Skeletal Maturity in dancers…pointe work

Following on from my post about Pointe Assessments….Why bother? I would like to discuss why we consider skeletal maturity of dancers prior to starting pointe work.

Children are different physiologically to adults, they can regrow connective tissue, they go through periods of rapid growth and their bones are softer than an adults. Up until the ages of 16 we go through periods of rapid growth, which includes but is not limited to our bones. When it comes to boney fusion in our feet, signally the end of growth, this in fact begins at 2mnths of age in-utero.

There are variations between girls when it comes to physiologic development and this is largely to do with when they begin puberty and at what rate. Considering that at age 10 girls experience a period of rapid growth that occurs right up until age 12. Once bone has completely stopped growing we see fusion of the growth plates and this occurs earlier in the feet around 14 years in girls and 16 in boys. A child’s shoe size will change rapidly from age 5 to age 12 with around 0.9cm on average per year, which isn’t great news for parents when it comes to school shoes but also pointe shoes.

Considering that children are going through periods of rapid growth, their bones are softer, and considering that pointe shoes in particular carry a ground force reaction of 10 x our body weight, shouldn’t we consider that early pointe work is detrimental to bone in terms of joint and bone injury alone? Does it put our dancers at risk of early onset arthritis in the feet, stress reactions, fractures and early growth plate fusion if we load too early and too intensely?

So coming back to when we consider children to be pointe ready, if we were to use skeletal maturity alone to determine when it’s safe, this would not be until at least 14 years of age. However, as I have found we must consider a variety of factors that go into deciding when pointe work is achievable. As George Balanchine, master of choreography on pointe reported to have said that there is no reason to get a young dancer up on full pointe if she cannot do anything when she gets there.

So what do we use to determine pointe readiness if not skeletal maturity?

Sam