How Is Turnout In Ballet Achieved, Anatomically?

June 8, 2021

Transcript below of: How is turnout in ballet achieved, anatomically?

Hey everybody! Welcome to this month’s question of the month. Here I am, David Keil, ready to answer your yoga anatomy questions. If you want to submit a question yourself, go to This month’s question comes from Ivana and it’s about turnout in ballet.

The Question:

“Hi David,
I am really enjoying your Comprehensive Anatomy Course. [DK Note: That’s a course on the website that you can actually go buy and do the course.] I have a question regarding external rotation of the knee. In one of the lesson videos, you mention that the bent knee will induce an external/internal rotation of the tibia, whereas a straight leg will permit rotation from the hip. As in ballet, the turnout of the feet needs to happen with a straight knee. The rotation needs to happen both at the hip and tibia. I am wondering what is the mechanism for this to happen (apart from genetic predisposition)? Also, how damaging would a turnout in ballet be, long-term?
Best regards from Chile,

The Answer:

Well Ivana, let me clarify. Let me go back to your question. This could just be phrasing from Spanish to English. But, what you wrote was that the bent knee will induce an internal or external rotation. So, inducing means that it’s going to create it, basically. When you bend the knee 10 degrees approximately, or more, it then has the opportunity — it doesn’t mean it will — but it has the opportunity to externally rotate the tibia relative to the femur or internally rotate the tibia relative to the femur. Okay, I just wanted to clarify that. It’s free to rotate once you bend it 10 degrees, but it doesn’t mean that it will. There is another way to say the second part. When the knee is straight, then internal and external rotation if you were looking at a foot — let’s say in the turnout in ballet — is coming from the hip joint.

Where does turnout come from, anatomically?

I’m not a ballerina, if you couldn’t tell already. I’ve never taught ballet. I’ve certainly taught multiple dancers. What I would say is that I’m not 100% sure. You’re saying it and you’re a ballet dancer. I do have somebody that I could consult on this and I probably should have. It’s not that you want your turnout in ballet to come from your tibia, right, and your knee joint. But, of course some of it will go through the knee. You’ll put a natural torsion there.

So when you talked about genetic disposition, you know, our anatomy can be changed to a degree. If you started dancing when you were four years old, or five years old, or six years old, when your bones were still forming, and you put yourself into that turnout position in ballet, you were creating a spiral force through your leg. The majority of that is coming from your hips. But, because of the nature of your foot being planted and the tibia, you’re going to create some external rotation. But I dare say, it might not be at the knee joint. It might be that you create a twist in the tibia itself, if you’re starting from a young age. Okay? That’s if.

How much of that happens, I don’t know. I haven’t done research. I haven’t looked at numbers on that. But that’s the only other way that it’s really going to happen, anatomically speaking. It’s not coming from the knee joint when it’s straight. Okay, that’s my understanding. Maybe you can email me again and I can check in with a couple of friends who have been in the ballet world forever. They might inform me a little bit better.

Effects of turnout in ballet over the long-term

Alright, the last part of your question is also important though. That is, how damaging would a turnout in ballet be long-term? It depends on how much of it is coming from the tibia/knee area versus the hip joint. If more of it is coming from the hip joint, I would worry about it less. You know, if you’ve been doing it forever, then your body has come to accommodate how it is put together and how it formed, let’s say in those early years as a young dancer. So, turnout in ballet might not be a problem, long-term. I don’t predict the future.

But I can predict this, I will answer another question on YouTube. So, if you go to, submit a question and I’ll answer it on video.