What foot type do we have here?
OK, so this gentlemen comes in with knee pain, L > R and an interesting “jog” in his gait from midstance to toe off (ie, the 2nd half of his gait cycle).
A few questions for you:
Q: What foot type does he have?
Q: What is the next question you should be asking?
A: Is it a rigid deformity (ie the 1st ray is “stuck” in plantar flexion or flexible (ie, the 1st ray can move into dorsiflexion. Hint: look for a callus under the base of the big toe in a rigid deformity
Q: Which is the best type of shoe for this person? Motion control, guidance or neutral?
A: most likely, neutral. A motion control shoe will usually keep the foot in more relative inversion, and that may be a bad thing for this person. Mobility is key, so a flexible shoe would probably be best.
Q: Would a conventional or zero drop shoe be appropriate?
A: A conventional shoe, with a higher ramp delta, will most likely accentuate the deformity (especially if it is a rigid deformity). This is for at least 2 reasons: 1. plantar flexion is part of supination (due to the higher heel; remember plantar flexion, inversion and adduction) and this will make the foot more rigid. 2. The medial side of the foot will be hitting the ground 1st; if the 1st ray is in plantar flexion, this will be accentuated.
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