The front of the ankle is as common an area for dancers to get injuries as the back of the ankle is where dancers most often get pain. For this reason their pain may be overlooked as disregarded but it can actually be a good indicator of some technical problems. When trying to diagnose the causes of pain at the front of the ankle we need to look at the structures that may be contributing to the pain. The structures at the front of the ankle include mostly tendons and ligaments so this rules out a lot of muscular issues and possible fractures.
Often young dancers have not been using their full pointe range when working on demi-pointe and when they start into their pointe shoes, these ligaments can be stretched as the foot is pushed into its end range, without the strength to control this range. Not being able to work to full range indicates that there is insufficient strength in the lower leg and the ankle of the dancer and needs to be addressed through careful conditioning exercises.
Flexible arches are prone to instability so not only does the dancer have to work on achieving full range and the stamina of the muscles to stay en pointe but also on the stabilising muscles around the side of the ankle to maintain a good alignment. This does include strengthening work but also proprioceptive work so that the dancer can instantaneously recognise when the ankle is misaligned and can correct the line. Poor alignment through the ankle, like sickling, can also place extra stress of the ligaments on the outside ligaments at the front of the ankle. More information on how to improve the dancer's stability and proprioception can be found in The Perfect Pointe Book.
Both these factors may be contributing factors to the development of pain through the front of the ankle. Assessing whether the dancer has insufficient range or strength can be done through our Seated Pointe Rise video as below. Next is our video Bent knee calf rises which assess whether the student is able to hold their ankle at full range or if the muscles required to maintain full range also have insufficient strength.