Pre-Pointe Assessment

Original Editor - Rachel Vogel

Top Contributors - Rachel Vogel  

Introduction[edit | edit source]

Dance injuries associated with pointe work are highly prevalent within the dance community[1], particularly in a pubescent population where learned motor patterns may be in a period of re-acquisition with a rapidly growing and changing body.[2] Pre-pointe assessments are used to determine whether a ballet dancer is safe to progress to dancing en pointe. This transition will usually occur around 12 years of age.[3][1][2]

Previously, chronological age, years of dance training, and ankle plantar flexion range of movement was the only indicator of readiness, but studies suggest that a combination of functional testing and other contextual factors is more useful to gauge safe and successful performance.[2]

Protocols worldwide have not yet been standardised, but in relevant studies, attempts have been made to identify musculoskeletal variables between pre-pointe and novice pointe students to ascertain readiness.[3]


Special Questions
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A minimum of 3-4 years of ballet training is suggested to ensure the dancer has the correct physical and cognitive maturity, strength and proprioceptive awareness for pointe work.[1][2]

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Some dance teachers will ask for radiology images to confirm the evidence of growth plate closure and therefore readiness for pointe work, but studies have suggested that growth plate closure does not correlate with the completion of bone maturity (which will happen in later teenage years), and therefore is an irrelevant consideration.[5]

Objective[edit | edit source]

Observation[edit | edit source]

  • Assessment of positions in first, second and fifth, with compensation strategies observed
  • In each special test, care must be taken with pelvic and trunk stability. When a dancer moves into a position en pointe, their base of support narrows and they reply increasingly on proximal support from their body. Weak or fatigued hip abductors have been associated with increased postural sway and subtalar joint inversion during single leg stance, which can leave the dancer vulnerable to inversion ankle sprain.[2]

Functional Tests[edit | edit source]

  • Single Leg Heel Lift: 15-25 consecutive heel lifts without a decrease in the quality of movement[3][2]
  • Single-leg Sauté Test: 16 consecutive jumps; 8 should be performed with proper execution (maintaining a neutral pelvic position; an upright, stable trunk; neutral lower extremity alignment, proper toe-heel landing with a completely extended knee and pointed foot in the air)[2]
  • Modified Romberg test: single leg with parallel stance, arms crossed and eyes closed for (equal to or greater than) 30 seconds[2]

The Single-leg Sauté Test was the strongest predictor for pointe-readiness classification overall.[2]

Movement Testing[edit | edit source]

  • Non-weight bearing plantar flexion (PF) AROM: 88-90 degrees is favourable[3]
  • Non-weight bearing dorsi flexion (DF) AROM: 10-15 degrees is favourable[3]
  • Weight bearing lunge test: 30-40 degrees of DF[3]
  • Plantar flexion isometric strength

Special Tests[edit | edit source]

  • Pencil test: determines overall plantar flexion of the ankle-foot complex. The test is performed by having the dancer long-sit, while a straight-edge level or pencil is placed along the top of the dorsal talar neck. The dancer passed this test if the adequate plantar flexion was equal to or greater than 90 degrees was detected as evidenced by the straight edge clearing the distal most part of the tibia just proximal to the malleoli[2]
  • Topple test: the dancer must perform a single pirouette en dehors with the gesture leg in full retire and the support leg fully extended, while maintaining a vertical trunk and demonstrating a controlled, decelerated landing[2]
  • Double- leg lower (DLL) test: the dancer is able to maintain a neutral pelvis to at least a 45 degree angle from the floor[2]
  • "Airplane" test (an advanced version of the Single-leg Step Down test): In this test, the trunk is pitched forward and the non-support leg is extended to the back, keeping the pelvis square to the ground. The subject performs five controlled pliés while horizontally adducting the arms in order to touch the fingertips to the ground.[2]One study cites 2 repetitions is best for differentiating between readiness for pointe[3], others specify four out of five pliés should maintain neutral alignment of the knee and ankle.[2]
  • Star Excursion Balance test: in 3 directions[3]

The Airplane test and Topple test were the most sensitive for distinguishing between dancers identified as not ready for pointe work by their dance teachers.[2]

References[edit | edit source]

  1. 1.0 1.1 1.2 Altmann C. Roberts J. Scharfbillig R. Jones S. Readiness for en pointe work in young ballet dancers; are there proven screening tools and training protocols for a population at increased risk of injury? Journal of Dance Medicine and Science. 2019,23(1);40-45.
  2. 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 Richardson M. Liederbach M. Sandow E. Functional criteria for assessing pointe-readiness. Journal of Dance Medicine and Science. 2010, 14(3); 82-88.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Dewolf A. McPherson A. Besong K. Hiller C. Docherty C. Quantitative measures utilized in determining pointe readiness in young ballet dancers. Journal of Dance Medicine and Science. 2018;22(4):209-217.
  4. Perfect Form Physiotherapy. Why does she even need a pre-pointe assessment? Avaliable from [last accessed 20/11/2021]
  5. Shah S. Determining a young dancer’s readiness for dancing on pointe. Current Sports Medicine Reports. 2009;8(6);295-299