This study brings about a few points worth mentioning:
- folks in the Indian population have flatter feet
- the amount of great toe extension is important, especially as it relates to foot pain
- foot prints can tell you a lot about a foot
- foot exercise and footwear modifications achieved the best outcomes
Lets look at some of these points.
just how much great toe extension (or dorsiflexion as foot geeks like to say) is necessary? The great toe must extend 40 degrees to walk normally and most folks can dorsiflex 65 degrees. If this is impaired (something called “hallux limitus”) it can:
- shorten your stride length
- make you have difficulty with high gear push off
- will probably give you pain at the metatarsal phalangeal junction
foot prints can tell you a lot about a foot
Gee, we have been saying this for a few years now and have been advocating the use of a pedograph as well. In fact, we wrote the ONLY book about it’s interpretation, available by clicking here.
foot exercise and footwear modifications achieved the best outcomes
We have almost a thousand posts on this blog, and nearly 100 youtube videos, many of which talk about foot exercises, their indications and how to do them
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Flatfoot in Indian population.
Department of Orthopaedics, Moti Lal Nehru Medical College, Allahabad, India.
PURPOSE. To compare outcomes of different conservative treatments for flatfoot using the foot print index and valgus index. METHODS. 150 symptomatic flatfoot patients and 50 controls (without any flatfoot or lower limb deformity) aged older than 8 years were evaluated. The diagnosis was based on pain during walking a distance, the great toe extension test, the valgus index, the foot print index (FPI), as well as eversion/ inversion and dorsiflexion at the ankle. The patients were unequally randomised into 4 treatment groups: (1) foot exercises (n=60), (2) use of the Thomas crooked and elongated heel with or without arch support (n=45), (3) use of the Rose Schwartz insoles (n=18), and (4) foot exercises combined with both footwear modifications (n=27). RESULTS. Of the 150 symptomatic flatfoot patients, 96 had severe flatfoot (FPI, >75) and 54 had incipient flatfoot (FPI, 45-74). The great toe extension test was positive in all 50 controls and 144 patients, and negative in 6 patients (p=0.1734, one-tailed test), which yielded a sensitivity of 96% and a positive predictive value of 74%. Symptoms correlated with the FPI (Chi squared=9.7, p=0.0213). Combining foot exercises and foot wear modifications achieved best outcome in terms of pain relief, gait improvement, and decrease in the FPI and valgus index. CONCLUSION. The great toe extension test was the best screening tool. The FPI was a good tool for diagnosing and grading of flatfoot and evaluating treatment progress. Combining foot exercises and foot wear modifications achieved the best outcome.