Health Care Professionals

Tripping the Light Fantastic— Dancing “En Pointe”

Tripping the Light Fantastic— Dancing “En Pointe”

How does a ballerina dance “en pointe”—wearing special shoes that make it appear as though all her body weight is balanced on the tips of her toes?   Even for a tiny dancer weighing 85 pounds, looking light and ethereal in such a precarious position is an amazing feat of biomechanics.

Think about what a wondrous machine the foot is— definitely worthy of the best possible care. Each foot has 26 bones, so together, the feet contain almost 25 percent of all the bones (206, to be exact) in our body. When dancing on pointe, all those foot bones are compressed into sturdy shoes made to distribute a dancer’s weight throughout each foot.

History

Records are scarce on the origins of dancing on pointe, but it is believed that pointe work began in England or France between 1815 and 1835. Maria Taglioni was an early pioneer of pointe work. She danced on pointe in Paris in 1832, in the romantic ballet La Sylphide.  In 1833, Pauline Montessu performed the first known turn in pointe shoes.  Choreographer George Balanchine is credited with bringing ballet and pointe work to the United States of America.  In 1934, he opened The School of American Ballet in New York City.  The school is still in operation and is considered a world leader in ballet training.

Training and Injuries

It takes years of devoted training to dance on pointe.  Preparation for pointe work is a gradual process beginning with exercises at the barre to develop strength in the feet, ankles and legs.  The dancer then moves on to center exercises which emphasize turnout of the feet, pointing the toes and general ballet technique.

Although little girls have danced on pointe, professional trainers and doctors feel that a girl should be around 11 or 12 years of age before starting pointe work. The medical literature describes factors such as maturity, proper technique, strength, and postural control as the more significant factors in determining pointe readiness. An in-office evaluation of these factors can be performed by a physician to assist dancers, their family, and their dance instructor(s) in determining pointe readiness. It is also recommended that the dancer have trained in ballet flats for at least three solid years.  She must be physically capable; she must have excellent technique; and she needs to be emotionally mature to take direction and remain focused on training.  Foot and ankle injuries (including bunions, sprained ankles, Morton’s neuroma, plantar fasciitis and stress fractures) account for about half of all ballet injuries.  Starting pointe work too early increases the risk of injury.  It can also cause permanent damage to the foot because the bones can be too soft prior to about age 12.

Pointe Shoes

Great care should be taken with the fit of pointe shoes, particularly for a dancer new to the technique. An experienced shoe fitter will recognize the dancer’s foot type and recommend the correct shoe. The “peasant” foot (considered the ideal) has toes that are even, which helps the dancer distribute her weight evenly while on pointe. Her shoes should have a wide toe box. The “Grecian”- style foot has a longer second toe and needs special attention in fitting. The “Egyptian”-style foot has tapered toes and requires a narrower toe box.

Modern pointe shoes are usually handmade and consist of outer fabric (usually satin), a heavily-reinforced toe box, a shank, and a rubber or suede sole. The dancer sews on her own elastic and ribbons, which are wrapped around the ankles to keep the shoe in place. The stiff toe box is made from paper, glue and burlap. Even with all the reinforcement, a pair of shoes may only last 4-12 hours. A dancer will often go through a number of pairs for just one performance.

The shoes are fitted to a dancer in demi-plié (knees slightly bent) and feet in “first position” — turned outward with the heels touching.  The feet will be at their longest in this position, so an accurate measurement can be taken. The shoe must fit snugly to avoid corns and calluses but not so tightly that toenails are traumatized.  Blisters are also common, so again, a good shoe fit is essential.

What about Men?

I was curious to know why we don’t often see male ballet dancers on pointe.  Although you might think they are too muscular and heavy, men can and do dance on pointe, both in “serious” and comedic dances.  In fact, there is an all-male dance company called Les Ballets Trockadero de Monte Carlo that performs on pointe. Although their performances are a light-hearted approach to classical ballet (the men wear tutus and dance the female roles), these dancers are incredibly athletic and talented.  I encourage you to check out their website—I promise it will make you smile.

With my new-found respect for all things ballet, I think it’s time to call the local dance theater and make reservations for their upcoming production of "Cinderella."

References and Resources

http://lowerextremityreview.com/article/pointe-shoes-complicate-biomechanics-of-ballet

http://lowerextremityreview.com/cover_story/breaking-pointe-foot-and-ankle-injuries-in-dance

http://www.healio.com/pediatrics/journals/pedann/2016-1-45-1/%7B782240ae-9227-4f1b-abee-d83b4f17ed9a%7D/assessing-readiness-for-en-pointe-in-young-ballet-dancers

http://en.wikipedia.org/wiki/En_pointe

http://www.pointeshoefitting.co.uk

http://en.wikipedia.org/wiki/School_of_American_Ballet

http://www.trockadero.org/history.html

http://www.sab.org/

-- Patty Boyd, IPFH

 

Reviewed by Rachel Rader, DPM, IPFH Scientific Advisory Board
Last updated April 27, 2016

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