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Preparing For Pointe Work

Preparing for Pointe Work


When can a dancer begin pointe work? How can you tell that a dancer is ready? What milestones should be achieved in preparation? Is the age of the dancer the main and most reliable factor? 12 years is mentioned so frequently; is this the recommended age/guideline? Is having strong feet the main consideration?


Our opening paragraph contains some of the main myths associated with preparing for pointe work. Leading researchers, practitioners and educators in the field all agree that, despite a widespread, established belief, considering chronological age alone as a main and somewhat arbitrary criterion for pointe work commencement constitutes an unsuitable means for establishing physical maturity; and it is the latter that must be established in order to promote the health and wellbeing of the dancer. There are many other more critical factors to consider in relation to evaluating the physical maturity required to safely begin pointe work. Growth and development progress differently from individual to individual, and children will often be at very different stages at a given chronological age; the 12-year mark widely advocated historically being a good example. Bone growth tends to complete slightly earlier in the foot that the leg. The epiphyses, or growth plates, in the foot tend to close on average at approximately age 16 years for boys, and 14 years for girls; so, one can see that previous thinking around the promotion of age 12 is somewhat misguided given that bone growth is very unlikely to be complete at that age (Weiss et al., 2019). 


Current research suggests one should consider all of the following factors carefully in relation to beginning pointe work:

  • Ankle plantar flexion range of motion. Research suggests that it is a ‘supernormal range of ankle joint motion’ that is required for pointe work (Richardson et al., 2010). One study, comparing professional female ballet dancers with the general population, found that the former had an average of 113 degrees of plantar flexion, compared with a mere 48 degrees among the latter (Hamilton & Hamilton, 1992). The Pencil Test (Novella, 1995) is a recognised  method for determining the overall degree of plantar flexion in  the ankle-foot complex. The dancer assumes a long-sit position and a pencil is placed along the top of the dorsal talar neck. In order to ‘pass’ the test, plantar flexion must be greater than, or equal to, 90 degrees; the straight edge of the pencil must clear the distal most part of the tibia, which is just proximal to the malleoli. Weiss and associates and the IADMS Dance Educators Committee of 2019 suggest that attempting point work in the presence of insufficient anatomical facility and range of motion in this regard has the potential to ‘place excessive stresses not only on the foot and ankle,  but also on the leg, pelvic girdle, and trunk’. They also recommend being aware of the fact that ‘insufficient range of motion may not improve with time, and children with these restrictions may never obtain sufficient flexibility for pointe work’ (2019, p.3).

  • Years of training, and type of training; a dance training that consists of a class once a week in recreational setting is clearly very different from a dancer in a vocational school who trains for several hours a day, week in, week out. Weiss and associates and the IADMS Dance Educators Committee (2019) suggest that for students who are taking a ballet class at least twice a week, pointe work should not be initiated until the fourth year of training. One line of current thinking suggests that if a student is not truly pre-professional, pointe work should be discouraged, unless all other criteria detailed here can be met.

  • Skill acquisition has been identified as a crucial factor in relation to beginning pointe work; competent mastery and correct technical execution of all preparatory actions, that would include plié and relevé, is essential. Richardson and associates report that ‘the ability to control proper alignment and balance during dynamic tasks, such as turning and jumping, plays a critical role in prevention of lower extremity injury’ (2010). Their research is founded upon several studies which evidence the fact that poor alignment and impaired balance performance are known risk factors in relation in relation to traumatic lower extremity injury.

  • Lower extremity strength and neuromuscular control. Although strength in the foot is important, research finds pelvic and trunk stability, achieved through the activation of core musculature, crucial. Quin and associates (2015) suggest that any postural instabilities or alignment issues must be identified, along with any muscular imbalances. They also recommend considering the dancers current and past injury history in relation to the lower limb, the pelvis and the trunk, as this could indicate potential weaknesses which must be addressed through strength training and training that promotes proprioceptive awareness. Any hypermobility of the lower extremity will likewise require attention through such training prior to beginning pointe work. The research of Richardson and associates suggests that muscular strength and endurance of the hip abductors is an important consideration in relation to safe participation in pointe work. The hip abductors and external rotators, in combination with the aforementioned trunk control, assist in ‘maintaining a level pelvis and preventing femoral adduction and internal rotation during single leg stance. As the base of support narrows, for example during relevé en pointe, the dancer will rely increasingly on proximal control to maintain proper vertical alignment and balance’ (2010).

Ankle strength is essential in order to control the required range of motion at the ankle. One can use the performance of single leg heel rises as an objective measure to assist in establishing the degree of ankle strength. The test, first established by Lunsford & Perry (1995) and then applied in dance context by Thomas & Parcell (2004), suggests a dancer should be able to perform at least 25 repetitions.


There are a range of simple functional motor tests and dance specific tests that can be performed in order to assist in ascertaining a dancer’s readiness for pointe (Shah, 2009; Richardson et al., 2010; Quin et al., 2015). Research suggests the ‘Airplane’ test, (Liederbach, 2007, as cited in Richardson et al. 2010) the Sauté test, and the ‘Topple’ test (Lopez-Ortiz, 1994, as cited in Richardson et al. 2010; Liederbach, 1997, as cited in Richardson et al. 2010) to be particularly pertinent in relation to gauging pointe readiness, with one study finding the Sauté test to be ‘the strongest predictor of pointe-readiness classification overall’ (Richardson et al., 2010). The ‘Airplane’ test, (Liederbach, 2007, as cited in Richardson et al. 2010) requires the dancer to stand on one leg, with the trunk pitched forward, the non-support leg extended to the back, and the pelvis kept square to the ground. The dancer then performs five controlled plies whilst extended the arms down to touch the floor each time. Dancers must maintain neutral lower extremity alignment on at least 4 out of the five repetitions in order to pass the test. The single leg sauté test requires the dancer to perform 16 consecutive single leg sautés or hops. The dancer’s knee must be fully extended in the air, with the foot fully pointed; with good use of the plié in evidence along with proper toe-heel landings. The aim of this test is to maintain a neutral pelvic position, a stable trunk and evidence neutral lower limb alignment, thereby evidencing dynamic trunk control and good lower extremity alignment. At least 8 out of the 16 hops/sautés must be executed correctly to ‘pass’. The ‘Topple’ test (Lopez-Ortiz, 1994, as cited in Richardson et al. 2010; Liederbach, 1997, as cited in Richardson et al. 2010) looks at the dancer’s ability to perform a single en dehors pirouette from fourth position with the gesture leg in full retire, the supporting leg fully extended, the maintenance of a vertical trunk throughout, and the demonstration of a controlled, decelerated landing.


Quin and associates suggest that when pointe work begins it should only consist of approximately 15 minutes duration, and should take place after class and before cool-down. The extensive literature review conducted by Altmann and associates (2019) reveals a trend towards pre-pointe training, whereby dancers undertake a range of activities and methods in order to enhance their preparation for pointe work and ensure as smooth and safe a transition as possible. These activities included body conditioning classes, extra technique classes, and specific pre-pointe exercises; as well as education and support around the use and care of pointe shoes themselves. All such activity contributes towards a commitment to safe practice and can only be beneficial for the dancer.


So, in determining readiness for pointe a whole range of factors should all be taken into consideration, as each one offers its own crucial and significant contribution to this very critical assessment. It goes without saying that if any aspect raises concern, it is advisable for the wellbeing of the dancer to wait and address the concern first.



References:


Altmann, C., Roberts, J., Scharfbillig, R., & Jones, S. (2019). Readiness for en pointe work in young ballet dancers: Are there proven screening tools and training protocols for a population at increased risk of injury? Journal of Dance Medicine & Science, 23(1), 40-45. https://doi.org/10.12678/1089-313x.23.1.40 


Hamilton, W. G., & Hamilton, L. H. (1992). A profile of the musculoskeletal characteristics of elite professional ballet dancers. The American Journal of Sports Medicine, 20(3), 267-273. https://doi.org/10.1177/036354659202000306 


Lunsford B. R., & Perry, J.(1995). The standing heel-rise test for ankle plantar flexion: Criterion for normal. Physical Therapy, 75(8), 694-698. https://doi.org/10.1093/ptj/75.8.694 


Novella, T. M. (1995). An easy way to quantify plantar flexion in the ankle. Journal of Back and Musculoskeletal Rehabilitation, 5(3), 191-199. https://doi.org/10.3233/bmr-1995-5304 


Quin, E., Rafferty, S., & Tomlinson, C. (2015). Safe dance practice. Human Kinetics.


Richardson, M., Liederbach,  M., & Sandow, E. (2010). Functional criteria for assessing pointe-readiness. Journal of Dance Medicine & Science, 14(3), 82-88. https://pubmed.ncbi.nlm.nih.gov/21067685/


Shah, S. (2009). Determining a young dancer’s readiness for dancing on pointe. Current Sports Medicine Reports, 8(6), 295-299. https://doi.org/10.1249/jsr.0b013e3181c1ddf1 


Thomas K. S., & Parcell, A. C. (2004). Functional characteristics of the plantar flexors in ballet dancer, folk dancer, and non-dancer populations. Journal of Dance Medicine & Science, 8(3), 73-77. https://www.ingentaconnect.com/content/jmrp/jdms


Weiss, D. S., Rist, R. A., & Grossman, G. & the International Association of Dance Medicine and Science (IADMS) Dance Educators’ Committee. (2019). Guidelines for initiating pointe training. https://iadms.org/media/5779/iadms-resource-paper-guidelines-for-initiating-pointe-training.pdf








 Denise Horsley, MSc. – Blommaert Ballet School Dance Science Advisor