title: When can I start pointe work? Guidelines for initiating pointe training.
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.
authors.affiliation: Harkness Center for Dance Injuries of NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, USA; Department of Orthopaedic Surgery at New York University School of Medicine, New York, New York, USA. david.weiss@nyumc.org
authors.forename: David S
authors.initials: DS
authors.lastname: Weiss
authors.forename: Rachel Anne
authors.initials: RA
authors.lastname: Rist
authors.forename: Gayanne
authors.initials: G
authors.lastname: Grossman
mesh_terms: D000843:Ankle Joint / Q000502:physiology; D001846:Bone Development; D002648:Child; D003615:Dancing / Q000193:education* / Q000293:injuries / Q000502:physiology*; D003657:Decision Making; D005260:Female; D005528:Foot / Q000502:physiology; D006801:Humans; D009140:Musculoskeletal Diseases / Q000517:prevention & control*; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D018570:Risk Assessment