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Footwear in classical ballet: a study of pressure distribution and related foot injury in the adolescent dancer.
Pearson SJ, Whitaker AF. J Dance Med Sci. 2012;16(2):51-6.
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.
Dancers are exposed to many landings from jumps during class and performance, and repetitive loading has been linked with an increased risk of injury. Little is known about the effect of different dance shoe types on jump landings, and with so many dance shoe designs available to choose from, a thorough exploration is warranted. Dance technique dictates that jump landings be “rolled through the foot,” with a toe strike followed by controlled lowering of the ball of the foot and heel. For this study, 3D motion analysis was used to capture the movement of 16 female dancers performing sautés in second position. Lower limb joint kinematics were examined during the landings, both barefoot and in different jazz shoe designs. The results showed that all dancers executed the technique of “rolling through the foot.” All jazz shoe designs increased knee and ankle sagittal ROM (p < 0.05) but reduced ankle frontal plane ROM and midfoot ROM in all three planes (p < 0.05). Chorus shoes increased maximum knee flexion by more than 5° during the plié. Jazz shoes restricted midfoot sagittal and transverse plane motion and MPJ sagittal motion compared to barefoot throughout stance phase (p < 0.05). These changes may translate to a reduced capacity to absorb impact or decreased propulsion. Dance jump landings in the jazz shoe designs tested may appear to be heavier due to the greater reliance on knee flexion to absorb impact and less push-off for subsequent jumps.