape up and over the knuckle, de-rotating the first metatarsal. The tape is then wrapped around the big toe. This often helps align the toe more correctly in the shoe. A tape can also be used to keep the head of the first metatarsal in closer to the second, to reduce the sideways drift.

Any padding should be in a donut configuration so as to distribute the pressure to the area around the bunion, rather than to increase the pressure on the already tender area. Create custom designed shapes by cutting pieces out of a simple foam rubber shoe inner sole that you can buy from the supermarket. They are cheap, comfy, and you can even get deodorizing ones. Cut a circle larger than the inflamed area, and then remove the center portion so that there is no increased pressure on the inflamed area. Adhere the padding onto the foot to keep it in place with thin hypoallergenic white tape so that it does not slide around when dancing.

Having a family history of developing bunions is not a barrier to commencing pointe work; however the dancer must take special care of her feet to avoid early development of this often painful condition.

Lisa Howell (B.Phty) is a Physical Therapist (Physiotherapist) based in Sydney, Australia, who specialises in the assessment and treatment of dancers of all ages, from young students to professional level, and teachers. She is dedicated to the education of dancers to help prevent injury, and to develop optimal performance at every level. She produces a FREE weekly dancer's newsletter with tips on all aspects of dance to help spread her knowledge around the world. To find out more about "The Perfect Pointe Book" or to receive the newsletter, go to www.theperfectpointebook.com

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How Do You Fit Pointe Shoes Properly?

All brands make several different shapes and styles of pointe shoes, which are designed for different people and different uses. This is often very confusing for first time buyers, so if at all possible get your dance teacher, or an experienced dancer to go along to the fitting with you. The fitters in various stores can range from exceptional to very average, so it is a good idea to get a name of a good fitter on the recommendation of someone you trust.

While the person who fits your shoe should check all of the following things, it is good to know what to look for, and to feel, yourself. The fitter can look at how the shoe looks from the outside, but only you can feel what is going on inside.

If possible, ask your teacher to come with you the first time you get your pointe shoes fitted, so that they can check the fit. If they cannot go, always check the fit of the shoes with them with them before you sew on the ribbons, break in the shoe or dance in them. If you get them dirty by wearing them around the house, they my not be able to be returned to the store, and it can get to be a very expensive exercise.

Each part of the pointe shoe has a name. Try to learn the names for different parts of the shoe before you head to the store for the first time. That way you'll know what the fitter is talking about if she asks "Is that vamp too high?". There are many sites online that can help you with this.
Always try the shoe on with any padding or 'Ouch Pouches' that you will wear while dancing, and check the shoe in each of the following positions.

A) Check the fit of the box - The foot should fit snugly in standing; with the toes not too squashed in (They should be able to lie flat). There should be no bulging of the skin over the top edge of the shoe in standing. The top of the box should sit against the skin of the top of your foot. You should be able to slide the tip of your finger in to the shoe over your toes, just. If the box is too round for a flat foot, there will be more of a space here. You can flatten the box slightly, but it will also alter the width.

B) Take a look at the length of the wings. The wings should come up to the side of the big toe joint. If they are too short, the box will pull the big toe in on an angle and may cause a bunion to form. If they are too long, it may be hard to work properly through the demi-pointe.

C) Check the position of the heel of the shoe. The satin of the heel should come 7/8 of the way up your heel bone. Too high, and you may get problems with the attachment of your Achilles tendon attachment. Too low, and you will get frustrated with the heel of the shoe popping off when you rise.

D) Watch the length of the vamp, the front of the shoe. If the vamp is too long you will not be able to rise through the demi-pointe effectively. If it is too sort for long toes however, you will feel like you are falling out of the front of the shoe.

E) When you plie in a wide seconde position, the foot is at its longest and widest, so it is important to check that there is enough room in the shoe for your foot while dancing. Your toes should stay long in the shoe, and just touch the end of the shoe at the depth of your plie. If you have very short toes, you may need to pad up inside the box of the shoe to get a nice line of the shoe, and a correctly fitting box.

F) It is important to check the fit of the shoe in an upright position before putting any weight on it. Place the tip of one shoe on the floor, with your weight on the other foot. Press down slightly to check the fit of the box. The foot should be supported in the box, and not sink down too much. Check the amount of satin at the back of the heel. If the foot has slid forward in the shoe, because the shoe is too wide, there will be more satin. If the top of the foot is bulging out, the box is too small. Make sure that both the big and little toe knuckle joints are supported by the wings. If they are too short the top of the wings will cut in and give an unsightly line to the toe of the shoe.

G) Check the length of the shoe by peeling the satin of the shoe off the heel and folding it back under the shoe. Place the foot back en pointe, and check where the sole finishes. The end of the sole/shank should be just short of the end of the heel. If the shoe is too long (as in the picture on the right), there may be bagging of the satin at the back of the shoe, as the satin is cut to cup the heel. If the shank is too short however, the foot will tend to wobble more, and the satin will pull too low. This results in the back of the shoe often poping off when rising from demi to full pointe and can be very annoying.

H) Look to see that the shank sits in line with the sole of the foot when the foot is en pointe. If the shank of the shoe is twisting, check the alignment of the foot first. As long as the box is sitting square and the foot is in good alignment, it should be ok. Often twisting of the shoe is due to the shank not conforming to the shape of the arch and can be remedied by breaking in the heel of the shoe before wearing. However, the shank may also twist on the foot if the box is too narrow, so recheck this area again.

Once you have a good fit, you may try weight-bearing through the shoe by stepping up onto pointe. Hold onto the back of a stable chair or bench, and place one foot en pointe. Put some weight through that shoe and then bring the other foot up onto pointe. Make sure your toes are pointed long in the shoe and that there are no areas of severe pressure on any toe. Isolated areas of pressure may be solved by use of specific padding in the shoe, but should be avoided with a good fit if at all possible.

Lisa Howell (B.Phty) is a Physical Therapist (Physiotherapist) based in Sydney, Australia, who specialises in the assessment and treatment of dancers of all ages, from young students to professional level, and teachers. She is dedicated to the education of dancers to help prevent injury, and to develop optimal performance at every level. She produces a FREE weekly dancer's newsletter with tips on all aspects of dance to help spread her knowledge around the world. To find out more about "The Perfect Pointe Book" or to receive the newsletter, go to www.theperfectpointebook.com

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What is Osgood Schlatters Disease?

The way some muscles attaches into the growth plates of your bones can cause problems if you are doing a lot of sport involving jumping and running, which is why a lot of girls and boys who dance or do athletics get issue with their knees. This happens especially around periods of growth when the growth plates are more active.

If you have pain below the knee cap, and you think it may be the growth plates, it may be a syndrome called Osgood Schlatters Disease. This is not really a 'disease' but is just named after the guy who discovered it.
The tendon that attaches the patella (knee cap) to the tibia (shin bone) is called the patella tendon. The tendon attaches to your tibia right on the growth plate. The muscles of the front of the thigh (quadriceps) attach into the top of the patella which acts as a pulley to allow you to straighten your leg without the muscle rubbing over the edges of the bone. If you bend and straighten the knee many times, the constant pulling on the growth plate can aggravate it and you can get quite a bit of pain.

Things you can do to reduce the amount of pain and pulling include...

· Gentle stretching of the Quadriceps
· Strengthening your buttock muscles to reduce the load on the Quads
· Taping techniques to redistribute the load going through the tendon
· Strengthening other muscles around the hips so not as much strain goes through your knees.
· Icing the tendon after exercise, on a gentle stretch, to reduce the inflammation.

If you are having more random pains, more at night, and the pain is above the knee joint, it may be purely action at the growth plate of your femur (long thigh bone). Make sure that when it has been a little sore you do not do too much jumping or strong stretching. Keep the muscles around the area relaxed with gentle stretching, and heat may help relieve the pain by bringing more blood to the area.

Use Rest, Ice, Compression, and Elevation to settle any sudden increases in pain.

Lisa Howell (B.Phty) is a Physical Therapist (Physiotherapist) based in Sydney, Australia, who specialises in the assessment and treatment of dancers of all ages, from young students to professional level, and teachers. She is dedicated to the education of dancers to help prevent injury, and to develop optimal performance at every level. She produces a FREE weekly dancer's newsletter with tips on all aspects of dance to help spread her knowledge around the world. To find out more about "The Perfect Pointe Book" or to receive the newsletter, go to www.theperfectpointebook.com

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What Pointe Shoes Are Best For My Feet?

There are many different brands of pointe shoes, made in very different countries and there is no one shoe that is perfect for everyone. Different dancers have different shaped feet, and so require different proportions to their shoe to get that magic fit. Some people have very long narrow toes while others have a very broad foot with a very narrow heel. Finding (or creating) a shoe that fits well can take a lot of searching, along with a little trial and error.

One way to find the shoe that is best for you is to go to a store that has several makes of shoe to find the one that suits your foot the best. Once you find which brand suits you, a specialty store that stocks only that one brand will probably have more shoes around your size to get a great fit. Some dance teachers like all their girls to have the same brand; however the chances of all those feet needing the same shoe are pretty slim! It is better for each girl to find the shoe that fits them the best, and then find ways to make the satins appear the same for performances.

All brands make several different shapes and styles of pointe shoes, which are designed for different people and different uses. This is often very confusing for first time buyers, so if at all possible get your dance teacher, or an experienced dancer to go along to the fitting with you. The fitters in various stores can range from exceptional to very average, so it is a good idea to get a name of a good fitter on the recommendation of someone you trust.

The strength of the shank is important, yet very controversial. Some people like beginners to have a stronger shank to help support them en pointe until they get stronger, while others believe that the learner needs a softer shank to learn how to work through the shoe properly. Generally the second option is the best, especially when you have strengthened the feet and ankles properly before starting pointe. When you are beginning pointe you are only doing a few minutes of pointe work at the end of class, and so you don't need a super strong shoe to last you the rigors of a professional class. A medium density shank will allow you to break the shoe in enough to help you work through the shoe, yet still support you en pointe.

Lisa Howell (B.Phty) is a Physical Therapist (Physiotherapist) based in Sydney, Australia, who specialises in the assessment and treatment of dancers of all ages, from young students to professional level, and teachers. She is dedicated to the education of dancers to help prevent injury, and to develop optimal performance at every level. She produces a FREE weekly dancer's newsletter with tips on all aspects of dance to help spread her knowledge around the world. To find out more about "The Perfect Pointe Book" or to receive the newsletter, go to www.theperfectpointebook.com

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