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How to Choose and Prepare Pointe Shoes

Originally researched and written by Holistic Ballet Summarized below by Richelle Stevenson. Read the full article here!

(PC: Philip Stevenson care of the Gaynor Boutique NYC)

Modern pointe shoes are constantly developing and its important to know how different shapes, sizes and brands can effect your feet. This article has excellent advice on perfecting your pointe shoe fit by starting with the basics. Each brand usually has additional and specific ways to adjust the shoe for their brand. For example, these suggestions from Gaynor Mindon and an excellent resource for finding your perfect fit. A Tour of Your Shoes Holistic Ballet broke down the layout of the shoe and what to keep in mind while fitting your shoes. Here are a few of my favorite tips.

Shoe Size: Bring the padding you plan to use with you but don't be afraid to have a minimalist approach. Many beginning dancers cram extra lambswool and thick toe pads into their shoes. While this may add layers of 'rub room' to cover your toes, dancers tend to purchase a larger shoe size to accommodate these layers. Unfortunately this larger size can actually cause extra sliding within the shoe (especially as the toe pads thin) and increase blisters. The Box: In selecting your box, there are many elements to consider: shape, width, platform and vamp. A box which is too narrow can increase pressure in the sides of your feet and create bunions. A vamp too low and your metatarsals (aka "knuckles") won't be supported and will create buckling. As the author states, "In General, a longer box is more supportive but also requires more strength to rise onto pointe. If the box is too short, e.g. stops below the joint of the big toe, the foot collapses and you "sit in your shoe" with all your weight resting on your knuckles." It's important to try each of these differences to see what not only feels the best but snugly supports each angle of your foot. The Shank: It's common for professional dancers to have multiple shanks depending on the purpose for their shoes, perhaps using a stronger shank for rehearsals and a softer shank for performances. This article outlines a nice rule of thumb, "The higher or stronger the arch of your foot, and also the longer your foot is, the harder your shoe needs to be." But keep in mind, having a harder shank is not always better. Some dancers need a softer shank if dealing with an injury. Sometimes beginning dancers need a softer shank initially to strengthen their intrinsic muscles as they learn to articulate their feet and then a harder shank to continue strengthening later in their training. The biggest thing to look for is proper placement atop the platform en pointe: too soft for a high arch will lead to sinking into the shoe and too hard will prevent the dancer from getting fully over their box. Ask your fitting professional, your teacher and the dance medicine specialists at Magna PT if you need help with this.

Not sure where to start? Check out this chart!

Clinician's Corner

Taking care of Blisters What are your toes telling you?

Richelle Stevenson, LAT ATC

Everyone who dances en pointe, has experienced dancing with blisters at some point. Likely they have also endured a bunion and bruised toenail or two. However, these common-place wounds may be an indication that your shoes and your alignment need an adjustment. Bunions- These are often caused by a box which is too narrow and by slightly pronated feet (collapsing arches). For instance, dancers who force their turnout and roll their ankles inward increase pressure along the MTP joint (the side/ base of your big toe); increased pressure at this joint, over time, can stretch the capsule and shift the bones of your feet. If you start to feel pain in this joint, please don't write it off as necessary for ballet. Try using a spacer between your first and second toe while you dance and getting a slightly wider box to help direct the force evenly while dancing. More importantly, I suggest contacting an orthopedic or podiatrist professional to alleviate this excessive pressure before you permanently develop a bunion. Bruised Toe Nails- For most people in society, a blackened toe nail is the result of dropping an extremely heavy object directly on the toe. This large force causes bleeding between the nail bed and the nail itself. For dancers, however the trauma often occurs when excessive force is pinpointed to a particular region of the toe (and the box of the shoe). If the platform is too small, dancers may put excessive pressure on the tip of their big toe causing deep bruising beneath the nail and painful bleeding. From a physical therapy standpoint, generally this is also a sign that feet, core and leg muscles are weak or disengaged. If you repeatedly endure bruised toenails, you may need a strengthening program to disperse the force of dancing throughout the body. The link below is an excellent resource for information on subungual hematomas (bruised nails). I recommend seeking medical care, especially if this is your first bruised toenail because the nail bed itself can become lacerated with improper treatment. The biggest thing to remember with bruised nails is to continually clean the area; infections are common and cause greater concern and pain. Blisters- Some blisters are inevitable with dancing en pointe. When you discover blister, consider their location and the life of your shoes. Do you constantly receive blisters at the same location? Perhaps your shoes need to be broken in with water prior to dancing, or your strength should be examined. You may also not be utilizing the intrinsic (inner foot muscles) and relaying too heavily on the small toe muscles or even curling your toes. If the box is too wide or you used heavy padding during fitting (see the article above), then there is more room to rub along the sides of your toes and even the tips. When you do receive a blister, use protective "donut padding" to prevent it from bursting. The blister has a more efficient and protected healing process if it remains intact. This is especially important if it becomes a blood blister. If the blister does rupture, be sure to clean it regularly and leave the skin intact if possible. Check out the resource below from the Rockettes for further care instructions. Additional Resources Bruised Toenails Blisters 101: Prevention and Care

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