Foot Orthotics Lab

Question 1

Orthotic Evaluation - Standing

Answer 1

• Landmarks
• Foot/toes/arch height
• FPI 6
• Gait analysis

Question 2

How to evaluate femoral torsion

Answer 2

1. Palpate greater trochanter while medially/laterally rotating femur
2. Locate neutral hip position (GT most prominent laterally)
3. Maintain position and assess distance of med/lat femoral condyles from table (should be equal distance)

Question 3

An alternative for evaluating femoral torsion

Answer 3

Craig’s Test (Prone)

Question 4

How to evaluate tibial torsion

Answer 4

1. Assume position of femur so that med/lateral condyles are parallel with table
2. Have patient maintain the position while the PT envisions a line intersecting the med/lateral malleoli
3. Measure angle between femoral condyles (parallel to table top) and Malleolar line

Question 5

Normal Tibial Torsion

Answer 5

18-25 degrees

Question 6

Evaluating 1st Ray Position

Answer 6

1. Compare relaxed position of 1st MT head relative to the 2nd
2. If PF’d, assess 1st MT mobility

Question 7

1st MTP Extension

Answer 7

a. Place ankle in neutral PF/DF
b. Normal: 0-60°

Question 8

Oblique Mid-tarsal Axis Integrity

Answer 8

a. Stabilize calcaneus at end-range inversion/supination
b. Grasp 4th & 5th MT heads
c. Attempt to push 4-5 MT heads superiorly (DF)
d. Should get resistance early in range (min motion)

Question 9

Longitudinal Midtarsal Axis Integrity

Answer 9

a. Stabilize calcaneus at end-range inversion/supination
b. Grasp all MT heads
c. Attempt twisting motion, turning MT heads as a unit
d. Should have equal motion in both directions

Question 10

Foot Inspection

Answer 10

a. Callus
b. Corns
c. Lesions

Question 11

Subtalar Joint Neutral

Answer 11

1. Place pillow under contralateral hip or have patient assume a figure-4 position. (Puts femur in neutral position)
2. Bisect the calf (use boney midline)
3. Bisect the calcaneus vertically
4. PT’s medial hand palpates the head of the talus anteriorly; lateral hand grasps the 4th and 5th MT heads.
5. Slowly abduct/adduct in transverse plane.
   (a) With adduction, lateral talus becomes prominent
   (b) With abduction, medial talus become prominent
6. STJN is the point where the talar head is equally prominent medially and laterally
7. Measure RF position: Calcaneus/Calf
8. Measure FF position: Calcaneus/Line through MT heads

Question 12

Subtalar PROM

Answer 12

• Inversion
• Eversion

Question 13

Subtalar Joint Neutral in Standing

Answer 13

Palpate anteromedial/lateral head of the talus while patient raises/lowers arch (keeping toes on the ground). Find neutral position of the joint and have patient hold that position.

Question 14

Measuring Subtalar Joint Neutral in Standing

Answer 14

1. Height of Navicular Tubercle
2. Calcaneal and Tibial Varus/Valgus
3. First Toe Extension
   a. Should get 40-60° MTP extension
   b. Should see windlass mechanism

Question 15

Measuring Resting Standing Foot Position (pt relaxes)

Answer 15

1. Height of Navicular Tubercle
2. Calcaneal and Tibial Varus/Valgus
3. First Toe Extension

Question 16

Navicular Drop

Answer 16

Height in STJN - Height in RSFP
1. Average navicular Drop: 7-10 mm