Forefoot varus and hip and knee kinematics in 1-legged squat
In order to determine the effect of forefoot varus during dynamic closed chain activities, 3-dimensional kinematic data of the hip and knee was compared between adolescents with and without forefoot varus. No differences were established in hip adduction and knee abduction angles, but subjects with forefoot varus showed increased hip internal rotation.
Although it is often hypothesized that forefoot varus (FV) causes substantial compensations in the kinematics of proximal body segments – such as internal rotation and adduction of the hip and frontal plane abduction of knee – the evidence to date is inconclusive.
In order to determine if an altered movements pattern is present in adolescents with and without FV, 46 asymptomatic subjects (23 with FV, 23 matched subjects based on anthropometric characteristics and tested leg) underwent goniometric assessment of forefoot alignment and rearfoot angle. Subsequently, 3-dimensional kinematic data of the hip and knee was collected using electromagnetic tracking equipment.
Interestingly, only internal rotation of the hip was increased in subjects with FV – no differences were present in hip adduction and knee abduction between subjects with and without FV. The authors nevertheless conclude that FV causes significant changes in mechanics of proximal segments in the lower extremity and speculate that during high-speed weight-bearing tasks such as running, the effects of FV on proximal segments in the kinetic chain might be more pronounced.
How do you assess forefoot varus (or in general foot pronation) in your clinical practice? And do you use specific intervention strategies targeting this?
> From: Scattone Silva et al., Man Ther 20 (2015) 79-83. All rights reserved to Elsevier Ltd.. Click here for the Pubmed summary.