For young dancers who've dreamed of twirling across a stage as the Sugar Plum Fairy or Clara in “The Nutcracker,” being told they're ready to begin pointe work is an exciting milestone. Dancing en pointe is an incredibly athletic feat that requires strength, balance and control, along with mental toughness and maturity.
There are many different factors to consider when determining if your dancer is ready for the physical and sometimes emotional demands of dancing en pointe. Liz Chesarek, PT, DPT, a Children's Healthcare of Atlanta Physical Therapist, knows firsthand about the stress pointe work puts on the body. She grew up dancing and has a Bachelor of Arts in dance.
She studied the science and is a member of the International Association for Dance Medicine and Science. She developed science-based guidelines used by physical therapists as part of the Children's Dance Medicine Program to evaluate whether a dancer is ready to begin pointe work.
"We're providing guidelines and education to keep dancers safe and free of injury and pain," says Chesarek. "We give recommendations, not a concrete yes or no, and defer to instructors and families to ultimately make the decision."
The guidelines recommend a dancer be, at a minimum:
- At least 12 years old
- At least four years into ballet training
- In a ballet technique class for at least one hour a week
- Strong and controlled in the ankles and hips
- Able to control turnout
Dancers mature differently
Chesarek says the guidelines are not an end-all checklist. She cautions parents to remember that dancers, like all children, mature differently and should be evaluated on an individual basis.
"A dancer may be 13 years old, but if she didn't start dancing until she was 10, it would be better to wait until she has four or more years of technique," Chesarek explains. "Technique training is important to developing strength and control of turnout in the ankles and hips."
Physical therapists and dance instructors can also use functional tests to help determine a dancer's readiness for pointe, including assessing proper positioning, strength and control, and the ability to maintain balance during dance-specific skills.
Look for dance-specific expertise
Physical therapists evaluate dancers by looking at the amount of motion in the dancer’s foot and ankle, says Chesarek, making sure both move enough to get en pointe.
"We have measurements for motion and flexibility that are specific for dance," she says. "We don't compare dancers' measurements against other kids their age who don't dance."
An evaluation may also reveal muscle weakness or tightness that over time could lead to pain in the knees, hips or arches of the foot. Chesarek says physical therapy specifically for dance-related pain or injury can help prepare a dancer for pointe work or a return to pointe work after an injury.
"It may mean stretching tight muscles that are limiting them from getting full motion, and strengthening hips and the core," says Chesarek. "We have ballet floors and bars in our clinics allowing us to do exercises specific to dancers that are more function-based. For instance, instead of doing an exercise a football player might need, like a squat, we're working on demi pliés with control of turnout."
Chesarek says guidelines, evaluations and recommendations should always be considered with the dancers' emotional and physical best interests in mind.
"Dance is based in aesthetics, and dancers want to look good en pointe," she says. "We give recommendations based on what's best for the dancer and what will keep her dancing as long as possible."
Where you take them matters
The Sports Medicine Program at Children’s Healthcare of Atlanta is one of the few programs in the country devoted to the care of young athletes. Our therapists and athletic trainers also focus on the unique needs of dancers—artistic athletes. Dance-focused rehabilitation and training help dancers stay strong or return to the studio as quickly and safely as possible. Because we only work with kids and teens, we recognize when they are ready to progress to the next level of treatment and how to motivate them.
This is general information and not specific medical advice. Always consult with a doctor or healthcare provider if you have questions or concerns about the health of a child. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away.