It takes considerable strength in the feet, ankle, leg, knee, and abdomen to dance en pointe. Students must be at least 11 or 12 years of age before attempting pointe work. The bones and growth plates in the feet are usually not fully hardened and developed before that age. Serious foot deformities can result from starting pointe too early, even if the student is strong and skillful. Attempting to dance en pointe before the feet and toes are fully grown can cause career-ending damage that will prevent dancing en pointe for a lifetime. Top ballet schools have specialist orthopaedic consultants, and foot X-rays are an obvious and necessary safeguard before pointe work begins.