Pointe work often brings blisters and calluses—par for the course for most ballet dancers. Raina Gilliland, 20, can attest to the challenges. The Minnesota Dance Theatre company member started pointe class when she was 8. Problems she's already had include ingrown nails and a bunion. However, Gilliland admits some of her injuries could have been prevented if she had taken better care of her feet.
Dancers, pointe shoe fitters, and podiatrists all agree that finding pointe shoes that truly fit—and continuing to adjust that fit throughout your career—reduces the chances for injury. “Dancers think they get to a certain age and they stop growing," says Jane Denton, a Bay Area podiatrist who works with San Francisco Ballet dancers. “But their feet get longer and wider with use over time."
Marika Molnar, director of Westside Dance Physical Therapy in Manhattan and director of physical therapy at New York City Ballet, recommends that dancers get refitted for pointe shoes every six months to a year. “You could be a 7.5 when you're 20, but when you're 25, you could be an 8 or a 7.5EE," she says.
Padding can help. Gilliland uses paper towels—“whatever's in the bathroom"—and a toe spacer to help cushion her bunion. She's seen many other kinds of padding used, including blue masking tape, which is waterproof and doesn't slip. “But using lots of padding makes it not only harder to get into the shoe, but can change the shoe's shape, or even contribute to its breaking in the wrong way," Gilliland says. “Try to keep it simple, so you don't mess with the shape of the shoe."
Once you do find the right box, shank, vamp, width, and padding, you may still have to deal with minor foot problems. Here's how to prevent and treat a few of the most common:
Blisters If you dance on pointe awhile, you build up calluses, so blisters usually aren't as common. “On rare occasions if I get one," says Gilliland, “I let it dry overnight, and maybe put on a little Neosporin + Pain Relief. Then I do what I can to avoid irritating it." If she has to wear her pointe shoes the next day, she'll rub more ointment on and cover it with her paper towel padding. Thin gel sleeves often can help to prevent irritation, but if there is chronic blistering, “you need to see if it's the shoe that is causing it," Denton says.
Corns Corns occur when pressure causes your skin to thicken into a deep, cone-shaped mass, pointing down inside the skin between toes. For a hard corn, pumice it gently so it doesn't get too large, and wear lamb's wool between the toes when in pointe shoes, Molnar advises. However, if you develop a soft corn, go see a podiatrist. “Dancers should not try not to gouge it out themselves," Molnar says. “I've seen too many nasty consequences."
Bruised Nails/Missing Nails If a bruised nail looks like it may be close to falling off, try to keep it attached as long as possible. If the nail is very loose on one side, bandage it. It helps to protect the nail bed from the pressure of the pointe shoe, Denton says. Molnar suggests that dancers also ice the toe as needed, or use Anbesol (an oral pain relief product) because it numbs the skin.
If the skin under the nail seems raw, keep it covered with a layer of antibacterial cream and bandage it, especially while dancing, to prevent infection. And if the nail falls off and you still have to dance, Denton suggests slipping on a gel toe sleeve for cushioning and protection.
Bunions Bunions, while hereditary, can be exacerbated if a dancer overdoes her turnout, rolling forward into the front edge of the big toe, causing joint deformity. A foam toe spacer helps keep the toes properly aligned and counteracts the pressure inside the pointe shoe. Denton recommends Voltaren gel, an anti-inflammatory available by prescription.
Gilliland has her own version of a foam spacer: She takes a makeup wedge, cuts it down to fit, and replaces it every couple of days. “It absorbs the sweat," she says, “and they're cheaper to buy in bulk."