Problem Feet - 3 Reasons Why You Might Need To Stay Off Pointe

11:53 AM

Most ballet students can eventually get on pointe with hard work and solid training, and most can avoid injury if they train carefully. However, there are cases when a dancer should not go on pointe at all. Here are a few examples.

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Keep in mind these are examples and affect a very small group of dancers. Some of these issues can be resolved early in life and training, while others are permanent. For the sake of preventing long-term chronic injury, these dancers may need to avoid pointe training altogether.

To learn more about the potential injuries of pointe, check out this article, and this one.

1. Your bones are not lined up. This is an X-ray of a young child whose bones are not lined up. This kind of structure does not allow for the pressure that will come with pointe work.

photo used with permission

Remember, bones grow in response to pressure; if they are not lined up and pressure is put on places where there is no protection, or in a place where the bone isn't designed to absorb pressure, you can end up with deformed feet, bunions, or other issues. 

This is one benefit to getting X-rays before going on pointe. Not all schools require it. I'm of the mind that we get enough radiation in our day-to-day lives, so I don't require it unless I'm concerned about the shape of a dancer's foot.

2. You cannot point your ankle enough. I actually see this in a lot of dancers! Some dancers just don't have the range of motion to be able to get up onto their shoe. 

In order to dance en pointe correctly and without injury, dancers need to be on the platform, or the flat toe part, of their shoe. To do that, you must be able to point your ankle at least 180 degrees to your shin bone, so that you're perpendicular to the floor.  

This dancer is not high enough on her releve to be able to do pointe. Photo used with permission.

If a dancer can't point their ankle enough, they will be behind their shoe, and will physically not be able to get all the way up on the platform without bending their knees.

This dancer's ankles are mobile enough, as they are a straight line. Photo used with permission.

This is a problem because 1. you can't dance with bent knees and 2. if you stretch the leg straight and are behind the shoe, that can damage the Achilles tendon.

Some people insist these are the students who should use a foot stretcher, to increase your arch. This is extremely dangerous and not recommended. Most of the time, a dancer whose feet don't get up to at least a straight line aren't doing it because their muscles are tight, it's because structurally, that's just as far as they can go. There is usually something stopping them. Putting more pressure on something that is already under pressure is just not safe. Learn more about this here. 

Some dancers can stretch their feet without injury or risk, while others can have major issues as a result. Always check with your teacher, and your doctor before stretching your feet in any way.  Photo used with permission.

If you do manage to stretch the ankle out and increase your arch, you may end up with pain, arthritis, bunions, miss-formed bones, or other foot issues as a result of lifting your arch higher than your bones intended for it to be! (this is exactly what happened to me!)

3. Your IT band is so tight you can't properly lengthen or rotate your leg. There is more to pointe that just feet! I have seen some dancers who are so tight in some areas that they cannot lengthen their legs fully, or if they can lengthen, they can't rotate. Their IT band literally keeps their leg from being able to rotate. If you're unable to do the technique flat, there's no sense in trying to do it on pointe. 

This goes for other parts of the body as well - if your calves are too tight, or your hamstrings are locked up, and you cannot fully lengthen and extend, there is no way you will be able to stand on 2 or 1 foot with straight legs on your toes. 

Luckily, most of these issues can be fixed, but there are some dancers who cannot stretch these problem areas out due to structural issues, alignment issues, neck tension, tight ligaments, or some other issue outside of their control. Most dancers can stretch most muscles to allow for at least decent range of motion - however, ligaments don't stretch back after stretching them, and fascia barely stretches at all (fascia is kind of like a Chinese finger trap... more on that another time). There can be some cases where tightness and limited range of motion will cause injury to a dancer if they go on pointe.

Challenging - but not impossible - issues

There are a few situations where pointe is difficult, but also could be in your future depending on your teacher and the steps you take to prevent injury. It will always be a risk, but it may still be possible to experience pointe. Here are a few examples.

1. Your feet are shaped somewhat sickled. Even if your bones are lined up correctly, some dancers put pointe shoes on and their feet always look sickled, no matter how they put on their shoe, correct their alignment, or stretch/strengthen their ankle mobility.  This is only an injury risk in that it's so easy to fall sideways off a sickled foot, and this could lead to a major injury. 

Now I'm not talking majorly sickled; I'm talking just subtle enough that it's difficult to not fall to the side. 

Dancers with naturally sickled feet should go to an extremely experienced fitter and work with a teacher who has an understanding of safe foot alignment methods. 

2. You have an extremely small, or disappearing heel. This can be a challenge to fit, and sometimes even with a good fit and shoe alterations, dancers can struggle to keep their shoes on their feet. Although this won't keep you off pointe, you will need to find a way to keep your shoes on that will work for you. This isn't something that will really keep you from going on pointe, but I have had dancers get discouraged with pointe work because of their disappearing heel. 

3. You have scoliosis. The question often arises, can dancers with scoliosis go on pointe? Yes, many can, but some cannot. It really depends on the severity, curve, and range of motion in the back and hips. I've had at least 4 dancers with scoliosis go on pointe with no complications or long-term issues; I've also had dancers with severe scoliosis and have had to keep them off. It really depends on the dancer. This is why you must find a teacher and studio that you trust!

4. Something is snapping. Many dancers may find that when they begin pointe, or even when they begin pre-pointe, something in their foot "snaps" every time they eleve to a high demi-pointe. This is quite common and is usually just a tendon or ligament sliding over a bone to accommodate the hight. Although it probably doesn't hurt, it could become an issue in the long-run. Dancers who have this snapping in their feet should contact a dance therapist, sports therapist, chiropractor, or podiatrist for advice on continuing pointe work, or for stretches/conditioning to prevent long-term damage. 

5. Your toes are weird lengths. It is not impossible for a dancer with long or "weird" toes to dance on pointe, but it's extremely difficult and requires expert fitting. If one toe is significantly longer, not having a shoe that fits can cause that toe to buckle within the shoe. I had a dancer whose 3rd and 4th toes were almost 1 inch longer than the rest of her feet - finding shoes and padding that kept her blister-free and pain-free was an adventure to say the least.

When it comes to pointe, I believe most students can at least experience it, if they have the training to support it. But it's important to remember that pointe is not for everyone, and damaging your body long-term for the sake of doing something you want as a teenager isn't wise or responsible. As adults, it's our job to coach and support our dancers and young people, and sometimes that means making difficult choices for them that they wouldn't be able to make themselves. 

Dancers, trust your teachers and parents. 

Teachers, do what is right for your students. 

Parents, help your child learn to enjoy dance as a whole, and find the right kind of dance for them so they can enjoy it without chronic suffering long-term.

How a teacher needs to have a difficult conversation is different for everyone, but honestly and communication between parent, dancer, and teacher is always the best way. 

Happy dancing! 

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