Home > Blog > Physiotherapy > Conditions > Dancing Injuries > Knee Pain > En Pointe Care - Care And Support For En Pointe Dancers
En Pointe Care
Care And Support For En Pointe Dancers
Preserving And Transforming The Pointe Work Experience
Welcome to En Pointe Care, a specialist division of Phoenix Rehab, where we aim to help en pointe dancers protect their toes and feet, in order to prolong the en pointe passions that they have - for as long as they want to.
My name is Louise, and I am a licensed En Pointe Orthotics fitter and sole distributor for Singapore. By training and experience, I am also a senior physiotherapist in Phoenix Rehab, and mother to two children.
En Pointe Orthotics refers to a very specific customized silicone toe pouch, fitted and customized specifically for every level of ballet dancers who wish to embark on en pointe techniques, or who already practice en pointe.
EN POINTE ORTHOTICS
En Pointe Orthotics is an innovative, flexible, fully custom made silicone insert, worn inside the box of a pointe shoe.
The development of EPO was researched and refined through substantial trials and work with dancers, teachers and in consultation with industry professionals including Orthopaedic Foot and Ankle Surgeon Dr Aneel Nihal and physiotherapist Peter Georgilopoulos.
Dancers have described a feeling of better control, balance and comfort.
EN POINTE ORTHOTICS IS EXCLUSIVELY AVAILABLE
The crux focus of En Pointe Orthotics and En Pointe Care is to transform and preserve the longevity of a dancer's career biomechanically, anatomically and physiologically.
En Pointe Orthotics are only available through Accredited En Pointe Orthotic Fitters. Issues of fit, alignment and support are addressed in a highly customized and personalized approach.
INCREASED COMFORT, SUPPORT AND ALIGNMENT
Effective, consistent and reliable and without restricting movement, En Pointe Orthotics provides the necessary support, a more even weight distribution and alignment of the toes which may help diminish the risk of injury and prevent deformity.
The specially formulated EPO material is flexible enough to absorb energy yet firm enough to provide support and alignment without sacrificing the feel through the floor. Many dancers have commented on the fact that they can dance for longer periods en pointe without the pain in their feet and toes.
EN POINTE CARE ORTHOTICS FITTING
En Pointe Orthotics (EPO’s) are fitted by accredited En Pointe Orthotic fitters only.
The best time to have your EPO’s made are when you are ready for some new pointe shoes. This will ensure that the pointe shoes correctly suit your individual foot shape and to accommodate an En Pointe Orthotic. You will be able to have EPOs made into your current pointe shoes but please discuss this with your fitter prior to your fitting appointment.
A personalised En Pointe Orthotic consultation and fitting will take approximately 45-60 minutes. This is just an estimate as the complexity of the fitting will determine the appointment length. Your En Pointe Orthotics are available to take home immediately after your En Pointe Orthotic fitting. It is suggested that you leave the En Pointe Orthotics for 24 hours before dancing in them.
In Singapore, Louise (myself) am the only registered EPO Fitter, so if you live in Singapore, am passing through Singapore or want to have a fitting in Singapore, contact me (firstname.lastname@example.org) and we can arrange an appointment.
For more information:
- For addition information including cost and payment.
- To make an appointment for an EPO fitting
- To discuss if you are having the EPO’s made in your current pointe shoes or newpointe shoes.
If you have any other questions, they may be answered in the Frequently Asked Question (FAQ) are
EN POINTE CARE ORTHOTICS BENEFITS
Benefits Of Wearing En Pointe Orthotics
En Pointe Orthotics are a custom made EPO silicone insert that fits over the toes then inside the box of a pointe shoe providing unsurpassed support, alignment and comfort. The specially formulated EPO material is flexible enough to absorb energy yet firm enough to provide support and alignment whilst maximising balance, control and comfort.
In more detail, En Point Orthotics aligns the toes whilst en pointe and distributes the body’s weight more evenly across them.
“Pointe work is as rigorous as it is beautiful and the many small structures of the foot are simply not well matched anatomically to the punishing demands of dancing en pointe”
– The answer: En Pointe Orthotics.
Medical Endorsement Dr Aneel Nihal – Orthopaedic and Trauma Surgeon
MBBS ,FRCS (Glas), FRCS (Ed), FRCSEd (Tr & Ortho), FRACS (Ortho), CIME (ABIME)
EN POINTE CARE ORTHOTICS PRICE
- Individuals In-Clinic En Pointe Orthotics + Fitting SGD 350 per pair. Location: Phoenix Rehab Group @ Novena Medical Center
- Individuals On-Site En Pointe Orthotics + Fitting SGD 400 per pair
- Group On-Site En Pointe Orthotics + Fitting SGD 350 per pair (min 3 pairs)
For #2 and #3, we will go to you at the comfort of your home, workplace, or hotels (for those traveling through Singapore).
By appointment only. For appointments, please contact me email@example.com
EN POINTE CARE ORTHOTICS FREQUENTLY ASKED QUESTIONS (FAQ)
How long will my En Pointe Orthotics last?
The life span of En Pointe Orthotics differs and depends based on variables with each individual dancer.
En Pointe Orthotics are made from a highly durable EPO material. The degree/rate of wear and tear will depend on the hours of pointe work per week, the individual dancer’s technique and how the orthotics are cared for.
How much will a pair of En Pointe Orthotics cost?
The cost for a pair of En Pointe Orthotics is determined by the En Pointe Orthotic Fitter, taking into consideration the complexity of the fitting.
Here in En Pointe Care, the total fee per pair including fitting fee is SGD 399.
Where can I get a pair of En Pointe Orthotics?
We provide the customized fitting and En Pointe Orthotics in Singapore.
- you're in Singapore
- live in South East Asia and/or
- passing through Singapore
and want a pair, contact us and we can arrange an appointment.
Can I wear En Pointe Orthotics in my current pointe shoes?
There may not be enough room in your current pointe shoes.
We highly recommended that your En Pointe Orthotics are fitted in a new pair of pointe shoes to ensure the correct fit for your feet which will provide the best possible support.
How long does an En Pointe Orthotic fitting take?
A personalized En Pointe Orthotics consultation and fitting will take approximately 60 - 90 minutes.
This is just an estimate. The complexity of the fitting will determine the appointment length. Please contact us for more information.
When will my orthotics be ready to take home?
When the appointment is completed you will be able to take your personalized En Pointe Orthotics with you.
We do however suggest you wait 24 hours before dancing in them (this is to allowed 100% complete curing of the EPO material).
Can I wear my En Pointe Orthotics in any style of pointe shoe?
Your En Point Orthotics will be/have been moulded using a specific style of pointe shoe most suited to your foot and as such provide the perfect fit in that style only, however they may be transferable between pointe shoes that are of similar box and vamp shape.
Please note that the size and width of the pointe shoe must be fitted correctly to allow for maximum support and alignment from your En Pointe Orthotics.
Do I need to have to have En Pointe Orthotics made every time I go up a size in pointe shoes?
As long as your En Pointe Orthotics are fitting your toes comfortably you can transfer them to the next size up pointe shoe. You will need to take your En Pointe Orthotics to every pointe shoe fitting to ensure the correct fit of your next pointe shoes.
How do I care for my En Pointe Orthotics?
- Please keep your En Pointe Orthotics clean and dry when not in use.
- We recommend that you “air” your orthotics until they are dry.
- Please change the desiccant in your En Pointe Orthotics box regularly.
- Handle with care when positioning and removing your En Pointe Orthotics. Cleaning your EPOs are quick and easy with instructions on the inside base of your EPO box.
- EPOs can also be cleaned in your dishwasher. The EPO material used is an inert non-toxic material and as such does not cause any skin problems. We have had NO reports of any fungal or bacterial infections due to the wearing og EPOs. There is very little to no foot odour of used EPOs.
Can another dancer try on and wear my En Pointe Orthotics?
As everyone’s feet are different, your personalized En Pointe Orthotics should not be worn by another individual.
Your En Pointe Orthotics are custom made and designed to accommodate the shape and style of your foot only.
Do I need to wear additional accessories with my En Pointe Orthotics?
Your En Pointe Orthotics are expertly fitted to ensure maximum support, control and alignment, therefore additional accessories are not required and should not be required at all, unless you outgrow/wear out your EPO.
How long will it take me to get use to wearing my En Pointe Orthotics?
If you are new to pointe work, En Point Orthotics will maximise support and comfort immediately.
If you are an experienced ballet dancer it may take a few dance/wears until you are completely comfortable with the supportive feel.
When is the best time to be fitted for En Pointe Orthotics?
As a senior physio and an accreditted En Pointe Orthothics fitter, we believe that the best time to be fitted for your En Pointe Orthotics is NOW.
The reason for this is because pointe work will take a toll on your soft tissues of your toes, foot and ankle, and our job is to preserve your soft tissue so that you can dance and do en pointe without pain and for years, if not decades =)
Wearing En Pointe Orthotics from the beginning stages of your pointe work is preferred however, all dancers, whatever level, will benefit by maximising strength and control whilst limiting chances of impending injury or deformity.
Do the En Pointe Orthotics allow for natural movement?
En Pointe Orthotics are crafted from a flexible EPO material allowing the foot to freely roll up and through demi pointe. The En Pointe Orthotics material is flexible enough to absorb energy yet firm enough to provide support and alignment.
COMMON INJURIES AND PROBLEMS RELATED TO DANCING EN POINTE
Our feet and toes endure enormous amounts of stress and significant weight-bearing while dancing en pointe. As a result of this stress, there are certain foot conditions that may develop at any time. En Pointe Orthotics aims to prevent these foot problems rather than accepting them as part of a dancers life.
En pointe dancing is the culprit in many cases of bunions, hammertoes, sesamoiditis, bursitis, trigger toe, and stress fractures. (Reference :Dr. Kelsey Armstrong)
The rigors of pointe work are well known to contribute to a multitude of foot and toe problems which may include:
BUNIONS OR HALLUX VALGUS
Bunions (sometimes referred to as Hallux abducto valgus) are enlargements of the inner portion of the metatarsophalangeal (MTP) joint at the base of your big toe.
The foot bunion is the result of changes that occur in the framework of the bones at the front of your foot. Instead of pointing straight ahead, your big toe begins to lean into your second toe, throwing the bones out of alignment.
En Pointe Orthotics support the toes improving the alignment as well as protecting the bunion area from added pressure. A Partial En Pointe Orthotic can also be an alternative in this case and we can explore this.
Despite wearing shoes designed for this form of dance, dancing en pointe still may cause friction between the toes and the shoes themselves which can cause chaffing and blistering.
You may need wound care cleaning and management by our senior hand therapists to ensure
- wound heals well
- prevent wound-related infection
- prevent recurrence
With the perfect fit of the custom-made EPO, there are dancer’s claim that they no longer get blisters in their toes when wearing EPO’s.
CALLUSES AND CORNS
With the joy of pointe work usually comes the not-so-pleasant experience of having unsightly calluses. Ongoing rubbing and pressure on the toes may cause these calluses to form.
This may seem a protective measure for the rigors of pointe work however this may also lead to painful
- irritation under and around the calluses
- discomfort and
- sometimes pain
It has been suggested to maintain the calluses before you get to the pain.
En Pointe Orthotics philosophy is in prevention, so no need to “Maintain before Pain”
Phoenix Rehab will help address any dance-related injuries and pains
FUNGAL AND BACTERIAL INFECTIONS
We have not had any reports of either fungal or bacterial infections of the toes in dancers wearing EPO’s despite it being a common occurrence among dancers.
The En Pointe Orthothics material does not harbor bacteria and can be easily washed.
However, we recommend en pointe dancers (and all dancers) to have good foot hygience (wash, have at least 2 well-used pairs to swap around whenever dancers air / rest their orthotics etc)
Hammer refers to a toe that bends in the middle and curls downward.
It can and will make dancing en pointe painful (even walking and turning and moving about can be affected).
En Pointe Orthotics will help to align and support the toes, preventing or improving pre-existing hammertoes. Patients may benefit also from a counter-acting customized toe splint to straighten the affected toes, normalizing toe tendon length and movements.
Clients that claim to have suffered from stress fractures due to pointe work have said that they no longer suffered these fractures since wearing en pointe orthotics.
(Most likely, the reason for this is because EPO orthotics helps to even and spread out the force applications during dance moves and especially with en pointe techniques)
Trigger toe is an injury that most commonly affects ballet dancers, due to the physical demands of dancing en pointe (its brother-related condition is trigger fingers, which our senior hand therapists commonly treat)
Trigger toe symptoms are usually mild at first with only mild discomfort however progressively and eventually the dancer may find it difficult or impossible to dance en pointe, and will experience especially sharp pain when lowering the foot from the pointe position to a flat position.
If trigger toe is not diagnosed and treated properly (and in some cases even if it is), it can mean the end of a dancer’s career.
As the condition is rare ongoing research into the benefits of En Pointe Orthotics are continuing.
TOE NAIL DAMAGE
If you are a ballet dancer en pointe, issues involving the toes are probably nothing new. Considering that your entire body weight is balanced on your toes while dancing, it’s no wonder that your feet and toes look like they’ve taken a beating.
Dancing on your toes day after day puts tremendous stress on them, and that stress is sometimes evident by the appearance of the toenails. Because of the pressure placed on the toenails while en pointe, some dancers develop bruising of the nails.
Bruised toenails can cause intense pain (not to mention an unsightly appearance) for dancers. When the bruising is caused by dancing en pointe, it is usually the result of repeated pressure to your nail. Pressure strong enough to cause bleeding.
Tiny blood clots form under the nail, causing pain to the dancer as the toenail is lifted away from the nail bed. In extreme cases, a portion or the whole nail can eventually be lost.
If your feet are weak, you may also be compensating by knuckling your toes which also causes too much pressure on your nails. You may benefit from dance physiotherapy.
En Pointe Orthotics are made to fit like a glove to the exact contours of your toes, down to your toe prints, grooves and crevices. This precision custom pointe pouch has been shown to eliminate any damage to toe nails in all reports from dancers in EPO’s when worn correctly and nails kept trimmed.
In all trials and client feedback, clients have reported that they have not sustained any occurrences of bruising, fungal infection, ingrown, or loss of toenails since wearing EPO’s
- BSc (Hons) Physiotherapy (Queen Margaret University, Scotland) 2006
- Allied Health Professions Council (AHPC Singapore)
- Craniosacral therapy
- Scar management
Louise returned to Singapore in 2006 after studying in Scotland, and has worked in an array of rehab settings in Singapore, from public hospitals (Changi General Hospital, Tan Tock Seng Hospital, National Heart Center), Ministry of Defence, nursing homes, private hospital Mount Elizabeth Orchard, before settling to private practice and specializing in musculoskeletal physiotherapy and spinal physiotherapy.
During her free time, she enjoys:
- spending time with her kids and husband
- participating in baby wrapping/carrying
- reading up on more physiotherapy skills and technique upgrades
Back to Top
Phoenix Rehab physio Services
Phoenix Rehab Group works with specialist
physiotherapists and rehab therapists who are highly
trained, qualified, experienced and passionate to provide high level of
expert care to our patients.
PHYSIOTHERAPY & PHYSICAL THERAPY
HAND THERAPY & SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, and requires Hand Therapy to increase the function of their hand
following injuries or post-operations as well as custom made hand splints.
Commonly treated hand pain injuries includes
CLINICAL PILATES & WELLNESS PILATES
Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.
It is a system of safe and effective exercises, which
meet specific individual needs, to treat a wide range of injuries
You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.
TRADITIONAL CHINESE MEDICINE (TCM)
DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY
Sports and deep tissue release massage helps to increase nutrient-rich blood
flow to tired, tight and tense muscles to
- accelerate recovery and
- shorten downtime / recovery period required
It also prevents
muscles from scar tissue micro-tears (and potential ruptures), and increases muscle
Done regularly, it will keeps your muscles healthy and fit with body/movement-confidence. Read the benefits of regular deep tissue release therapy here.
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
do Tell Your Family, Friends And Colleagues About Us =)
We appreciate you as our valued clients and want you to know that the #1 way we grow as a clinic/brand is through word of mouth referrals from valued patients like yourself.
We do not rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients. When you have the chance, please tell your family, friends and physicians about the positive results and experience you have had in our physio clinics.