Are You Ready for Pointe? A Dancer's Guide to Pointe Readiness

ankle ballet dance feet injury prevention Jun 24, 2020

Written by Tiffany Waniczek-Nowicki, PT, DPT

Ballet dancers are always extremely excited to go en pointe. It is every little ballerina’s dream.

But how do you know if you are ready?

What criteria should be checked off before you know you are safely ready to go en pointe?

What are the possible consequences if you start pointe too early?

It is important to know that pointe readiness is be based on multiple factors, and the more criteria that is checked off, the safer it will be to start pointe.


Common recommendations for pointe readiness:
(These are not listed in order of importance)
• Age: at least 11-12 years old
• Ankle range of motion: at least 90 degrees of plantar flexion/pointed foot which can be determined by the pencil test described below
• Strength: Good core and lower extremity strength which can be determined by the 3 pointe readiness movement tests listed below
• Balance: ability to hold single leg balance for at least 30 seconds with eyes closed
• Ballet training: minimum of 3 to 4 years of intensive ballet training with at least 3 ballet classes per week.

What age is appropriate to start pointe?


Generally speaking, the most common age range of ballet dancers starting pointe is 11-13 years old and sometimes as early as 9 years old. The pointe readiness age varies throughout expert opinions, medical doctors, dance teachers and researchers.
However, the most common recommended minimum age requirement for starting pointe is at least 11 years old. The most popular criterion cited in the dance literature for advancement to pointe work is 12 years old [4][5]. This is because the bones of the feet do not fully develop and ossify (harden) until approximately 13-15 years old, making it extremely important that the dancer is strong enough to support their developing bones. It is important to note that the determination of starting pointe work should not be solely based on age. The musculoskeletal development and motor skill levels of dancers at the age of 11-12 vary greatly. Which is why pointe readiness should also be determined by the dancer’s strength, range of motion, movement coordination and ability to maintain proper alignment with ballet specific movements.

How do I know if I have the appropriate ankle range of motion?

Ankle plantar flexion range of motion, or the pointed toe position, is important for the dancer to go en pointe. Due to the increased forces and load on the ankle when the foot is en pointe, it is recommended the dancer has at least 90 degrees of plantar flexion range of motion in order to improve stability and decrease risk of ankle inversion sprains [1][4]. So how do you know if you have 90 degrees of plantar flexion? Try the Pencil Test.


   Pencil Test

While the foot is pointed, the pencil is placed on the dorsal talar neck (highest point of the foot). A “Pass” = the straight edge of the pencil must clear the most distal part of the tibia (lower leg) – pictured here.

 

 

 

Measuring Good Range of Motion in the Ankle

Ankle dorsiflexion range of motion, or the flexed foot position, is also important for dancers to demonstrate good shock absorption specifically for jumping. It is recommended that a dancer has 10-15 degrees of non-weight bearing dorsiflexion, and 30-40 degrees of weight bearing dorsiflexion [2]. Your ankle range of motion can be measured with a goniometer by a physical therapist.

A.                B. 

Figure A shows the measurement of non-weight bearing dorsiflexion range of motion and Figure B shows the measurement of weight bearing dorsiflexion range of motion.

 

Pointe Readiness Movement Tests

The following three tests have been determined to be the most predictive of pointe readiness [4].


1. Airplane Test:


The body is pitched forward into a flat back arabesque with the working leg extended to the back at 90 degrees and the pelvis square to the ground. The dancer then performs a single leg plie on the standing leg while bringing their fingertips to the ground. The dancer returns to the starting position and performs five plies total.

C.       D.

Figure C Shows the side view of the starting position of the Airplane Test. Figure D shows the front view of the finishing position.

What is considered a pass?

Maintain neutral lower extremity alignment for four of the five plies. The knee points
over the 2nd-3rd toes of the foot, pelvis remains square to the ground, the head/trunk remains stable, the foot does not pronate, and the dancer does not lose balance for four out of five attempts.

2. Topple Test

The Topple Test is a single Pirouette en dehors from fourth position.

What is considered a Pass?

The gesture leg must be in full retiré/passe position with a fully extended supporting leg while maintaining a vertical trunk and demonstrating a controlled, decelerated landing. The dancer must complete one successful turn out of two attempts.

3. Saute Test

The Saute Test consists of 16 consecutive single leg saute jumps without support.

E.       F. 

Figure E shows the front view of the saute landing. Figure F shows the side view of the saute jump.

What is Considered a Pass?

The dancer must keep a neutral pelvic position, upright and stable trunk, neutral lower extremity alignment, proper toe to heel landing, and fully straighten the knee and point the foot while in the air for at least 8 out of 16 repetitions.

Other Important Factors to Consider Before Starting Pointe

  1. Cardiovascular endurance: the dancer should be able to complete full classes without excessive amounts of rest due to health conditions or injury.
  2. Turn out: ballet turn out should be achieved with proximal hip musculature rather than twisting at the knee or ankle. The kneecap should always be pointing over the 2nd-3rd toe even in turn out positions. Without proper hip turn out strength, dancers are at a higher risk of knee and ankle injuries.
  3. Calf strength: the dancer should be able to perform a minimum of 15-20 consecutive single leg relevés without a plié [2][4].
  4. Cross training: it is important that dancers also perform strengthening exercises outside of dance. Some good examples are yoga, Pilates, cardio (cycling, elliptical, swimming), strength training, balance training, core strengthening.
  5. Good mental health: the dancer should be mentally prepared and invested in the challenges pointe can bring and demonstrate a good sense of maturity and responsibility.
  6. Sleep: pre-teen to teenage dancers should be sleeping a minimum of 9 – 9 1⁄2 hours per night for adequate body recuperation.
  7. Nutrition: the dancer should be maintaining a healthy weight through good diet and exercise with whole foods and complex carbs.

What Are The Potential Consequences If I Start Pointe Too Early?

The major consequence of starting pointe too early is increasing the amount of stress on the developing bones and musculature which eventually can lead to injury. Dancing en pointe increases the forces placed on the foot by 12 times body weight [3]. Due to the high amount of bone growth between the ages 9-15, the growth plates of the foot/ankle are not fully formed and are more susceptible to high impact forces. If a dancer does not have the proper training, bone growth, range of motion, and neuromuscular control (strength/coordination) the risk of injury increases which can be detrimental to the dancer’s technical development and future career. Some experts believe that starting pointe too early can permanently damage developing bones however this has not been proven through evidence based research.

Who Should I Consult Before Starting Pointe?

It is best if you seek multiple opinions to make sure you are ready for pointe. I would recommend having a consensus between your ballet teachers and medical professionals such as physical therapists. Medical doctors, physical therapists and other health care professionals who specialize in dance can conduct the three pointe readiness movement tests to determine if you are ready to go en pointe.

 


 

Tiffany is a Doctor of Physical Therapy here at Evergreen PT. She has been dancing competitively and recreationally since the age of three. Her dance background includes  ballet, jazz, hip hop, tap, Pointe, contemporary, salsa, and more. In addition to treating patients, Tiffany also runs monthly workshops on different educational workshops for dancers. For more info visit our workshops page. 

 

To schedule an appointment with Tiffany or one of our staff please give us a call at (626) 683-8536 or Request an Appointment here. Lastly, don't forget to subscribe to our blog to get more great insights from our specialists!

 


 

Please note that this blog is not meant to be used as medical advice. If you are wondering if you are ready for pointe, please consult your medical doctor, physical therapist, and dance instructor. 

 

 

References:

  1. Clippinger K. Dance Anatomy and Kinesiology.; 2007.
  2. DeWolf, Andrew; McPherson, Alyssa; Besong, Kathryn; Hiller, Claire; Docherty, Carrie; Qualitative Measures Utilized in Determining Pointe Readiness in Young Ballet Dancers. Journal of Dance Medicine & Science, 2018; 22(4): 209-217.
  3. Meck C; Hess R; Helldobler R, et al. Pre-pointe evaluation components used by dance schools. J. Dance Med. Sci. 2004; 8:37Y42.
  4. Richardson, M., Liederbach, M., & Sandow, E. (2010). Functional criteria for  assessing pointe-readiness. Journal of Dance Medicine & Science, 14(3), 82-88.
  5. Shah, Selina. Determining a Young Dancer’s Readiness for Dancing on Pointe.  Curr.Sports Med. Rep., 2009; 8(6): 295-299.

 

 

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