Pressure analysis of the ballet foot while en pointe

Pointe dancing (dancing on the extreme ends of the toes with the aid of a toe shoe) as performed by the advanced female ballet dancer, causes unnatural loading of the foot. This leads to many acute and chronic conditions such as blisters, bunions, bruised toenails, tendinitis and degenerative joint disease. To determine the effectiveness of the current shoe, the authors measured the normal pressure distribution on the foot en pointe. Sampling the entire forefoot in the toebox of a pointe shoe showed that pressures are localized at the bony prominences and at the ends of the toes. About 5% of total force is found at the heel and ball of the foot. The pressures on the forefoot range from 0 to 500 kPa and account for about 80% of the total axial force, the remaining 15% being supported by shear forces on the skin. Lubricating the foot and shoe causes peak pressures to increase by as much as 43% and causes difficulty because the foot slips about in the shoe. Further study may result in a shoe design that distributes pressure more evenly over the entire foot, eliminating peak pressures and thus reducing injury.