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?

A: Forefoot valgus, L > R. The forefoot is everted with respect to the rear foot. Need to brush up? click here and here for a refresher

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. 

The Gait Guys. Foot Nerds to the max. Convincing you to join forces with us in spreading the word and gait literacy. LIke this post? tell others! Don’t like this post? Tell us!

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