Gait_2

Question 1

A physical therapist observes a patient’s foot with an inverted calcaneus in subtalar neutral that does not compensate during weight-bearing. What is the initial foot position?

Answer 1

Uncompensated Rearfoot Varum:

• Calcaneus remains inverted in subtalar neutral.
• No compensation occurs during weight-bearing.
• Increased lateral pressure on the foot.
• Overactive tib anterior, tibialis posterior, soleus overactive
• Weak peroneals
• Foot, especially first ray is plantar flexed/can’t get great toe to the ground
• Common symptoms: lateral ankle instability, shin splints, lateral knee pain.
• Treatment: Cushion orthotics, posterior chain mobilizations.

Question 2

A physical therapist observes a patient’s foot that demonstrates an excessively pronated forefoot position in subtalar neutral. During weight-bearing, the calcaneus everts, and the medial longitudinal arch flattens. What is the initial foot position?

Answer 2

Uncompensated Forefoot Valgus:

• Forefoot is everted relative to the rearfoot in subtalar neutral.
• No compensation occurs; the lateral forefoot does not adapt to the ground.
• Increased ground reaction forces on the lateral forefoot.
• Often leads to callus formation beneath the fifth metatarsal.
• Treatment: Orthotics to support the forefoot.

Double Check this…

Question 3

A physical therapist observes a patient’s foot with a rigid, inverted forefoot in subtalar neutral. During weight-bearing, the forefoot remains supinated and does not adapt to the ground. What is the initial foot position?

Answer 3

Uncompensated Forefoot Varus (Rigid) / ‘Paddlefoot’:

• Forefoot remains inverted in subtalar neutral, even during weight-bearing.
• Pronated in weight bearing but in Non-weight bearing they look supinated.
• No flexibility to adapt to ground surfaces.
• Causes increased pressure on the lateral border and first ray.
• Gait: Poor shock absorption, high arch, pressure under the second metatarsal head.
• Treatment: Supportive orthotics, mobilizations to improve flexibility if possible.

Question 4

A physical therapist observes a patient’s foot with an inverted calcaneus in subtalar neutral. During weight-bearing, the foot compensates with excessive pronation to bring the forefoot to the ground. What is the finished foot position?

Answer 4

Compensated Rearfoot Varus

Question 5

A physical therapist observes a patient’s foot with a valgus forefoot position in subtalar neutral. During weight-bearing, the forefoot compensates with increased supination to adapt to the ground. What is the finished foot position?

Answer 5

Compensated Forefoot Valgus

Question 6

A physical therapist observes a patient’s foot that demonstrates a flexible, pronated forefoot position in subtalar neutral. During weight-bearing, the foot compensates with increased pronation to bring the forefoot to the ground. What is the finished foot position?

Answer 6

Compensated Forefoot Varus (Flexible)

Question 7

A physical therapist observes a patient’s foot with a rigid, supinated forefoot position in subtalar neutral. During weight-bearing, the forefoot remains supinated and does not adapt to the ground. What is the finished foot position?

Answer 7

Rigid Uncompensated Forefoot Varus

Question 8

A physical therapist observes a patient’s foot that demonstrates a rigid forefoot position in valgus during subtalar neutral. During weight-bearing, the foot compensates with excessive pronation to bring the lateral border to the ground. What is the finished foot position?

Answer 8

Compensated Forefoot Valgus