Feet are the foundation of a dancer’s alignment and posture and determines stability and balance. The dancer places 4 times their body weight on their metatarsals in relevé, but places 12 times their body weight on their toes en pointe. The shape of your feet often determines the shape and sizes of the different parts of the shoe - the shoe must be fitted to help support the downward force of the body and avoid injuries.
Certain foot shapes are naturally prone to certain tendencies (sickling, curling toes, pronating, etc.) that lead to injuries. Selecting the correct shape can help prevent chronic joint and muscle pain, as well as encourage proper alignment not just in the feet, but throughout the entire body. The wrong pointe shoe could force compensation leading to poor alignment, injuries and muscle development as well as decreased proprioception that could affect the rest of their lives.
For example, a dancer experiencing big toe pain may sickle (unconsciously pulling away from the pain). This may lead to uneven muscle development, instability or even injuries resulting from falling. The same dancer might begin to unconsciously block pain signals coming to the brain from the toe resulting in decreased proprioception - this decreased awareness of the muscles in the foot and their function could lead to the stagnation of muscle development.
The foot can be divided into three parts: Forefoot, Midfoot and Hindfoot.
Forefoot
The forefoot is the front of the foot made up of toe bones (phalanges) and the long bones attached to them (metatarsal bones). Each toe has 3 phalanges (except the big toe that has 2) connected by joints. Phalanges connect to the bigger metatarsals at the ball of the foot. There are two small pea-shaped sesamoid bones at the base of the big toe that enable the toe to move up and down.
The length and shape of the phalanges, metatarsals and joints determine the shape of the feet.
Though there are several other factors that determine the shape of the pointe shoe (we will cover those later on in the curriculum), choosing a pointe shoe model with a box shape that is closest to the foot shape of the forefoot is a great start.
There are 5 main foot shapes
Egyptian: The toes decrease in length from the big toe to the little toe
Roman: The first 3 toes are of equal length, while the other two are usually shorter
Greek: Second toe is the longest, including the big toe and the rest decrease in size
Celtic: First and 3rd toes are of similar length with a longer second toe, and the other toes decreasing in size to small little toe
German: Large big toe and the other four are the same size
Lesser known shapes include:
Orient: Similar to Egyptian feet with the big toe followed by other toes inclined in the shape of an arc
African: First two toes are similar in length, with the other three in descending order
Aboriginal: The second and third toes are longest and similar in length
Norwegian: Variation of the Egyptian foot with a sharper taper
Mongolian: Big toe is significantly longer to the shorter second toe and the rest taper moderately
*Note that these shapes are idealized foot forms of their respective culture’s art and not necessarily connected to ancestry. Most people have slightly different foot shapes and some may even have 2 completely different types altogether.
Toes
Although there are many different shaped toes, the two most general groups are: tapered and non-tapered.
The length of the toes, the difference in length between the toes, how sharply they taper, which toes are longer than the others, and the gaps between the toes, all determine what the shape of the box should be.
Because pointe shoes are symmetrical, the fitter must consider the overall shape and taper of the toes and how much surface area there is at the tip of the toes that will touch the end of the shoe. For example: a tapered foot with a big toe that is longer has more surface area than a tapered foot with a second toe that is the longest. Or having a foot with 2 or 3 toes that are longest and similar in length has more surface area than having 1 toe that is the longest.
The ratio of this surface area to the width of the metatarsals will determine the shape of the box.
The 2 major types of tapered toes are Egyptian and Greek (other tapered shapes are variations of these 2 types). Egyptian foot (the first toe is the longest) and Greek foot (the second toe is the longest) are generally considered less stable en pointe than the Roman foot (3 or more of the toes are pretty even in length).
Greek narrow foot and Egyptian narrow foot generally need a tapered toe box. Greek wide foot and Egyptian wide foot need the slightly tapered toe box.
Greek (also called Morton’s Toe)
Second toe is the longest. This foot structure is largely considered the least stable and an improper fitting may lead to hammertoes (claw toes, mallet toes), bunions and/or other injuries. Because the second toe is smaller and weaker than the big toe, it is not meant to bear much weight. The fitter must be sensitive to make sure the pressure stays off the second toe both when the dancer is flat and when the dancer is en pointe. It is common for dancers with Greek toes to be wearing regular street shoes that are too short especially if they are particularly narrow or tapered. The toe box must be tapered enough so the weight is distributed to the other toes and support the sides of the feet to lift the dancer out of the box.
Common issues with Greek foot type: This foot type is more prone to over pronation. The shorter first metatarsal is oftentimes elevated which means the stronger first metatarsal isn’t participating until later in the weight bearing cycle putting the bones, muscles, tendons and ligaments under more stress and strain.
People with Greek foot type are more likely suffer from variety of foot ailments due to its instability:
• Metatarsalgia (ball-of-foot pain)
• Morton’s Neuroma
• Metatarsal Stress Fractures
• Plantar Fasciitis
• Bunions
• Hammer, Claw and Mallet toes
Greek Narrow: second toe is the longest and other toes sharply taper into a triangle. Has the least amount of surface area at the tip of the toes.
The length should be measured from the back of the heel all the way to the tip of the second toe when standing on flat to give the second toe ample room to straighten. If pointe shoes do not give enough length or are not tapered enough, it can lead to hammertoes.
The dancer needs a sharply tapered box with a small platform to take the pressure off of the second toe and distribute the weight to the other toes
If the dancer has a tendency to pronate or supinate, a flatter sole should be considered to help promote correct alignment.
Greek Wide: second toe is longest and other toes slightly taper down.
A wide greek foot with a slight taper is a bit more stable and allows for a slightly broader surface area on the platform.
The length should be measured from the back of the heel all the way to the tip of the second toe when standing on flat to give the second toe ample room to straighten.
The dancer needs a moderately tapered box and a medium platform to accommodate the width but still take the pressure off of the second toe and distribute the weight to the other toes so the second toe doesn’t bare all the weight
Egyptian
Big toe is the longest and the other toes taper down. While this foot shape is considered the most functional and stable en flat, the toe box must be tapered enough to distribute the weight to the other toes and there isn’t too much pressure on the first toe.
Egyptian Narrow: big toe is longest and the other toes sharply taper down into a triangular shape. Second smallest surface area after Greek narrow foot type.
The length should be measured from the back of the heel all the way to the tip of the big toe (which is the longest) when standing flat.
The dancer needs a sharply tapered box with a small platform to take the pressure off of the first toe and distribute the weight to the other toes
Egyptian Wide: big toe is the longest and the shorter toes slightly taper down
The length should be measured from the back of the heel all the way to the tip of the big toe when standing on flat. The length of the shoe should be larger than the foot length by about half an inch.
The dancer needs a slightly tapered box with a medium platform to take the pressure off of the first toe and distribute the weight to the other toes.
*Notice that the description for both Greek and Egyptian are similar. Because pointe shoes are symmetrical, they must be wide enough to accommodate all the toes while tapered enough to bottle neck the toes from falling into the floor and putting pressure on the longest toe.
Roman (Square/Peasant/Giselle)
First three toes are more or less the same.
This type of foot is considered the ideal shape for pointe. It is the most sturdy and easiest to balance en pointe due to the wide surface area. Dancers with this foot type can wear square shoes with a wider platform.
Certain training programs that prefer the longer look of a narrow, tapered box must consider making an exception for this type of foot. A platform that is too narrow or tapered may cause unnecessary pressure on the big toe joint (hallux metatarsophalangeal (MTP)) causing possible damage that may lead to injuries such as stress fractures, bunions, sesamoiditis as well as external injuries such as bruised toenails on the pinky toe.
Simian Foot
The big toe slants into the smaller toes.
This type of foot may have characteristics of other foot types (Greek or Egyptian). It is more prone to bunions especially if there is a large gap between the first and second toes.
* Gapping between toes: Some dancers have large gaps between toes and others do not. Dancers with large gaps between toes may appear wider than they are. Their feet typically compress or shrink as the shoe squeezes the toes to fill in the gaps.
A spacer between the first and second toe could help correct the alignment on the big toe. The fitter should also select a width that is wide enough and wings that cover both sides of the ball of the foot.
Rothbart’s Foot
The big toe and second toe cannot lie flat when the foot is on the ground in a neutral position.
The Rothbart's foot is considered a genetic and abnormal type of foot. This type of foot may lead to bad posture and sesamoid pain in dancers. A wedge (sponge, gel or lambswool) placed under the big toe may help correct placement of the foot and relieve pain.
*We suggest using an accessory such as an orthotic in both the Simian and Rothbart’s foot type. The spacer between the toes as well as the wedge under the big toe is to help correct the alignment (horizontal alignment for simian and vertical alignment for Rothbart’s foot). Just like a splint or a cast will set the alignment and weaken the bones and muscles while it is in place, these accessories will help keep things in place but may further promote the deformity and lack of strength.
These accessories are necessary in the beginning while the dancer is not strong enough to correct the alignment on their own strength and help prevent injuries. It must be used in conjunction with a series of strengthening and mobility exercises so the dancer can eventually wean off these accessories and rely on their own skill, endurance and strength.
Common problems arising from wrong shape
Hammertoes: Presence of Hammertoes can be spotted by one or more bent toes and oftentimes corns on the top of the toes from rubbing on the shoe.
This is generally a result of a muscle imbalance between the tendons on the top and the tendons on the bottom of the toe. Hammertoes can also be caused by improperly fitting shoes (both street and dance shoes) that constrict and bend the toes. If the dancer’s toes stay in this position for a prolonged period, the tendons eventually shorten to accommodate it. When shoes are fitted too wide, too square in shape or short in length, this can cause the foot to slide to the end of the shoe and cram at the end of the box.
Flexible Hammertoes: most flexible Hammertoes can be reversed by exercise and properly fitted shoes. Dancers can straighten the toes by taping and setting the toes straight and strengthening the toes by various exercises (we will go over that in the injury section)
Rigid hammertoes: cannot be straightened even with manipulation. Pain and loss of function may be more severe.
*Flexible hammertoes may turn into rigid hammertoes if not treated
Hallux Valgus (Bunions): Dancers should not form bunions or hallux valgus deformity any more than the general population if the shoes are fitted correctly. Sometimes these conditions are genetic and unavoidable but pointe shoes should not cause, worsen, or increase the likelihood of getting bunions.
However, if the dancer is fitted in shoes that are too tapered, narrow, promote rolling in or too low in the profile, they may develop pain, swelling and inflammation. Dancers with prominent bunions should be fitted with a higher wing and wider box along with accessories that will relieve pain and correct alignment.
Dancers who are genetically predisposed to bunions include Simian foot shape and those who have flat feet. Intrinsic muscle exercises are important for all dancers but especially for those who are prone to bunion.
Hallux Limitus: Dancers experience pain on the top of the big toe joint (Metatarsophalangeal (MTP)) rather than the side, as a bunion. This limits the ability to bend the big toe backward. This can occur if the foot is compressed inside a shoe that is too low profile and limits range of motion or a shoe with a vamp that is too long and does not allow proper roll through.
Ingrown toenails: Ingrown toenails may occur if the shoes are too narrow or tapered. As the nail grows, this edge digs into the soft tissue, becoming embedded and causing pain, redness, and swelling. Without proper treatment, the nail area can develop an infection. The nail fold may get irritated or penetrated if the shoes compress the toes too tightly. If the dancer requires a tapered or narrow shoe but still suffers from ingrown toenails, suggest cutting the nail straight across and not too short on the edges and use various gel, lambswool or other padding combinations to better cushion the big toe.
Though ingrown toenails may be genetic and unavoidable, there are solutions such as soaking feet in epsom salt and practicing good hygiene - this includes washing toe pads.
Metatarsals
The metatarsal bones, or metatarsus are a group of five long bones in the foot, attached to the toe bones (phalanges).
The width of the pointe shoe is determined by the widest part of the foot. Typically where the base of the toe meets the head of the metatarsals. These joints are called metatarsophalangeal joints or MTP joints. The shoes must be tight enough to stabilize and support the feet en pointe while wide enough not to over stress on these joints.
The shoe should fit snugly at the ball of the foot with all five toes flat in the shoe. If the dancer feels like they are sinking to the bottom of the shoe, the shoe is likely too wide and should be adjusted.
Compression
Another factor to keep in mind is how compressive the dancers’ foot is. How compressive their metatarsals are will determine how tightly the shoes should fit. To measure how compressive a foot is, the fitter must determine how much the foot “shrinks” in width and length when pointed. A compressive foot has a tendency to fold and fall inside the pointe shoe, possibly jamming and bruising the toe nails at the bottom of the platform when standing en pointe. Some are more prone than others to compressive feet.
In order to prevent this, the fitter must measure the difference between the foot when it is flat and when it is pointed. The bigger the difference, the more compressive the foot is, and the more compressive foot should be fitted tighter in a narrower or tapered box. For a compressive foot, the fit of width should be closer to the size when it is pointed than when it is flat on the floor, and should consider a lower profile shoe.
Some other ways to determine how compressive a foot is:
1. to squeeze the metatarsal when the dancer is standing on flat and checking to see how much and how easily it compresses and
2. to have the dancer relax and lift their foot off the ground to see how much it naturally “shrinks” when there is no pressure on the bottom of the foot.
Common problems arising from the wrong width
Morton's neuroma: pain in the ball of the foot, most commonly the area between your third and fourth toes.
Morton's neuroma may feel as if you are standing on a pebble. Tingling and numbness may follow. May be caused by shoes that are too narrow.
Sesamoiditis:
Pain at the base of the big toe.
It is caused by inflammation of the tendons attached to the 2 small sesamoid bones at the ball of your foot. May be caused by shoes that are too narrow.
Stress fracture: an incomplete fracture caused by repeated stress in the metatarsal bones. There are many other factors that could contribute to stress fractures, including nutrition, hard floors and low BMI, but could also be caused by wearing their shoes too narrow or too wide because of insufficient support. Stress fractures are most common at the base of the second metatarsal.
Bunions (See section on toes)
Blisters and Bruised toe nails: May be caused by friction from shoes that are too big.
Week 2 Assignment
Post a photo of your feet (or a friend's, colleague's, or any photo you found online) on the Week 2 Assignment page.
Describe the forefoot of the feet in the photo in detail including type, shape, width, compression and any genetic abnormalities or natural tendencies.
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