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Hi All,

Is there any research on the "impact of 1st MPJ function with FFVR posting" ?
Short or Long Term consequences of blocking up the first MPJ / Windlass?

For example; A young adult, with a mobile flat foot / FF supinatus - Using an EVA orthotic and extending the FFVR to control the medial column - Is there issues with blocking up the 1st MPJ? (I know at uni this was a big no no! We were taught only FFVR post a true rigid FFVR)

Thanks in advance,

Cheers MP

 

Re: Impact 1st MPJ Function with FFVR Posting

Position of the first ray and motion of the first metatarsophalangeal joint.

Roukis TS, Scherer PR, Anderson CF.

J Am Podiatr Med Assoc. 1996 Nov;86(11):538-46.

Although they did not look at a varus forefoot wedge they did look at increasing thickness of material under the 1st met head, if I recall correctly.

I don't like the term blocking up motion. There is a continuum. The more force on the plantar surface of the metatarsal the more force is likely to be in the plantar fascia to hold the first ray down. The more force in the plantar fascia the harder it will be to dorsiflex the hallux.

Instead of looking at forefoot to rearfoot, it might be easier to examine the force on the first met head. There could also be a rearfoot varus that runs out of eversion range of motion before the first met head bears significant weight. If the problem is too much weight on the lateral column (as with partially compensated varus forefoot or rearfoot) then you need to get more weight on the medial column. It's kind of like Goldilocks. A first met can have too much weight, too little weight, or be in the range of just right.

Eric

 

Re: Impact 1st MPJ Function with FFVR Posting

Thanks Eric for the Reply

 

As far as I'm aware this is still the best study on kinematic influences of forefoot varus posting in-vivo.