1st I have started a new thread from a question Jeff Root asked in the Challenging the foundations of the clinical model of foot Posture thread- https://podiatryarena.com/index.php...f-the-clinical-model-of-foot-function.108197/
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here is a definition that I found
Jeff rather than give you referenced definitions I will give you might thoughts, which might be called BS but there you go
Forefoot supinatus.
Evans EL1, Catanzariti AR2.
Author information
Abstract
The supination of the forefoot that develops with adult acquired flatfoot is defined as forefoot supinatus. This deformity is an acquired soft tissue adaptation in which the forefoot is inverted on the rearfoot. Forefoot supinatus is a reducible deformity. Forefoot supinatus can mimic, and often be mistaken for, a forefoot varus. A forefoot varus differs from forefoot supinatus in that a forefoot varus is a congenital osseous deformity that induces subtalar joint pronation, whereas forefoot supinatus is acquired and develops because of subtalar joint pronation. This article discusses the acquired form of forefoot supinatus.
https://www.ncbi.nlm.nih.gov/pubmed/24980930
Not once it there mention of what position the Reafoot needs to be in or a measurement so I could just leave this here and Jeff et al would ask what position is the rearfoot in it must be in STJ neutral and we would go round and round again.
So apart from having a busy life with work and running and having a birthday I have been thinking, why does it matter what we do, measure define etc and what would we get out of a discussion apart from people getting cranky.
So during my runs last week I have been thinking which like I have written before this is dangerous.
Point 1 - do we even need to know if it is a FF Supinatus or Varus - sure we do,
Point 2 do we need to know how many degrees it is - Nope
Point 3 does this link a non-weightbearing assessment "measurement" to a weight-bearing, (which I believe is the key to any assessment - ie assessing motion at MTP1 non-weight bearing to weight bearing ) and I believe it does if we look at the Maximum Eversion Height Test . Eric talks about here - https://www.podiatrytoday.com/guide-orthotic-prescription-writing-tissue-stress-theory-approach.
If we look at the gait cycle when does a forefoot "deformity" become something that will be important for us to consider. So if we look at the relationship in "general" forefoot loading will occur as the Tibia reaches perpendicular to the ground. so this is the point that is interesting for us when thinking about the forefoot.
So if we place the ankle at 90 degrees and use the idea that the ground represents the frontal plane, look at the forefoot relationship to the frontal plane - Inverted, Everted or Parallel
Then we need to look at stiffness if the Forefoot is inverted how much force does it take to get parallel to the frontal plane without any rearfoot motion occurring. This guessturement of Force is important not the degrees, lets face it a true FF Varus deformity is extremely rare so what we really need to know is the amount of force required to get a change at the forefoot if that is what we want to do. This then combined with the Maximum Eversion Height Test will give us the angular posting we might want and the stiffness will add us in the material choice.
So how would I assess this
Pt lies prone on the assessment coach, ankle joint is placed at approx 90 degrees, look down the heel using an imaginary line to represent the frontal plane, look at the forefoot, see the relationship to the frontal plane if inverted, hold the ankle joint and calcaneous in one hand, evert the forefoot until parallel to the imaginary line representing the frontal plane and take note of the force required.
I would then use the Maximum Eversion Height Test but take that measurement with the ankle at about 90 degrees .
I am sure there are wholes in the idea and it might be a bit of a word salad, but I don´t think we need to have the STJ in any "position" if the ankle is at 90 degrees, we don´t need to measure the forefoot from the rearfoot but in the frontal plane alone, we don´t need a measurement in degrees, but need to look at stiffness, and the Maximum Eversion Height Test gives us a way to communicate with labs or ourselves on the height we want in posting and the stiffness at the forefoot helps us in the material/process of cast modifications
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National profile of foot orthotic provision in the United Kingdom, part 2: podiatrist..physiotherapy
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National profile of foot orthotic provision in the United Kingdom, part 2: podiatrist..physiotherapy
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1st mpj capsule inflammation
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