PAC Workbook 2 Chart 1

Question 1

What are some potential compensations we may see with a forefoot varus?

Answer 1

NWB: Limited DF, MF eversion, increased abduction, PF 1st ray, hallux issues
Gait: Central/low HS, prolonged or excessive pronation, excessive tibial/femoral rotation due to pronation, early heel lift, abductory twist, medial toe off

Question 2

What are some potential compensations for a rigid forefoot valgus?

Answer 2

NWB: MF inversion limited, hallux limitations, dropped T arch
Gait: Excessive lateral HS, supination/varus moment, tibial ext rotation, early heel lift, low gear TO

Question 3

What are some potential compensations for a flexible forefoot valgus?

Answer 3

NWB: limited inversion, hallux limitations
WB: more pressure medially than laterally
Gait: no specific compensations

Question 4

What would the difference be in terms of treatment between a flexible and a rigid forefoot valgus?

Answer 4

With a flexible FF valgus, we aren’t adding any posting unless we are sure the GRF are causing problems. The main component would be simply introducing arch support. Rigid FF valgus can be controlled with lateral posting, MT support, controlling supination

Question 5

What are some potential compensations for a rigid PF first ray?

Answer 5

NWB: 1stR limited in DF, hallux limitations, dropped T arch, hammer toes
WB: RF varus, genu/tibial varum
Gait: Excessive lateral HS, supination, tibial ext rotation, early heel lift, low gear toe off

Question 6

What are some conditions that could be caused by a PF first ray?

Answer 6

Plantar fasciitis, metatarsalgia, sesamoiditis, 1st MPTJ OA, corns/callusing

Question 7

What are some possible compensations that could come from a dorsiflexed first ray?

Answer 7

NWB: Limited RF inversion, MF inv>ev
WB: RF valg, pes planus, genu valgum
Gait: Central/low HS, excessive/prolonged pronation

Question 8

What are some compensations due to a hypermobile first ray?

Answer 8

NWB: 1st ray DF/PF excessively, FHL
WB: RF valg, abducted, pes planus
Gait: Central/low HS, excessive or prolonged pronation and tibial internal rotation, lack of supination, medial TO, abducted during swing

Question 9

What could we see when someone has a rearfoot varus?

Answer 9

NWB: lack of RF eversion, FF valg, PF first ray, FF equinus, limited MF ROM, limited ankle DF, dropped T arch,
Gait: excessive lateral HS, excessive varus moment, tibial ext rotation, low gear toe off

Question 10

What are some conditions we may see with someone with a rearfoot varus?

Answer 10

Peroneal tendonitis, PF, inversion sprains, PFPS, medial knee OA

Question 11

What are some compensations for a RF valgus?

Answer 11

NWB: lack of RF inversion, FF varus, hypermobile 1st ray, limited MF eversion/ankle DF
WB: pes planus, genu valgum
Gait: central/medial/low HS, excessive or prolonged pronation, tibial internal rotation, medial TO, swing abducted/pronated

Question 12

What might we see during assessment for someone with a pes equinus foot?

Answer 12

NWB: limited ankle DF, possible RF limitations dropped T arch
WB: genu recurvatum
Gait: toe to heel contact, excessive knee extension or supination, early heel lift, abductory twist

Question 13

What could we see when assessing a hallux rigidus?

Answer 13

NWB: <10 deg DF of the hallux, enlarged 1st MTPJ, limited first ray ROM, callusing of first MTPJ, pinch callus on 2-3 MT heads
Gait: medial TO, low gear toe off for pain avoidance, abductory twist,

Question 14

What is the difference between hallux rigidus and limitus?

Answer 14

Limitus will hace 10-35 degrees of hallux DF, whereas rigidus has 10 or less

Question 15

What are some assessment findings we might see with metatarsus adductus?

Answer 15

NWB: C shaped foot, hallux limitations
Gait: low gear toe off, circumduction

Question 16

What are some compensations for a morton’s foot (elongated 2nd MT)?

Answer 16

NWB: elongated 2nd MT, longer than hallux, hypermobile 1st ray, callusing under 2nd MT head
Gait: toe off affected due to pressure under 2nd MT and the position of the 1st MT

Question 17

What are some conditions that a mortons foot can lead to?

Answer 17

Morton’s neuroma, metatarsalgia

Question 18

What conditions could arise as a result of a dropped transverse arch?

Answer 18

Morton’s neuroma, claw and hammer toes, plantar plate tear

Question 19

What are some things that can cause in-toeing gait?

Answer 19

Muscular imbalances or weakness in the external rotators of the hip, tibial torsion, metatarsus adductus

Question 20

What are some causes for toe deformities?

Answer 20

Can be hereditary, narrow or tight footwear, dropped transverse arch, high pes cavus foot, unstable gait in elderly

Question 21

What is the typical gait presentation for someone who out-toes?

Answer 21

Prolonged pronation and a medial toe off, abducted through swing, central HS