I’m curious as to how the masses are assessing feet for foot
orthoses.
I was taught the subtalar neutral method whereby the perp.
calcaneal bisection is assessed in relation to the bisection of the
lower third of the lower leg, and the forefoot being in a
perpendicular relationship to these bisectors.
Now, as I was thinking – like all good interns do, this analysis of the bony
alignment of the foot is dependant on one thing in particular – the
lower third of the lower leg being perpendicular to the ground during
stance. What happens when you stand your patient and you notice this
line deviating from vertical? Maybe I missed that day of class, but I
would generally think that this would have to be accomodated for in
your posting. ie. if the patient has 5 deg. tibial varum you would
need to increase your medial post, or decrease your lateral posting
accordingly.
Is this something most clinicians pick up on during
gait analysis, are C.O.’s routinely measuring this tibial
varus/valgus relationship, is subtalar neutral still the most
accepted method??
I would really like to hear what assessment techniques are being used
and weather or not people feel this tibial angle is important.
THANKS -Jason, C.P.,O. intern
