Grishko’s pointe shoe is designed to alleviate pressure on the first metatarsal. Non-constrictive vamp. 3/4 shank is flexible, lightweight and quiet. Elastic not included, ribbons included. BEST FIT: Narrow to wide foot with slightly tapered toes. Size: 4-8 Adult. Width: X = N, XX = M, XXX = W, XXXX = WW. Shank: Soft, Medium, Hard. Imported.