The Importance of Foot Assessments

Original Editor - Vandana Tanwar Contributors - Vandana Tanwar and Kim Jackson  

Introduction[edit | edit source]

Foot assessment is a common approach in clinical practice for classifying foot type with a view to identifying possible aetiological factors relating to injury and prescribing therapeutic interventions.  foot care assessments are necessary, and should be one of our healthcare commitments.

Three types of classification[edit | edit source]

High Arch - High arch, pes cavus, cavus feet, varus foot, supinated, under-pronating, non-pronating

Neutral Foot - Neutral, normal, middle, average arch, rectus, normal foot

Flat Foot - Flatfoot, pes planus, flat arch, planus feet, low arch, valgus foot

Other classifications may include:

Neutral Foot - Time Sequences of shock absorption, adaptation, stance, and propulsion take place at the correct time.

Forefoot Varus - This foot takes too much time in the shock-absorbing phase and converts to propulsion late.

Symptoms:

superficial knee pain, shin pains, Achilles tendonitis, iliotibial (IT) band pain, plantar fasciitis, low back pain, etc. Orthotic treatments include orthotics that trick the foot into thinking it's down to the ground by bringing the ground up to the forefoot.

Rear foot Varus - This foot functions the same as Forefoot Varus when found with a Forefoot Varus. However, it functions like a Valgus foot when found with a Valgus Foot.

Rigid Forefoot Valgus - This foot prematurely converts to propulsion at a time when it should still be absorbing shock.

Symptoms:

A tendency to ankle sprains, an unsure gait, leg muscle problems, stress fractures, etc. Orthotic treatment includes an orthotic that tricks the forefoot into thinking all the bones are level with each other by bringing the ground up to the foot.

Very rare foot type.

Flexible or Plantar Flexed First Metatarsal - This is the hardest foot type to classify. It is capable of functioning like a Forefoot Varus, Rearfoot Varus, and in some cases, like a Rigid Valgus, but not as severe. Symptoms include everything including sciatica. Orthotic treatment is with orthotics to put the forefoot in neutral.

Equines - This foot type has the inability to place the foot 10 degrees closer to the shin as the center of gravity passes over the ankle.

Symptoms:

A foot that spends too much time in the shock-absorbing phase and little or no conversion to propulsion. Uncompensated, it is the worst running imbalance to treat. Stretching and heel lifts help most people but not all.

Other bio mechanical factors include: angles of the shin bones, knee, hip, and leg length diffentials, structural, and functional.

BENEFITS:[edit | edit source]

  • Prevention of amputation in diabetic cases.
  • Sports injuries prevention with corrective insoles and rehabilitation.
  • Early detection of gout/arthritis/athlete foot etc.
  • Minimizing recurrent falls injuries due to bio mechanical error of foot/ankle joint.
  • Early detection of callus/dry skin/ulcer etc.
  • Peripheral neuropathy is the most common component cause in the pathway to diabetic foot ulceration .so the clinical exam recommended, however, is designed to identify loss of protective sensation (LOPS) rather than early neuropathy.
  • regular foot assessments helps in :
    • relieveing pain and treats infections.
    • to identify possible health conditions.
    • supports good long term foot health.
    • making healthier long-lasting lifestyle changes.

Resources[edit | edit source]

  • Mayfield JA, Reiber GE, Sanders LJ, Janisse D, Pogach LM: Preventive foot care in people with diabetes. Diabetes Care 21: 2161–2177, 1998
  • pubmed
  • google search

References[edit | edit source]