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Flashcards in Foot Anantomy Deck (45)
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1

The First Ray

first metatarsal and first cuneiform bones. Pronation of the subtalar joint lowers the first ray to the ground in early stance and dissipates the shock of heel impact.

2

Second Ray

2nd metatarsal and 2nd cuneiform etc.
Fifth ray: just the 5th metarsal

3

First rocker:

calcaneus

4

Second rocker:

Talus: Dome creates the lower part of our second rocker

5

Third rocker:

Metatarsophalangeal joint

6

Midfoot:

Navicular, Cuboid, Cuneiforms

7

Pronation

DF, abduction, eversion

8

Supination:

PF, adduction, inversion

9

ER of normal foot:

7 degrees
see two toes

10

Compensated foot-

refers to a change in the structural alignment or position of one part of the foot to neutralize the effect of a structural problem in another part of the foot

11

Uncompensated

Uncompensated doesn’t tell you it the foot is normal or abnormal. It just is tell you that is isn’t changing its static position to deal

12

Relaxed calcaneal stance

The medial and lateral metatarsals are on ground
The lower extremity is vertical to floor (4deg)
The heel should be slightly twisted in (varus or inverted by 4 degrees)

13

Compensated Rearfoot Varus

The Subtalar joint possesses an adequate amount of pronation and the medial calcaneus is in contact with the ground.
Medial Translation (Shift)of the talus and lateral shift of the calcaneus
Increased rotation of the tibia
Flattening of arch – if mobile arch

14

Gait with compensated rearfoot varus:

Prolonged eversion of rear foot and flattening of arch
Heel whips to re-orient the foot
knees into valgum
Pelvis may anteriorly rotate

15

Some common conditions with compensated rearfoot varus

Subtalar joint arthritis
Achilles tendinopathy
Posterior tibial tendinopathy
Medial tibial stress syndrome
Knee pain with rotation of tibia
Hip pain with rotation of femur

16

Shoes that might help/ Compensated RF Varus

Stability shoes with an insert
Need heel counter
Need torsional rigidity
Need excellent match of arch of foot/shoe
Need depth for insert
Need to address forefoot problems which may arise

17

Uncompensated rear foot varus

Calcaneus in varus
Tibia in ER
High arch
Toe in contact w/ ground (PF 1st ray)
Pressure on outer border of foot
Often associated with wider foot typing

18

Gait with Uncompensated Rearfoot varus

High rigid arch through gait (compensated it was flattened)
Pressure on lateral border of foot
May have heel whip to compensate for out toe
The heel drives in and pulls out at an angle and there may be a pump bump

19

Conditions with uncompensated rearfoot varus

Medial Tibial Stress Syndrome: Shin Splints
Metatarsalgia
Cuboid syndrome
Stress fractures
Lateral ankle sprains
Knee pain

20

Large Uncompensated Rearfoot Varus
High Arched Foot (valgus forefoot)

Supinated Foot
Pes Cavovarus
The medial condyle of the calcaneus cannot be lowered to the ground.
May be associated with the forefoot being dropped into equinus so toe is like a door stop

21

Gait with Pes Cavus

Walks like on a tight rope
Heel in varus but first ray and rest of foot in valgus to compensate
Forefoot is also in equinus
Very intoed gait with big toe that when viewed from behind the patient appears during stance then disappears (peak a boo)

22

Shoes for Pes Cavo Varus

Neutral shoes may not have enough support as these feet need a high arch
Do need cushion but not at the risk of loosing heel
Torsionally stable shoe
Good heel counter
Cushion
STABILITY with cushion
DEPTH/WIDTH!!!!!!

23

Gait with compensated forefoot varus and rearfoot valgus

Severe midfoot collapse
Outoeing – too many toes sign
Splaying of toes
Pronation fully through gait cycle

24

Conditions with compensated forefoot varus and Rearfoot Valgus

Plantar fasciitis
Strain of the spring ligament
Post tib tendinopathy
Metatarsalgia
Bunions with hallux limitus

25

Uncompensated forefoot varus

The forefoot will not reach the ground
The rearfoot may also be rigid and not able to evert to reach the ground
May see big toe pressing into ground to stabilize
May see shift at talus or leg with ankle more medially
Often seen with tib varum or bowing of legs

26

Abdictovarus forefoot

abducted toe sign
medium/low arch
varus forefoot alignment
mildy inverted heel alignment; abducted forefoot
medial heel ppivot

27

Possible symptoms of abductovarus forefoot:

shin splints
plantar fascitis
cuboid syndrome
medial knee pain
tailor's bunion

28

Gait with uncompensated forefoot varus

More pressure on outer border of foot
More pressure on first ray and big toe
The foot may compensate with a heel whip
There may be other compensations up the chain

29

Severe Pes planovalgus

abducted toe sign
lateral column instability
flat arch
everted heel alignment
large toe sign

30

Symptoms of Pes planovalgus

pronates thru propulsion
severe MTJ instability
propels from central MTHs