En pointe is widely considered to be a technically challenging skill. Typically, children between the ages of 9 to 12 begin en pointe training, developing the muscles and stamina they will need to perform without risking injury. Although young ballerinas will be dancing en pointe at this stage, they will not yet be capable of performing larger works that require more hardy physical endurance. For the beginning dancer, attempting en pointe dancing greatly increases the risk of accidents or bodily damage.
To successfully dance en pointe, body alignment, musculature and discipline must all be developed. Because of this, many dancers spend years preparing for en pointe dancing and several subsequent years developing their skills. As the entire body is balanced on the toes, dancers must work diligently to develop their coordination and physicality so that they can successfully maintain their en pointe positioning without leaning or wobbling. Novice ballerinas and those beginning their en pointe training spend a large portion of their training using the barre. By bracing themselves against the barre, dancers are able to focus their attention on developing proper form.
Dancing en pointe is notoriously painful. The alignment of the foot and ankle creates an extraordinary amount of pressure and force that is ultimately applied directly to the toes. Because of this, dancers must not only develop their physical technique but also strive to increase their pain threshold.
Performing en pointe requires a daily ritual of shoe preparation, stretching, physical warm-ups and psychological fortification. The awareness of imminent pain can be disheartening to some. En pointe dancers must possess a stoic mental strength to practice and refine their abilities.