Some points on pointe – What the Experts Have to Say…

by Janine Bryant for The Dance Journal

Dancers know their bodies. We understand the pain tolerance required to move beyond normal ranges of motion into areas non-dancers just can’t even fathom going with their bodies. Like athletes (because that is what we are), there is a mind-body connection that begins to develop from a very young age after serious training begins.

During a young dancer’s formation, a significant rite of passage is the permission from their teacher to begin working en pointe. This is a huge milestone in the life of a female dancer which can be both significant and scary. Under the tutelage of a knowledgeable and skillful teacher, ballet dance students who are beginning pointe work will lay a strong foundation from which future training and technical development can build. The mind-body connection is fostered and, through a slow and carefully designed pedagogical method, an understanding of pointe technique is built as well as the strength required to master basic skills, which will lay the foundation to properly execute the more difficult ones.

The above scenario are the ideal conditions that one would hope to find more often than not in dance schools everywhere. However, this is not the case and, unfortunately, dancers are often allowed to don pointe shoes way too soon and way before their bodies are ready for them. Oftentimes, we find young dancers with lumbar hyperlordosis (sway back), with no strength whatsoever in their abdominals, struggling to rise onto their boxes and stay there by sheer will. Likewise, the external rotation required in the hip via the deep six external rotators is often not held strongly enough and, instead of holding turnout securely, upon rising onto the pointe shoes, the young dancer’s legs rotate inward significantly. The inward rotation down the chain from the hip is technically incorrect, as turnout in dance is supposed to afford dancers more stability. Moreover, dancers who don’t understand turnout mechanics are susceptible to hip, pelvic girdle, knee and ankle injuries. {4}

Fortunately, there are medical professionals and athletic trainers who have committed themselves to researching on behalf of the health and well-being of dancers, and they have a lot to say about this!

Dr. Jeff Russell, PhD in Dance Medicine and Science, founder and creator of the Choreohealth program ( and a Certified Athletic Trainer, has this to say:

  1. Not every ballet dancer should dance en pointe.
  2. Growing anatomy is susceptible to injury.
  3. Strength and technical proficiency are more important than age in deciding to start pointe work.
  4. The perceived value of a performance is never worth the cost of an injury.
  5. There is good, medically sound information available to guide the process of going en pointe.{2}

Dr. Selinah Shah, in her paper, Determining a young dancer’s readiness for pointe, lists several injuries and problems that can arise when a dancer is put en pointe too soon. These include bunions, traumatized toenails, corns and calluses, and more seriously, cortical hypertrophy (bone thickening) of the first, second and third metatarsals, and injury to the FHL (flexor hallucus longus) and peroneal tendons of the leg. {3}

What, then, can a dancer and teacher of dance do to ensure the best circumstances possible for beginning pointe work?

First, there are a few functional tests that teachers can give their students to ensure they are ready for working en pointe. These are listed here and can be found in detail in Richardson’s paper entitled, Functional criteria for assessing pointe readiness:

The Single Leg Step Down, The Airplane Test, Single Leg Heel Rise Test, Balance Test, Double-leg Lower Test, and The Topple Test{1}.

In addition, age is an important consideration, as bone strength and growth and development of each individual dancer varies. The age of the dancer should be included in the full array of factors considered when determining progression to pointe training. {1}

Thirdly, finding a well-fitting pointe shoe can make for a more positive first experience en pointe. Pointe shoes should be snug but not too tight, which can lead to blister and callus formation. {3} However, dancers should not be fitted for pointe shoes in the same way they are fitted for their regular street shoes. There should not be ‘room enough to grow’.

Lastly, years of experience and maturity should also be considered. Time in regular technique classes over a period of years as well as a committed and serious attitude will help to ensure a dancer is ready for the long haul that pointe training requires.

In the end, if all goes as planned, and the dancer’s body remains strong, with slow and meticulous training paving the way, the young dancer will have a positive experience and gain the skill and knowledge to move forward with a budding career as a ballet dancer!

Until next time, friends, dance healthy and strong!

Janine Bryant, Eastern University


  1. Richardson, M., M.S., A.T.C., Liederbach, M.,Ph.D., P.T., A.T.C., C.S.C.S., Sandow, E., P.T., D.P.T., Functional criteria for assessing pointe readiness, J Dance Med Sci. 2010:14(3):82-8
  2. Russell, J., PhD, Certified Athletic Trainer, What I wish every parent and dance teacher knew about pointe,, May, 2014.
  3. Shah, S., MD, Determining a young dancer’s readiness for dancing on pointe. Curr Sports Med Rep, 2009: 8(6), 295-299.2.
  4. Weiss, D., MD, Rachel Anne Rist, M.A., and Gayanne Grossman, P.T., Ed.M. When can I start pointe?: J Dance Med Sci. 2009:13(3).