Commencing pointe work is a rite of passage for many young dancers. It is an exciting milestone, eagerly anticipated by dance students, teachers and parents alike.
However, dancing en pointe is not a natural thing for a human body to be doing; few dancers are fortunate to have been born with the exact physical attributes required for safe dancing en pointe.
As a dance physiotherapist, dancers are referred to me by their ballet teachers for a pre-pointe examination. We conduct a thorough physical assessment to determine the student’s strengths and weaknesses, to establish whether the dancer will physically be able to achieve pointe work, and to implement a pre-pointe preparation plan.
The International Association for Dance Medicine and Science has developed the following recommendations for young dancers commencing pointe work:
- Not before age 12.
- If the student is not anatomically sound, do not allow pointe work.
- If she is not truly pre-professional, discourage pointe training.
- If she has weak trunk and pelvic muscles or weak legs, delay pointe work
- If the student is hypermobile in the feet and ankles, delay pointe work
- Consider implementing a strengthening program where appropriate.
- If ballet classes are only once a week, discourage pointe training.
- If ballet classes are twice a week, and none of the above applies, begin in the fourth year of training.
Stage of physiological development and mental maturity are key factors. Girls mature at different rates; ‘normal’ encompasses a broad range of physical shapes and variations in emotional intelligence.
Without appropriate foot and ankle bony morphology (shape) and adequate range of movement into plantarflexion (a pointed position), a girl will struggle to actually rise on to pointe. Conversely, a foot that is hypermobile and über flexible, may not have the essential strength within the arch to support the foot shape en pointe. Both ends of the mobility spectrum cause problems; poor habits quickly set in and the likelihood of injury is exacerbated. Hence why developing adequate intrinsic foot muscle coordination, activation and strength is vital.
Repeated single leg rises from flat to demi pointe reveals several technical capabilities. If concerns are identified in any of these, they must be addressed prior to commencing pointe work:
- Trunk control
- Pelvic and hip stability
- Knee control
- Calf muscle activation
- Ankle alignment and stability
- Toe control
- Balance
Students must be able to accomplish 25 perfect single leg rises (in a row!) before fatigue, to be considered ready to commence pointe class. It will take around 5 weeks to increase repetitions from 15 to 25, so get practising!
Often, pointe classes are scheduled at the end of a normal ballet class, when the students are most fatigued and at the greatest risk of injury, so teachers need to keep this in mind when planning class timetables.
The vast majority of students are not ready to commence pointe work after their initial physiotherapy assessment – there is much homework to do! From my experience, a diligent, patient but motivated student can achieve remarkable things.
CHARISSA FERMELIS
Physiotherapist B.Phty APAM