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Ballet is all about strong, graceful lines. Sickled feet are an artistic error — an incorrect way to hold the foot, and they’re a health risk, too. Sickling makes dancers more vulnerable to foot and ankle injuries.

Read on to discover what sickled feet look like, how to avoid them, and what you can do about this habit.

Sickled feet are not a health condition. Sickling is a behavior — a foot position that can lead to ankle instability, tendonitis, and injury.

When a dancer’s foot is sickled, the toes curve inward, and the heel drops back. This position distorts the continuous visual line running straight down the dancer’s shin and through the foot.

Dance historian Cyril Beaumont described the correct foot position in his masterwork “The Cecchetti Method of Classical Ballet: Theory and Technique.”

Beaumont said the dancer’s foot should be “extended as much as possible, with the instep forced well outward, and the pointe forced well downward.” It is a “serious error” when the dancer “forces the foot inward instead of outward” so that “the point is forward and the heel is backward.”

Some dance teachers expand on Cecchetti’s classic definition. Sarah Arnold, a ballet teacher with 30 years’ experience in the world of dance, explains that feet can sickle either inward or outward.

“Sickling the foot inward is more common,” she says. “When I’m talking to younger dancers, I call it ‘banana foot.’”

Sickling can happen in almost any dance movement or position: relevé, retiré, élevé, glissade, jeté — you name it. Any time a dancer points their foot on the barre, in the air, or on the ground, it can be sickled inward or outward.

Arnold created the #EndSickledFeet YouTube series to help educate dancers about the problem. She says turning out the foot correctly doesn’t start with knees or ankles. Correct foot position begins in the backside.

“The pelvis is responsible for turnout,” she points out. “When a dancer does not have enough strength to maintain turnout from the hip, or when a dance teacher demands an overly beveled foot, then you can create muscle memory in a position that leads to injury. Instead, turn out from the hip and present the heel forward.”

The medical term for a sickle with toes in is supination. Dr. Jason Bariteau, assistant professor of orthopaedics at Emory University School of Medicine, explains that in a supinated position, the peroneal tendons located on the outer ankle are stretched, which can lead to pain, weakness, and injury.

Bariteau, who has worked with physical therapists and dancers in the Atlanta Ballet, says some dancers may naturally tend to sickle their feet.

“This is one of those chicken and egg situations,” he says. “Sometimes chronic ankle instability leads to sickling, and sometimes sickling leads to peroneal tendons that are stretched and not as strong. Then you get that chronic ankle instability.”

“It all comes down to training,” Arnold says. Training builds strength, deepens a dancer’s understanding of technique, and develops an awareness of the body. Dance training is especially important to understanding and preventing sickled feet.

Proprioception

Newer dancers may not have a developed awareness of how their feet are oriented or positioned — a skill called proprioception. Without this keen awareness, dancers may not yet feel when they are executing a movement incorrectly.

With proper training, dancers can sharpen their ability to sense when their limbs are not positioned properly. Research has shown that professional ballet dancers have a well-developed awareness of the position of their ankle, knee, and hip joints that allows them to move efficiently.

Strength

Sickling can happen when a dancer isn’t yet strong enough to hold the foot in the correct position consistently.

With time and training, a dancer can build strong glute, leg, ankle, and foot muscles so that sickling is less of a problem. In studies, professional dancers who spent years developing strength and skill sickled their feet much less often during jumps than athletes who had little or no dance training.

Endurance

Studies show that when dancers are fatigued—by repetitive jumps, for example—it’s more likely that the biomechanics of the ankle will change in ways that could lead to injuries.

To build endurance and prevent lower-body injuries, dancers should also focus on developing their core stability, research shows.

While some dancers have stiff feet or feet that tend to sickle naturally, early intervention and proper training can make a big difference. Here’s what the experts recommend.

Work with a physical therapist

When a coach, ballet teacher, or parent notices that a dancer’s feet are sickling, Bariteau recommends finding a physical therapist who has experience treating dancers.

“For young dancers, a physical therapist who works with dancers will pick up on subtle findings, identify the problem early, and help correct habits,” he says. “That early intervention can help prevent stress on the ankle, which is critical to preventing pathology.”

The value of dance-informed therapy

Studies show that when ballet dancers have access to healthcare providers who understand the demands of dance, injury rates decline sharply — but up to 80 percent of university dancers have reported that their healthcare providers didn’t understand dancers at all. When faced with a dance-related injury, many advised dancers to “just stop dancing.”

Get personal instruction

Arnold echoes the need for one-on-one intervention. “If you’re constantly getting the same correction in class or being injured in the same way, you need personalized instruction from a ballet teacher or physical therapist,” she says.

Although individual ballet lessons can be costly, one or two individual lessons may be enough to highlight the problem and learn exercises to correct it.

To develop proprioception, Arnold recommends the following to dancers:

  1. Sit on the floor with legs extended in front.
  2. Close your eyes, flex your feet, and then slowly point the toes.
  3. While the toes are still pointed, open your eyes and notice how the feet are pointing.

Many times, dancers are sickling or turning out from the ankles. Repeating the exercise can help dancers become aware of what the correct position feels like.

Use care with social media

One further word of warning: Watch out for trends on social media.

“In social media, there is an aspiration to do the extreme,” Arnold cautions. “That’s not a good thing.” When dancers aim to copy extreme moves and positions — such as the recent trend called “oversplits,” — injuries can happen.

“Copying is not training,” says Arnold. “You can’t learn that way.”

Sickling is a ballet term that means a dancer is curving the foot in a direction that is not favored artistically and can be potentially damaging to the foot and ankle.

Sickling can lead to weakness in ankle tendons and chronic ankle instability, making them more vulnerable to injuries like tendonitis, sprains, and fractures.

To correct sickling, dancers need to develop both physical strength and more advanced awareness of how they move. Training with the right dance teacher or working with a physical therapist who specializes in treating dancers may be necessary to correct sickled feet before they cause injury.

If you’re a dancer devoted to the beauty of ballet’s lines, caring for your body is key — and that includes keeping your feet strong.