Functional testing for pointe readiness

Richardson, Megan MS, ATC, NYU Hospital for Joint Diseases, Harkness Center for Dance Injuries, New York, New York, USA; and Sandow, Emily MSPT, DPT, NYU Hospital for Joint Diseases, Harkness Center for Dance Injuries, New York, New York, USA

Purpose:

One of the most frequently asked questions in ballet and dance medicine is:  when should a dancer begin training en pointe?  In a recent teacher survey we conducted, the most common answer was age 12.  Little is known about health implications associated with pointe training, but millions of children take dance lessons every year with the goal of one day rising onto pointe.  As such, it would be useful to consider whether screening criteria can be established to determine a baseline level of functional capacity necessary for safe participation.  

Pointe work traditionally commences just prior to or during the onset of the adolescent growth spurt when the skeleton is immature and rapid neuromuscular changes are taking place.   Clinically significant adaptations in strength, flexibility, and proprioception associated with pubertal growth have been shown to influence both motor control and psychological state.   Tremendous variability exists between dancers with regard to musculoskeletal attributes, growth stages, psychometric factors and sociocultural features unique to each training and home environment.  Establishing universal criteria for pointe readiness, therefore, is challenging.  Nevertheless, a sound rationale for such can be constructed from findings in the dance pedagogy, dance medicine, exercise science and pediatrics literature.  

Approach:

A literature review on pointe-readiness and aspects of human development that shed light on the issue of safety for young dancers will be presented.  In addition, a battery of screening tests we are currently assessing for validity will be demonstrated.  

Relevance:

Development of a pointe-readiness screen based on information about the psychometric, biomechanical and energy demands of pointe may be helpful for general healthcare practitioners, parents and teachers striving to guide dance students into safe levels of participation.  Although screening tests are never foolproof determinants of success and risk, they may provide general safety benchmarks that promote wellness and enhanced performance.