ArticlePDF Available

When Can I Start Pointe Work?: Guidelines for Initiating Pointe Training

Authors:
  • Johns Hopkins University Peabody Insitute

Abstract

The initiation of pointe training for dance students should be determined after careful evaluation of a number of factors. These include: the dance student's stage of physical development; the quality of her (or his) trunk, abdominal and pelvic control ("core" stability); the alignment of her legs (hip-knee-ankle-foot); the strength and flexibility of her feet and ankles; and the duration and frequency of her dance training. For students who meet the requirements related to all of these factors, began ballet training at age eight or later, and who are taking ballet class at least twice per week, pointe work should be initiated in the fourth year of training. Students with poor core stability or hypermobility of the feet and ankles may require additional strengthening to allow them to safely begin pointe training. For those who are only taking ballet classes once per week, or who are not truly pre-professional, pointe training should be discouraged. No student with insufficient ankle and foot plantar flexion range of motion or with poor lower extremity alignment should be allowed to do pointe work.
90
Resource Paper
David S. Weiss, M.D., is at the Harkness Center for Dance Injuries of
NYU Hospital for Joint Diseases, NYU Langone Medical Center and in
the Department of Orthopaedic Surgery at New York University School of
Medicine, New York, New York, USA. Rachel Anne Rist, M.A., is Director
of Dance at Tring Park School for Performing Arts, Tring Park, Hertfordshire,
United Kingdom. Gayanne Grossman, P.T., Ed.M., is at Temple University,
Department of Dance, Philadelphia, Pennsylvania, USA, and Muhlenberg
College, Department of eatre and Dance, Allentown, Pennsylvania, USA.
Correspondence: David S. Weiss, M.D., NYU Langone Medical Center, 530
First Avenue, HCC Suite 5D, New York, NY 10016; david.weiss@nyumc.org.
is Resource Paper was written under the auspices of the Education and Media
Committees of the International Association for Dance Medicine and Science.
Copyright © 2009 by the International Association for Dance Medicine and
Science. is paper may be reproduced in its entirety for educational purposes,
provided acknowledgment is given to the International Association for Dance
Medicine and Science.
Abstract
The initiation of pointe training for
dance students should be determined
after careful evaluation of a number
of factors. These include: the dance
student’s stage of physical develop-
ment; the quality of her (or his) trunk,
abdominal and pelvic control (“core”
stability); the alignment of her legs
(hip-knee-ankle-foot); the strength
and flexibility of her feet and ankles;
and the duration and frequency of her
dance training. For students who meet
the requirements related to all of these
factors, began ballet training at age
eight or later, and who are taking bal-
let class at least twice per week, pointe
work should be initiated in the fourth
year of training. Students with poor
core stability or hypermobility of the
feet and ankles may require additional
strengthening to allow them to safely
begin pointe training. For those who are
only taking ballet classes once per week,
or who are not truly pre-professional,
pointe training should be discouraged.
No student with insufficient ankle and
foot plantar flexion range of motion or
with poor lower extremity alignment
should be allowed to do pointe work.
The young dancer asks,
“When can I begin pointe
work?” The answer usually
given, almost without thought, is
“at 12 years of age.” It would be bet-
ter if the response were “What kind
of dance student are you?” Starting
pointe at age 12 presupposes that
the child is beginning her fourth
year of ballet classes at a dance acad-
emy with a program designed to
train professional ballet dancers. Ac-
ceptance to such a program would
indicate that, at age eight or nine,
the child had sufficient anatomic
facility. The program itself would
consist of classes progressively in-
creasing in difficulty and frequency
over the first three years. By age
12 the student would be taking
four classes per week. Her feet and
ankles would be strong, her trunk
and pelvic control would be good,
and her proprioceptive skills would
be properly developed. Pointe work
would begin with 15 minutes of
exercises at the end of each class.1-6
This student should be distin-
guished from the child who began
classes at age five at a local dance
school and now, at age ten, takes
one ballet and one tap class a week.
She is small for her age, with weak
feet and ankles. She is very “loose-
jointed” (hypermobile) in her spine,
knees, feet, and ankles. Her teacher
wanted her to start pointe work two
years ago, but the mother thought
she wasn’t serious enough about her
dancing. Her cousin began pointe
work at age ten and she wants to
know why she cant start now.
Growth and Development
Can any one age be the correct
answer for all students? Are all
girls at the same stage of devel-
opment at age 12? The answer
to both questions is “No.There
may be significant differences in
girls’ physiologic development,
depending on the onset and tempo
of puberty. After age five linear
When Can I Start Pointe Work?
Guidelines for Initiating Pointe Training
David S. Weiss, M.D., Rachel Anne Rist, M.A., and Gayanne Grossman, P.T., Ed.M.
91Journal of Dance Medicine & Science • Volume 13, Number 3, 2009
growth proceeds at approximately
5.5 cm/year (two inches/year). For
girls, the growth velocity increases
sharply around age ten and reaches
a peak of approximately 10.5 cm/
year (four inches/year) at age 12.
Peak weight gain velocity of 8.5 kg/
year (18.7 pounds/year) is reached
at age 12.5 years, and quickly de-
celerates to less than 1 kg/year (2.2
pounds/year) at age 15.7 During
this rapid growth period there are
inevitably significant differences
in development from one child to
the next. Mr. Justin Howse, retired
Consultant Orthopaedic Surgeon
to the Royal Ballet Schools and
the Royal Academy of Dancing
(London, UK), says that “the only
factor which matters is the state of
development of the child, and to
be dogmatic about an age does not
make any reference to the child’s
maturity or immaturity.”8
The completion of growth in a
tubular (long) bone is signaled by
the fusion or closure of the epiphy-
ses (growth plates). This occurs in
the foot slightly earlier than in the
leg. The appearance of ossification
(bone formation) centers in the
foot begins at age two months in
utero. The last epiphysis to close in
the foot does so at an average age
of 16 years in boys and 14 years
in girls. From age five through age
12 the average girl’s foot grows 0.9
cm (0.35 inches) per year, reaching
an average foot length of 23.2 cm
(nine inches) at age 12. Thereafter
the average girl’s foot growth rate
slows to 0.8 cm (0.31 inches) per
year for the next two years.9,10 The
completion of bone growth in the
feet is often given as a reason for
choosing the age of 12 for begin-
ning pointe work. However, this
concept is basically erroneous, as
bone growth in the average girl’s
foot is not complete at that age.
How far along in bone matu-
ration is any one girl at age 12?
Knowledge of statistical averages is
not accurately predictive, as chrono-
logical age does not necessarily
correlate with bone age. Although
x-rays can show the completion of
growth in the foot, they are less
exact in determining the stage of
bone maturation prior to closure of
the epiphyses.7
If bone growth in the foot is not
complete at age 12, and if this is
a common age at which girls be-
gin pointe work, is there medical
evidence for damage to the bones
of the growing foot resulting from
training on pointe? Not to our
knowledge: not from studies, an-
ecdotes, or the authors’ collective
personal experiences. This is not
to suggest that initiation of pointe
work before age 12 is harmless;
indeed, by way of analogy, studies
involving gymnasts have established
the potential harm of repetitive
microtrauma to growing bones.11
If neither chronological age nor
bone maturation alone determines
when to begin pointe work, what
other factors must be considered? In
the fifth (and final) edition of her
seminal book Anatomy and Ballet:
A Handbook for Teachers of Ballet,
Celia Sparger writes: “It cannot be
too strongly stressed that pointe
work is the end result of slow and
gradual training of the whole body,
back, hips, thighs, legs, feet, co-
ordination of movement and the
‘placingof the body, so that the
weight is lifted upwards off the feet,
with straight knees, perfect balance,
with a perfect demi-pointe, and
without any tendency on the part of
the feet to sickle either in or out or
the toes to curl or clutch. This mo-
ment will arrive at different times
in different children, not only by
virtue of previous training but ac-
cording to their physical type, and
in this may be included the growth
of the bones.”12
Risks Associated with Starting
Pointe Too Early
As Sparger’s statement suggests, the
potential dangers to the child from
being placed on pointe before she
is ready have less to do with actual
bone or joint damage (although
these are real) than with inadequate
range of motion, strength, and sta-
bility. These factors may cause un-
due stress on the leg, pelvic girdle,
and trunk.
The child with hypermobile feet
and ankles is particularly at risk if
placed on pointe too early. This
condition, commonly described as
the “over-archedor “over-point-
ed” foot, can be deceptive. These
students have the suppleness to
achieve, or even exceed, the required
pointe position, and thus they are
more likely to be selected for ballet
in general and pointe work in par-
ticular. However, they often lack the
required strength and postural con-
trol to work safely on pointe. Prior
to beginning pointe work in these
students all the muscles of the leg
must be strengthened, and adequate
proprioceptive control developed,
to facilitate correct alignment.
At the opposite end of the spec-
trum, the child with an inflexible
foot and ankle, resulting in insuf-
ficient plantar flexion range of mo-
tion, is also at risk. To ensure proper
alignment on pointe the line of the
metatarsals (represented by the top
surface of the forefoot) should be
parallel to the line of the tibia (front
of the shin) when the foot is pointed
(combined ankle and foot plantar
flexion). Attempting to perform
pointe work without such anatomic
facility will place excessive stresses
not only on the foot and ankle, but
also on the leg, pelvic girdle, and
trunk. If there is hyperextension
(“sway-back”) of the knees, even
more ankle and foot range of mo-
tion (plantar flexion) is needed to
assure proper alignment on pointe.
Unfortunately, insufficient range of
motion may not improve with time,
and children with these restrictions
may never obtain sufficient flexibil-
ity for pointe work.
Assessing the Pre-Pointe
Student
One of the factors affecting the de-
velopment of muscular strength and
proprioceptive ability is the age at
which the child has begun studying
ballet. Although movement classes
beginning at age four may be ben-
eficial for other purposes, no proper
92 Volume 13, Number 3, 2009 • Journal of Dance Medicine & Science
ballet training can be accomplished
before age eight (both Cecchetti and
Balanchine agreed on this). Another
factor is the frequency with which
the child takes ballet class. In gener-
al, students taking ballet class once a
week will progress more slowly than
those taking twice a week. Those
taking four ballet classes a week will
progress fastest, but this frequency
is usually found only in professional
schools or academies.
Within any given class of 13
year olds there will be girls in dif-
ferent stages of pointe work, just as
there will be a variety of physiques
and abilities. This places a heavy
responsibility on the dance teacher.
The growth and development of
each student needs to be considered
when determining readiness to be-
gin pointe work. Teachers should
perform their own pre-pointe
assessment to ascertain whether
the student has proper postural
control (with good abdominal and
trunk support), sufficient lower leg
strength, and appropriate leg (hip-
knee-ankle-foot) alignment to begin
or continue working on pointe.
Communication with parents is es-
sential to explain the reasons behind
every decision, thereby preventing
misunderstandings.
Finally, we offer two observations
that emphasize the importance of
making a proper assessment of
when to start pointe work. First, the
dancer who is struggling to work on
pointe may have difficulty develop-
ing other aspects of her ballet tech-
nique; second, due to inability to
execute the movements required to
dance properly on pointe, she may
be prone to psychological problems,
including decreased confidence and
poor self-esteem. Hence, we suggest
that it is wise to be conservative
in choosing when to begin pointe
work. As Howse notes: “There are
certainly well-known dancers who
were not strong enough to start
their pointe work until they were
over the age of sixteen and this
has proved no handicap in their
career.”8
Guidelines
To summarize the above discussion
we oer the following guidelines for
when to begin pointe training:
1. Not before age 12.
2. If the student is not anatomically
sound (e.g., insucient ankle
and foot plantar exion range
of motion; poor lower extremity
alignment), do not allow pointe
work.
3. If she is not truly pre-profession-
al, discourage pointe training.
4. If she has weak trunk and pelvic
(“core”) muscles or weak legs,
delay pointe work (and consider
implementing a strengthening
program).
5. If the student is hypermobile in
the feet and ankles, delay pointe
work (and consider implement-
ing a strengthening program).
6. If ballet classes are only once a
week, discourage pointe training.
7. If ballet classes are twice a week,
and none of the above applies,
begin in the fourth year of train-
ing.
George Balanchine, master of
choreography on pointe, has been
credited with having created the
“baby ballerina.” He is reported to
have said that there is no reason to
get a young dancer up on full pointe
if she cannot do anything when she
gets there!13
References
1. Barringer J, Schlesinger S. e Pointe
Book (2nd ed). Princeton, NJ: Princ-
eton Book Co., 2004, pp. 136-157.
2. Grieg V. Inside Ballet Technique.
Princeton, NJ: Princeton Book Co.,
1994, pp. 104-106.
3. Guggenheim CL. A survey of elite
professional ballet schools regard-
ing the initiation of pointe work
in children. Med Probl Perf Art.
1994;9:15-7.
4. Huwyler JS. e Dancer’s Body: A
Medical Perspective on Dance and
Dance Training. Germantown, MD;
International Medical Publishing,
1999, pp. 115-119.
5. Solomon R, Micheli LJ, Ireland
ML. Physiological assessment to
determine readiness for pointe
work in ballet students. Impulse.
1993;1(1):21-38.
6. Watkins A, Clarkson PM. Dancing
Longer, Dancing Stronger. Princeton,
NJ: Princeton Book Co., 1990, p.
69.
7. Roemmich JN, Rogo, AD. Physiol-
ogy of growth and development: its
relationship to performance in the
young athlete. Clin Sports Med.
1995;14(3):483-502.
8. Howse J. Dance Technique and In-
jury Prevention (3rd ed). London: A
& C Black, New York: Routledge,
2000, pp. 59-60.
9. Blais MM, Green WT, Anderson M.
Lengths of the growing foot. J Bone
Joint Surg Am 1956;38(5):998-
1000.
10. Sarraan SK. Anatomy of the Foot
and Ankle: Descriptive, Topographic,
Functional (2nd ed). Philadelphia:
Lippincott, 1993.
11. Zetaruk MN. e young gymnast.
Clin Sports Med. 2000;19(4):757-
80.
12. Sparger C. Anatomy and Ballet: A
Handbook for Teachers of Ballet (5th
ed). London: Adam & Charles
Black, 1970, pp. 74-8.
13. Hamilton WG. Ballet. In: Reider B
(ed): Sports Medicine, e School-Age
Athlete (2nd ed). Philadelphia: W.B.
Saunders, 1996, pp. 543-581.
... 14,15 Most dance instructors and medical providers agree that a minimum of 3 to 4 years of classical ballet training is needed prior to beginning pointe work. 16,17 Ankle plantarflexion range of motion is another frequently cited criterion as dancing en pointe requires excessively large ranges of plantarflexion to position the foot appropriately. 18 Specifically, range of motion of at least 90° to 100° of plantarflexion has frequently been cited as a requirement. ...
... 14 IADMS offers 7 guidelines to consider when determining pointe readiness including chronological age (not before age 12), anatomically sound (sufficient ankle and foot plantarflexion range of motion and lower extremity alignment), presence of foot or ankle hypermobility, adequate trunk, pelvis, and leg strength, number of ballet classes per week, number of years of ballet training, and pre-professional training status. 17 Despite the numerous criteria cited in the literature and the seemingly comprehensive recommendations from national dance organizations, there is a lack of consistency in the tests used to determine pointe readiness which suggests the need for continued research in this area. Furthermore, dance teachers' knowledge of these tests and recommendations is unknown. ...
... This finding is consistent with the current literature which reports that the majority of instructors agree that a minimum of 3 to 4 years of ballet training is needed prior to beginning pointe work. 16,17 A dancer's strength, dance technique, and age were rated as the greatest indicators of a dancer's readiness to begin dancing en pointe with 100% of instructors reporting strength as a determinant of pointe readiness, 94% using dance technique, and 87% using the dancer's age as readiness criteria. These findings align with previous reports which have recommended strength, technique, and age as important considerations for determining pointe readiness. ...
Article
Introduction: Transiting to dancing en pointe is an important milestone for young dancers who wish to progress in ballet training. Various criteria exist regarding pointe readiness, including age, range-of-motion, endurance, strength, balance, and technique. However, awareness and use of these criteria by dance instructors is currently unknown. The purpose of this pilot study was to assess the awareness and use of pointe readiness criteria by youth ballet instructors. Methods: A cross-sectional web-based survey study design was used, which included questions regarding dance instruction experience, dance studio characteristics, and criteria used to assess pointe readiness. Ballet instructors were recruited for participation. Data are presented as percentages and frequencies. Results: Thirty-one ballet instructors completed the survey from 15 states (1 international). Years of pointe ballet instruction ranged from 2 to 30+ years, with 35% indicating more than 30 years of experience. Instructors reported students begin pointe at age 11.8 years (range 9-15 years). A majority of instructors require 5 years of ballet experience prior to dancing en pointe (range 2-8 years). Reported pointe readiness criteria included strength (100%), dance technique (94%), age (87%), and years of ballet experience (71%). While all instructors reported evaluating a dancer’s strength, assessments of flexibility and movement quality were not evaluated by 42% and 45% of instructors, respectively. Strength, dance technique, and age were rated as the greatest indicators of a dancer’s readiness to begin pointe. Finally, instructors reported low knowledge of existing pointe readiness criteria. Conclusion: Ballet instructors initiated pointe work at age 12 and required 5 years of ballet experience before beginning to dance en pointe. While strength, dance technique, and age were the top considerations for evaluating readiness, approximately 40% of instructors did not evaluate flexibility or movement quality prior to progressing to pointe, and overall, knowledge of existing criteria was low.
... According to most authors investigating dancers' feet, the muscles responsible for the foot and ankle joint should be able to sustain appropriately high force to perform pointé-work (26,27). The introduction of Raising the heels during choreographically demanding elements of classical dance (relevé on pointé, demipointé relevé, and arabesque) or while folk dancing in high heels deepens lordosis and reduces lumbar spine mobility in the sagittal plane (32). ...
... However, this difference disap-pointé-work-related exercises before the dancer's feet obtain their functional maturity weakens the feet and increases their susceptibility to injuries (27). Plantar flexion of 180º in relation to the central axis of the tibial bone and foot is a pre-condition of proper, entire, and safe pointé-work (26,27). However, the combination of high impact loads, defined as the level of maxGRF z (5.31-11.11 ...
... According to Weiss et al (26), muscles responsible for the foot and ankle joints must be sufficiently strong before commencing climbing on toes training. Introducing these exercises before reaching the full functional maturity of the foot weakens it and increases its susceptibility to injuries. ...
Article
OBJECTIVE: The study aimed to identify the effects of ground reaction forces (GRF) recorded during landing in typical elements of three dance styles, including classical, modern, and folk dance, on injuries` topography. METHODS: The research involved a survey and measurements of GRF generated during landing after the jump. The survey involved a group of 90 professional dancers. In the questionnaire, the dancers marked areas of the human body that were affected at least once by injuries. Biomechanical tests of the GRF recording were conducted on a group of 15 professional dancers. The analysis focused on the following parameters: a maximum value of the vertical variable of the GRF relative to body weight (maxGRF z ), the time between the moment from first foot contact with the ground to the moment of reaching the maxGRF z ( tmaxGRFz ), and the loading rate of the GRF relative to body weight (LR GRFz ). RESULTS: Regardless of dance style and sex, the lower spine, knee joints, ankle joints and feet were the areas most affected by injuries among professional dancers. The level of maxGRF z , t maxGRFz and LR GRFz during typical jumps in classical, modern, and folk dance was statistically significantly different (P<0.01*). The highest mean maxGRFz values were recorded for jumps performed by classical dancers. Furthermore, the sum of injury-affected areas differed significantly across various dance styles and was connected with the impact forces transferred by the dancer’s musculoskeletal system. CONCLUSION: The level of GRF is one of the decisive factors affecting the topography of professional dance injuries.
... It exemplifies progression in their dance education 1,3,4 and dedication to the art. 3 Many young dancers perceive that their progression en pointe will be precipitous, 1 yet transition to pointe requires attaining numerous criteria to determine readiness. These criteria include; chronological age 1-3,5-8 ; core, ankle, and pelvic stability 1,2,4,6-10 ; core, lower limb, and ankle strength 1,2,4,6-10 ; range of motion (ROM) 1,2,4,6-10 ; flexibility of the foot and ankle (plantar flexion) 1,2,4,6-10 ; balance 1,2,10 ; foot, ankle, and lower limb alignment 1,2,8,10 ; technique 2,4,10 ; years of training 2,3,5-10 ; musculoskeletal maturation 2,6,8 ; and stability and control while raising and lowering (or performing relevé) onto and from pointe. 2,11 to assess pointe readiness and help highlight dancers who can progress to pointe, need supplementary training, or should not perform en pointe. 2 The literature 6,11 suggests that the most significant functional test for pointe readiness is the airplane test (which helps determine a dancer's level of core stability); relevé and pirouette tests are also relevant indicators. ...
... It exemplifies progression in their dance education 1,3,4 and dedication to the art. 3 Many young dancers perceive that their progression en pointe will be precipitous, 1 yet transition to pointe requires attaining numerous criteria to determine readiness. These criteria include; chronological age 1-3,5-8 ; core, ankle, and pelvic stability 1,2,4,6-10 ; core, lower limb, and ankle strength 1,2,4,6-10 ; range of motion (ROM) 1,2,4,6-10 ; flexibility of the foot and ankle (plantar flexion) 1,2,4,6-10 ; balance 1,2,10 ; foot, ankle, and lower limb alignment 1,2,8,10 ; technique 2,4,10 ; years of training 2,3,5-10 ; musculoskeletal maturation 2,6,8 ; and stability and control while raising and lowering (or performing relevé) onto and from pointe. 2,11 to assess pointe readiness and help highlight dancers who can progress to pointe, need supplementary training, or should not perform en pointe. 2 The literature 6,11 suggests that the most significant functional test for pointe readiness is the airplane test (which helps determine a dancer's level of core stability); relevé and pirouette tests are also relevant indicators. ...
... 1,2,4,14 Subsequently, it has been suggested that dancers require at least 2 years of ballet experience prior to going en pointe, 12,13 and pointe training should be discouraged for dancers who are only doing one ballet class a week or have reduced ROM of the ankles and feet. 8 Dancers with the required and stable ROM who engage in numerous ballet lessons may have a greater proprioceptive ability to handle pointe training. 15 However, despite numerous physical attributes needed to successfully and safely train en pointe, chronological age is still the most common guideline used by many dance teachers to determine pointe readiness. ...
Article
Full-text available
Dancing en pointe is an integral aspect of ballet for female dancers and they start pointe training in young adolescence. The primary objective of this review was to investigate the screening tests used to determine pointe readiness in young adolescent female dancers, and the secondary objective was to determine the injuries associated with pointe training. The search engines Google Scholar, PubMed, Scopus, and Web of Science were mined using medical subject heading terms “pointe,” “pointe readiness,” “injury,” “young,” “adolescent,” “female,” and “dancer,” and a manual search of relevant articles was conducted. The inclusion criteria were: females aged 8 to 20 years, pre-pointe, training en pointe, and pointe-related injury. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following data were extracted; first author, year of publication, study design, participant size, mean age, testing, outcome, and general notes of each study. Risk of bias was evaluated using the Research Triangle Institute Item Bank (RTI-IB). Eight cross-sectional studies met the inclusion criteria. Results suggested that the topple, airplane, sauté, and relevé tests are statistically better determinants of pointe readiness than chronological age alone. Utilizing these methods alongside age, strength, body maturation, range of motion (ROM), and teacher evaluation could provide an all-round insight into a dancer’s readiness for pointe. However, the included studies had contradictory outcomes with regard to pointe-related injury and the review’s conclusions are limited by methodological design.
... The second year of education involves the introduction of demi pointe exercises with the pole. Exercises in this position trigger the transfer of load on the heads of instep bones, where the foot subjected to unnatural loads and adopts an unnatural position [2,12]. Children's bones, being still at the ossification stage, are then particularly susceptible to deformations [12]. ...
... Exercises in this position trigger the transfer of load on the heads of instep bones, where the foot subjected to unnatural loads and adopts an unnatural position [2,12]. Children's bones, being still at the ossification stage, are then particularly susceptible to deformations [12]. It was demonstrated that specific movement tasks of classical dance affect the dancer's locomotor system structure. ...
... In dance education, exercises increasing the muscular force of feet are introduced in forms 4-5 (at the age of 13 and 14) [28]. The aforesaid force must be sufficiently high to overcome the ground reaction force of grand jumps (grand jete, sissonne ouverte and grand pas de chat) generating a GRF of 4-9 BW [13,14] and responsible for difficult work in points [12]. In forms 7-9, the dance curriculum, in addition to grand jumps, includes pirouettes and intense work in points, introduced to enable the performance of grand fouette en tournant, cabriole or entrechat-six [28]. ...
Article
Full-text available
This work aims to assess footprint parameters in a group of professional ballet dancers and to determine the correlation between the aforementioned parameters and lateralization, stabilometric parameters, pedobarographic parameters and work environment conditions. A group subjected to tests consisted of 44 elite professional ballet dancers and the reference group was composed of 44 students. The test of balance and thrust under feet involved 30 s-long free standing with open eyes on a podographic platform. The research-related analysis was concerned with footprint parameters (foot length and width, Clarke angle, and Weissflog index), stabilometric parameters (path length and ellipse field, mean value of the velocity and deflection of the displacement of the center of the foot pressure on the ground) and pedobarographic parameters (percentage thrust on the right, left foot as well as the front and rear part the foot). Statistically significant differences between the groups were observed in relation to the stabilometric parameters, the percentage pressure of the left forefoot and the right heel, as well as the value of the Clarke angle (p ≤ 0.05). The longitudinal arch of the foot and the width of the foot in ballet dancers are not dependent on the total and professional career duration and weekly training volume
... Most dancers who train on a weekly basis require at least two to four years of training in ballet technique, with a good attendance record, before going on pointe 6.7.16 . For young female adolescents, the growth rate increases sharply around age 10 and reaches a peak of approximately 10.5 cm / year (four inches / year) at age 12 12,16 . Peak weight gain velocity of 8.5 kg / year is reached at age 12.5 years, and quickly decelerates to less than 1 kg / year (2.2 pounds / year) at age 15 12,16 . ...
... For young female adolescents, the growth rate increases sharply around age 10 and reaches a peak of approximately 10.5 cm / year (four inches / year) at age 12 12,16 . Peak weight gain velocity of 8.5 kg / year is reached at age 12.5 years, and quickly decelerates to less than 1 kg / year (2.2 pounds / year) at age 15 12,16 . There may be significant differences in physiological development amongst girls, depending on the onset and tempo of puberty 16 . ...
... Peak weight gain velocity of 8.5 kg / year is reached at age 12.5 years, and quickly decelerates to less than 1 kg / year (2.2 pounds / year) at age 15 12,16 . There may be significant differences in physiological development amongst girls, depending on the onset and tempo of puberty 16 . The completion of growth in a tubular (long) bone of the leg is signalled by the fusion or closure of the epiphyses (rounded end of a long bone) 3,11,12,16 . ...
Article
Full-text available
What determines pointe readiness? Most dancers who train on a weekly basis require at least two to four years of training in ballet technique, with a good attendance record, before going on pointe. Placing a child on pointe before they are ready may cause potential danger to them as they may not have adequate range of motion, strength, and stability. This article explores the growth and development as well as the basic parts of the pointe shoes. (Published on: scape.sg/venue/dance-science-articles)
... Point work increases demands for muscle strength, plantar flexion ankle range of motion, and a high level of balance control compounded by a narrower base of support than flat shoes. [3][4][5][6][7][8] These physical demands make it difficult for dancers, especially those in training, to dance stably in the complex movements of ballet. Even though balance control in pointe shoes plays a crucial role in ballet, the specific challenges associated with dynamic motion in dancing en pointe have not been fully understood. ...
Article
Introduction: En pointe, in which weight is placed on the tiptoes, is a fundamental practice for female ballet dancers with pointe shoes. The center of mass (COM) is maintained over the base of support and the relative position of COM to the center of pressure (COP) is especially important when conducting a pirouette in ballet. A pirouette is a fundamental turn in classical ballet with flat shoes and pointe shoes. The investigation of the turn with pointe shoes would be favorable for understanding the movement with limited base of support. Herein, we aimed to determine the differences in the ability to perform pirouettes with pointe shoes between professional and amateur ballet dancers. Methods: This study included 8 professional and 9 amateur ballet dancers. The dancers performed a single pirouette, and the movement was captured and analyzed in 3 phases: turning with double-leg support (TDS), turning with single-leg support in pre-swing (TSSp), and turning with single-leg support in mid-swing (TSSm). The analysis focused on the inclination between the vertical angle and the COP-COM line, the vertical maximum reaction force, and the jump-up time in each phase. Results: The results showed no significant differences between the TDS and TSSp. However, professional ballet dancers exhibited significantly lesser posterior inclinations (professional; 2.05° ± 0.90°, amateur; 3.88° ± 1.67°) and jump-up time (professional; 0%, amateur; 1.4% ± 1.3%) than amateur dancers during TSSm. Conclusion: Overall, the findings suggest that professional dancers exhibit superior control skills regarding the COP-COM line than amateur dancers during TSSm. These results may be attributed to the fact that professional dancers can maintain the COM as close to the upright as on the COP without jumping during TSSm. This enables professional dancers to conduct the movements esthetically and continue on to the other movements in the dance phase.
... plane and Star Excursion Balance Test), mobility (e.g., Beighton scale), flexibility (e.g., hamstring length), range of motion (ROM; e.g., hip rotation, ankle plantarflexion [PF] and dorsiflexion [DF], first metatarsophalangeal [MTP] extension), strength and endurance (e.g., flexor hallucis longus [FHL], core stability, ankle plantarflexors), and dance-specific technique assessments. 2,3,[8][9][10][11][12][14][15][16] However, they have yet to be validated for determining pointe readiness using cohorts of adolescent dancers either in the prepointe training phase or those novice to pointe dancing. 11 When ballet dancers begin dancing en pointe, they must learn how to transition from balancing on the metatarsal heads in demi-pointe relevé (standing on the balls of the feet with the ankle in maximum plantarflexion with toes extended) to the toes. ...
Article
Full-text available
Objective: There are no universally accepted requirements or uniform protocols to determine when dancers can safely commence dancing en pointe (shod relevé). The purpose of this study was to examine dancer-specific biomechanics of adolescent pointe dancers and explore factors that may help determine pointe readiness. Methods: Dancers (n=26; median age 14 yrs [IQR=13-16]) were stratified into two groups based on the ability to stand on the pointe shoe box as per a plumb line (Group 1: on the box; Group 2: not on the box) during parallel, shod relevé. Measurements included unshod weight-bearing range of motion (ROM) of ankle plantarflexion (PF) and first metatarsophalangeal (MTP) extension and shod posture assessment during first position elevé (rising into relevé with turned out, straight legs). Qualisys 3D motion capture and AMTITM force plates recorded dancers performing 10-15 repetitions of first position elevé. Comparison of three kinematic and three kinetic variables aimed to describe group differences during unshod and shod conditions. Wilcoxon signed-rank test assumed no difference between groups with a Bonferroni correction (p<0.0083). Results: During unshod parallel relevé, ROM was different between groups for first MTP extension (deg; MedGroup1: 90°, IQR 80°-90°; MedGroup 2: 70°, IQR: 70°-80°, p<0.0001) but no statistical difference in ankle PF (deg; p=0.0098). There were no differences in C7 displacement (m; p=0.5055), ankle PF moment (p=0.1484), or hip mediolateral and anteroposterior moments (p=0.8785 and 0.8785, respectively) during shod first position relevé, indicating that both groups tend to engage the same dominant muscle groups (trunk extensors, ankle dorsiflexors, hip flexors, and hip abductors) during elevé. Conclusion: Dancers in Group 1 demonstrated greater first MTP extension during unshod relevé compared to dancers in Group 2. Weight-bearing ROM could be a valuable tool in predicting pointe readiness of adolescent ballet dancers.
Article
Aims: In classical ballet, dancers may wear flat shoes and pointe shoes. To consider the kinematic changes between flat shoes and pointe shoes to prevent injuries, it is essential to focus on the fundamental ballet movement of standing on pointe. This study aimed to clarify the differences in the center of pressure (COP) displacement and lower limb muscle activity during the descending phase of a relevé when wearing pointe shoes versus flat shoes. Methods: Ten amateur ballet dancers volunteered for this study and performed a reléve wearing flat shoes and pointe shoes. We measured the COP displacement by using a footplate and electromyographies of the tibialis anterior, soleus, lateral gastrocnemius, and peroneus longus muscles during the relevé descending phase. These data were compared using a paired t-test or Wilcoxon signed-rank sum test. Results: The COP significantly shifted to the lateral side when dancers were wearing pointe shoes compared to wearing flat shoes (p<0.05). The muscle activity of the tibialis anterior and soleus muscles was significantly higher by 5.7% and 5.3%, respectively, when ballet dancers were wearing pointe shoes compared to flat shoes (p<0.05). However, there were no differences in both lateral gastrocnemius and peroneus longus. Conclusion: Greater muscle activities in the tibialis anterior and soleus muscles when wearing pointe shoes than when wearing flat shoes were associated with a larger lateral displacement of the COP. To control the COP displacement during the descending phase of a relevé, the muscle activity of the peroneus longus, which is antagonist of tibialis anterior muscle, and soleus muscles should be increased.
Chapter
In addition to the annual dance steps teaching plan, a training plan designed for the dancer to reach the main presentation's peak performance is required. This training plan is called periodisation and seems to be a great tool for optimizing performance and avoiding overtraining. This chapter addresses the concepts of periodization translated by sport and association with the conditions found in dance. The manipulation of the volume and intensity of the dancer's integral training will be at the heart of the periodisation proposed in this chapter. The division of phases of a company's season or a year in the dance school will be analysed. The different phases aim to prepare the dancer's body for this activity's demands, improving and maintaining one performance, health, and quality of life.
Chapter
Full-text available
The field of sports biomechanics aims to improve performance and decrease injury rates in athletes. Although first developed thinking of athletes, sports biomechanics analysis was expanded to the dance field due to the similarities between athletes and dancers, including high workload, high injuries incidence, and the constant seeking of performance improvements. For the past few decades, a field focused only on dancers, thus called “dance biomechanics,” has used sports biomechanics literature and produced its own knowledge analysing different dancers and many types of dance. Many questions have been made about dance, and some of those have been addressed by dance biomechanics. This chapter will explain how science has tried to answer many of them.
Article
Full-text available
Proper grouping of children for sports is important for injury prevention and for fair competition. We have reviewed several of the classification systems presently used as well as the physiologic underpinnings of pubertal growth and development and the accrual of strength and power. It is during adolescence that the greatest physiologic differences exist mainly because of the wide variations in the timing and tempo of the pubertal growth spurt in normally growing boys and girls. Maturity-based categorization, especially in contact and collision sports, would heighten the competition and lessen rates of injury.
Article
Proper groupings of children for physical activity and sport is important for injury prevention and competition. Several of the classification systems presently used are reviewed, as are the physiologic underpinnings of pubertal growth and development as they relate to the accrual of strength and power. It is during adolesence that the greatest physiologic differences exist, mainly because of the wide variations in the timing and tempo of the pubertal growth spurt in normally growing boys and girls. Maturity-based categorization, especially in contact and collision sports, would heighten the competition and may lessen rates of injury.
Article
Gymnastics training develops strength, flexibility, concentration, balance, grace, and speed in young athletes. In terms of hours per week and intensity of practice, the dedication to training at a young age, is unparalleled in most other youth sports. With this dedication comes the risk of injury to the immature musculoskeletal system, and it is our duty to ensure that these risks are minimized. Through adequate safety equipment, supervision, and spotting of difficult techniques, a number of acute injuries may be prevented. Maintenance of balanced flexibility and strength, modification of training to limit pain, and taping or splinting of wrists and ankles may reduce the risk of overuse injuries. Physician who deal with young gymnasts must have an understanding of the inherent risks of the sport to provide prompt diagnoses and appropriate management of injuries. The gymnasium can be a healthy environment as long as the health and safety of the child takes precedence over the success of the gymnast.
Inside Ballet Technique
  • V Grieg
Grieg V. Inside Ballet Technique. Princeton, NJ: Princeton Book Co., 1994, pp. 104-106.
Anatomy and Ballet: A Handbook for Teachers of Ballet
  • C Sparger
Sparger C. Anatomy and Ballet: A Handbook for Teachers of Ballet (5th ed). London: Adam & Charles Black, 1970, pp. 74-8.
A survey of elite professional ballet schools regarding the initiation of pointe work in children
  • C L Guggenheim
Guggenheim CL. A survey of elite professional ballet schools regarding the initiation of pointe work in children. Med Probl Perf Art. 1994;9:15-7.
Dancing Longer, Dancing Stronger
  • A Watkins
  • P M Clarkson
Watkins A, Clarkson PM. Dancing Longer, Dancing Stronger. Princeton, NJ: Princeton Book Co., 1990, p. 69.