Possible injuries caused by pointe work, prevention & treatment

Pointe work is highly demanding and can cause a lot of pain and injuries. However, before we become concerned about injuries, let’s emphasize, once again, how important the role of your ballet teacher is. Only the highly skilled, trained and certified classical ballet professor can train you properly, identify and correct your technique and posture errors and thereby help you avoid possible injuries.

Types of injuries

A dancing on-pointe ballerina may suffer from various types of injuries. Some of them can be quite serious or chronic, requiring treatment by a specialist and some others can be common minor injuries, easily treated and do not inspire any concern. The most serious injuries, for example, contusions, fractures, ligament injuries, tendon or ligament ruptures, chronic tendinitis etc. occur due to various reasons such as poor technique, continuously improperly performed exercises, overwork, accidents etc. In case of such injuries, you will need diagnosis and treatment by a specialist, podiatrist-chiropodist or Sports physiatrist.

However, if you follow some basic rules and most importantly, your teacher's instructions you will probably be able to avoid all of the above. During your first pointe lessons (until you find accessories that suit you and protect your toes, nails, and skin and until your feet get used to pointe work) you are likely to encounter some minor injuries such as wounds on the tip of your toes, blisters and more rarely subungual hematoma (claw that blackens when hit).

Dealing with injuries

Soothe your feet with a warm footbath after every ballet class. If you got injured and have blisters on your toes, you should clean your wounds regularly and thoroughly. For faster healing, use open shoes without socks if possible, to ventilate your feet or stay barefoot while you are at home. You can even put special medical dressings to avoid contamination. If you injure one of your toenails definitely let your teacher know. A subungual hematoma takes much longer to heal and the newborn nail will be fragile at the beginning (it will take about 1-2 months for the new nail to come out). 

Basic principles for the prevention of injuries

Back in ancient times, Hippocrates advocated that prevention is better than cure («Κάλλιον το προλαμβάνειν ή το θεραπεύειν»). Follow these basics rules and prevent yourself from injuries.

• Teaching and supervision by your ballet teacher. WHY? Because your teacher is the most important factor for you to learn how to dance properly and safely.
• Pointe shoes suitable for your feet, with ribbons and elastics properly stitched and tied. WHY? The correct fitting will reduce or eliminate pain while ribbons and elastics will provide your feet with support.
• Auxiliary accessories that reduce pain and prevent from wounds and blisters (e.g. pads). WHY? Technology has evolved and some accessories can help us in order to either feel less pain or avoid everyday injuries, such as wounds caused by the friction between the skin of your toes and the pointe shoes.
• Choose to train only in a dance studio. WHY? The special floor (parquet shock) absorbs the vibrations and is safer for the dancers (e.g. in case of a fall).
• Use rosin* when dancing on a slippery floor (e.g. due to moisture), always under the supervision and suggestion of your teacher. WHY? The grated rosin on your pointe shoes reduces slipperiness.
• Follow the ballet dress code and have your hair gathered into a bun. WHY? Classic ballet clothing has not been randomly chosen. The tights and leotards are comfortable and help your teacher see how your body works when performing exercises, while the bun has practical significance, as it helps you dance undisturbed and does not shadow the movements and "lines" of your neck. 

Also...

• Treat your feet well, especially your footpads, by keeping them clean with properly and in a straight line cut nails (avoid deep cuts).
• Never skip the most important parts of your ballet class: the warm-up and the stretching-recovery part.
• Do not try alone or without supervision of your teacher, steps unfamiliar or unknown to you.
• Stay focused on your lesson and your teacher’s instructions.
• Do not overdo it! Everyday workout does neither good nor helps you become a professional earlier! Your body and your musculoskeletal system need rest and it is scientifically proven that this valuable rest will improve your performance.
• Adopt a balanced diet and consume foods salutary for the bones, joints, and muscles.

 * The rosin is a resin derivative, used by ballerinas on pointe, for better traction on slippery floors.