Footwear in classical ballet: a study of pressure distribution and related foot injury in the adolescent dancer.

This study explores the relationship between dance shoe type and foot pressure characteristics. During adolescence, while the foot is still developing, limiting focal pressure on the feet may help reduce the risk of injury. In order to "condition" the feet for advanced dance, where pointe shoes are worn, it may be advisable to first utilize demi-pointe shoes. Eight female dancers were each tested in four footwear conditions (barefoot, soft, demi-pointe, and pointe shoes), and patterns of foot pressure were compared. A questionnaire was also distributed among sixty-five adolescent females currently training at vocational dance schools to examine shoe use and injury rate before and after the onset of pointe work. During ballet-specific dynamic movement, soft shoes and pointe shoes significantly vary in the plantar pressures they impose on the foot. Demi-pointe shoes provide an intermediate pressure condition, which may help the dancer adapt more gradually to the pressure demands of pointe shoes. Dancers who wore demi-pointe shoes prior to starting pointe were found to be less likely to sustain a ballet-related injury or a lower leg, ankle, or foot injury (22% compared to 30% in those who had not worn demi-pointe shoes). The dancers in this group were also older when they first reported an injury.