Editing Pointe technique (section)

==Health risks and injury prevention==
Dancing en pointe stresses the feet in various ways and thus can potentially cause injuries if the dancer does not plan ahead or take into account health and safety concerns. Injuries can result from improper technique, poorly fitting pointe shoes, and lack of effective cushioning and accessories.<ref name="Understanding Pointe" /> Some types of injuries are prevented by adhering to proper technique such as: correct upper-body positioning, maintaining straight knees when required, keeping body weight centered over the box of the shoes, and avoiding [[Glossary of ballet#Sickle|sickling]]. Problems dealing with technique can be easily fixed by proper training and one-on-one interactions with the dance instructor to improve the dancer's technique.<ref name="Understanding Pointe" />

Injuries due to toe misalignment are often avoided by adjusting toe alignments with [[Pointe shoe#Accessories|gel toe spacers]]. Toenail [[bruise|bruising]] can be caused by heavy pressure on the surface of the nail. This is typically prevented by keeping toenails clipped short, by wrapping tape around the toes, by using padding, or combinations of these.<ref name="Understanding Pointe" /><ref name="protecting toes" /> Bruising can also occur on the tips of the toes, especially when no padding is used. It is highly unadvised to dance en pointe without padding.<ref name="Understanding Pointe" /><ref name="protecting toes" />

Pointe work can cause friction between toes and the interior of the pointe shoe's box. This friction, under the high pressure of much of the dancer's body weight, can result in chafing and [[blister]]ing. This is often mitigated with [[lambswool]] or [[Pointe shoe#Accessories|toe pads]] or by wrapping tape around toes or use gel pads that can conform to any one problem area.<ref name="protecting toes">{{cite web |last1=Warnecke |first1=Lauren |title=Protecting Your Toesies For Pointe |url=http://www.danceadvantage.net/pointe-padding/ |website=Dance Advantage |date=5 January 2012 |publisher=Wordpress |access-date=11 April 2016}}</ref> Choosing between cloth and gel, gel, only cloth, wool, etc. for toe pads is a personal preference for each dancer, but each style has its own benefits.<ref name="Understanding Pointe" /><ref name="toe pads">{{cite web |title=Toe Pads |url=http://dancewearcorner.com/collections/toe-pads |website=Dance Wear Corner |publisher=The Dancewear Corner Inc. |access-date=11 April 2016}}</ref>

Other exterior injuries include [[Wounds|cuts]] caused by toenails piercing adjacent toes. This can be prevented by keeping toe nails cut short and filed smooth. Also, [[callus]]es may form on the bottoms and sides of the feet, which can crack open. This can be helped by the use of gel pad protectors on specific problem spots or using pads to surround the toes.<ref name="protecting toes" /> [[Ingrown nail]]s can result from ill-fitting shoes.

Ultimately, dancing on the tips of the toes is unnatural, painful and potentially harmful. Every other activity of the human foot, walking, running, jumping, has been part of its evolutionary journey from arboreal to bipedal locomotion<ref>McNutt EJ, Zipfel B, DeSilva JM. The evolution of the human foot. Evol Anthropol. 2018;1–21. https://doi.org/10.1002/evan.21713</ref> - dancing en pointe has not. Further, pointe shoes are symmetrical, there are no lefts and rights. The toes have to flex inwards to conform to the tapered shape of the toe box. Pressure of the body weight on the toes in this misaligned position may, with other factors, contribute to the development of bunions.

'''Other common injuries:'''
* Deformities such as [[bunion]]s, [[bunionette]]s, and [[hammer toe]]s
* Inflammations such as [[bursitis]] and [[sesamoiditis]]
* [[Plantar fasciitis|Dancer's heel]] (Plantar fasciitis), a tightening of the instep tendon that causes discomfort in the instep and heel
* [[Sprain]]ed [[ankle]]s
* [[Stress fracture]]s
* [[Achilles tendinitis]] and [[extensor]] tendinitis