Weakness in the intrinsic foot muscles and overuse of the extrinsics will also result in the toes ‘clawing’ both when rising, and en pointe. This is the biggest cause behind the nasty blisters that are often seen in photos of professional ballet dancers, however this does not have to be the case. Control of the intrinsic allows the middle joint of the toes to remain straight while fully pointing the rest of the foot. This does not affect the look of the line of the foot, but does make dancing much more enjoyable when free of pain!
In many other sports, orthotic devices may be worn in the footwear required that will help stabilize the arch and settle symptoms related to poor intrinsic muscle strength. Unfortunately, in ballet slippers, these orthotics cannot be worn (although many have attempted this!) so the dancer is often left to ‘live with’ symptoms, or have repeated extended breaks from dancing.
Watch the following video to see Lisa's perspective on whether dancers should or shouldn't wear orthotics.