Why Some Dancers Can't Get on Top of Their Pointe Shoe Box

Ava Bernardo was 11 when she started pointe, and her first year in pointe shoes, as she puts it, "was a recipe for disaster." Now a company artist with Indianapolis Ballet, she faced a hurdle many dancers know: getting fully on top of the pointe shoe's box, the stiff front platform of the shoe that the dancer stands on.

"I didn't realize how much would change from demi-pointe to pointe," Bernardo says. Rising only halfway onto the shoe's platform leads to poor alignment, balance problems and injury risk. The causes vary — limited foot and ankle flexibility, the wrong shoes, or technical weaknesses — so identifying the root cause matters before anything else.

Strength first, stretching second

Pointework demands a lot of plantar flexion (pointing the foot downward) to stand on the shoe's tip. Kristin Ruggieri, a pointe shoe fitter and ballet teacher who owns Attitude Dance & Active Wear in Norwalk, Connecticut, checks younger students at fittings for flexibility they haven't accessed yet. "I give their foot a gentle stretch to see if it's a structural issue or if there's flexibility they're not accessing," she says. Sometimes the answer is simply time: "they just have to be a little patient and wait until they're older and stronger."

But Ruggieri stresses that strengthening matters more than stretching. "If you just work on flexibility, there's an imbalance," she says. "You need the strength to maintain it." Her prescription:

• Point/flex TheraBand exercises
• Doming exercises for the foot's intrinsic muscles
• Calf raises off a ledge

Dr. Emily Sandow, DPT, OCS, a physical therapist at Westside Dance Physical Therapy in New York City, agrees — and warns against foot-stretching devices. "They may overstretch the ligaments on the top of foot, potentially contributing to ankle instability."

Sandow first tests overall readiness: core and calf strength, confident one-leg balance, and the "pencil test," where a pencil placed along a pointed foot should form a straight line from ankle to toe. Dancers who fail these assessments may need to delay pointe training. "It's a tough conversation, but [necessary] for health and safety," she says.

What about the big toe's muscle?

If a dancer passes readiness checks but still can't get over the box, Sandow tests the flexor hallucis longus, or FHL — the long flexor of the big toe. "It's the last muscle to push the foot off the ground in running and walking and crucial in propulsion onto pointe," she explains. The tell: keeping toes long when pointing, rather than curling under.

Her fix is working in class — maintaining toe length and smooth articulation in tendus, dégagés and relevés. "That helps the coordination of the foot muscles that are useful to propel onto the box of the pointe shoe," she says.

When pain is the real problem

Pain during pointework can signal a mechanical issue or overuse injury, such as a posterior ankle impingement (an os trigonum, or extra bone) or FHL tendinopathy. If pain persists after working through technical weaknesses with a teacher, Sandow says dancers should see a sports medicine professional — "ideally an orthopedic physical therapist or physician who is knowledgeable about the specific physical and technical demands of ballet."

What does this change for dancers in class?

Kathryn Sullivan, who teaches ballet and pointe at Steps on Broadway and Peridance in New York City, says demi-pointe work is the foundation. "Really going through half-toe when doing tendus builds incredible strength in the top and bottom of the foot," she says. On pointe, the cue transfers: "imagine you're doing a tendu inside the pointe shoe; really push down to get the toes working."

Posture counts too. "I make sure dancers aren't back on their heels, that they're not grabbing their hip flexors, and that their hip bones are forward," Sullivan explains. "Because if your hips are back, you won't get a full pointe position."

Shoes are the last variable. Dancers often blame the shank (the stiff sole spine), but Ruggieri says the box and wings matter more. "If the issue is ankle mobility, nothing you do to the shank is going to help," she says. Constricted toes can't push — a wider box or lower vamp may fix it. And squishy wings, the sides of the box that support the dancer laterally, mean the shoe is finished: "If the wings are too squishy and the paste is gone, you should not be wearing that shoe anymore."

Bernardo, who worked with Sandow and still does daily foot exercises, says the slow approach reshaped how she works. "In the long run, you have to make things work for you," she says. "It's hard in the ballet world, because you want instant gratification, but focusing on getting stronger every day changed my outlook on myself."