En pointe is a form of dancing in toe shoes, which have a hard base made of layers of paper, leather, or burlap, where the dancer is literally standing on the tips of her toes. Ballet risks a number of injuries to the lower half of the body, and about 60% of injuries affect the legs, hips, ankles, or feet. Of these, about half are specifically related to the feet and ankles, with dancing en pointe being significant a cause of injury.
Ballet is a highly selective art, and physical form matters extremely. Dancers who have the least difficulty performing en pointe tend to have toes all about the same length. They also have to have exceptionally strong ankles, since maintaining a pose or walking or dancing in this way must be guided by ankle stability.
People with a longer big toe tend to have more trouble because they are supporting most of their weight on two big toes. There are some modified toe shoes that can help, but a dancer either has “bad feet” or “good feet.”
Some minor medical problems that occur regularly with this type of dancing are calluses, bunions, and blisters, although more significant problems can include bone spurs, and bone degeneration. Not all dancers do well with this type of dancing, no matter how much they would like to.
Actually, the biggest risk in dancing this way is ankle sprain. This is the most common ballet injury, and repeated sprains can end a dancing career of any type. Because of the problems related to en pointe dancing, it is questionable whether a person not interested in a ballet career should ever progress to training for it.
There are some people who should definitely not dance en pointe. Diabetics, who can suffer tremendous complications from even minor injuries, like blisters, to the foot are probably best served by finding another form of dancing that is gentler on the feet. In most cases, 12 is considered the youngest age at which children can begin to train for this style. Beginning toe shoe training before the foot is fully formed can influence how the foot will form, creating lifelong foot problems.
Many ballet dancers who have trained extensively suffer residual foot problems for the rest of their lives. Especially when dancers train four to five hours daily, this can create medical problems regularly, and many dancers are encouraged to be stoic about the pain. In fact, stoicism is often adopted especially as dancers begin to age, since injuries can shorten a career. Dancers may dance on injured feet or limbs, but often do so at a physical cost in later life.
Parents should really consider whether the potential risks of en pointe training are worth it, especially in younger kids. If a child is aiming toward a career in ballet, then naturally she will have to hazard the risk of this kind of dancing. For children who have other goals in mind, this style may never be necessary.