A Study Supporting much of what we have been saying.

  • folks in the Indian population have flatter feet
  • the amount of great toe extension is important, especially as it relates to foot pain
  • foot prints can tell you a lot about a foot
  • foot exercise and footwear modifications achieved the best outcomes

Lets look at some of these points.

folks in the Indian population have flatter feet
foot morphology is not only developmental, but has a genetic component, that can differ in different populations
the amount of great toe extension is important, especially as it relates to foot pain

just how much great toe extension (or dorsiflexion as foot geeks like to say) is necessary? The great toe must extend 40 degrees to walk normally and most folks can dorsiflex 65 degrees. If this is impaired (something called “hallux limitus”) it can:
  • shorten your stride length
  • make you have difficulty with high gear push off
  • will probably give you pain at the metatarsal phalangeal junction

foot prints can tell you a lot about a foot

Gee, we have been saying this for a few years now and have been advocating the use of a pedograph as well. In fact, we wrote the ONLY book about it’s interpretation, available by clicking here.

foot exercise and footwear modifications achieved the best outcomes

We have almost a thousand posts on this blog, and nearly 100 youtube videos, many of which talk about foot exercises, their indications and how to do them

The Gait Guys. Increasing your “Foot IQ” each and every day. If you are new to us, thanks for reading and feel free to “dig in” and search this blog, as well as our youtube channel. Have a question? Want to take your learning to the next level? Consider taking the International Shoe Fit Certification Program and put yourself at the front of the line when it comes to shoe fit. email us at thegaitguys@gmail.com for more info. 

 
J Orthop Surg (Hong Kong). 2013 Apr;21(1):32-6.

Flatfoot in Indian population.

Source

Department of Orthopaedics, Moti Lal Nehru Medical College, Allahabad, India.

Abstract

PURPOSE. To compare outcomes of different conservative treatments for flatfoot using the foot print index and valgus index. METHODS. 150 symptomatic flatfoot patients and 50 controls (without any flatfoot or lower limb deformity) aged older than 8 years were evaluated. The diagnosis was based on pain during walking a distance, the great toe extension test, the valgus index, the foot print index (FPI), as well as eversion/ inversion and dorsiflexion at the ankle. The patients were unequally randomised into 4 treatment groups: (1) foot exercises (n=60), (2) use of the Thomas crooked and elongated heel with or without arch support (n=45), (3) use of the Rose Schwartz insoles (n=18), and (4) foot exercises combined with both footwear modifications (n=27). RESULTS. Of the 150 symptomatic flatfoot patients, 96 had severe flatfoot (FPI, >75) and 54 had incipient flatfoot (FPI, 45-74). The great toe extension test was positive in all 50 controls and 144 patients, and negative in 6 patients (p=0.1734, one-tailed test), which yielded a sensitivity of 96% and a positive predictive value of 74%. Symptoms correlated with the FPI (Chi squared=9.7, p=0.0213). Combining foot exercises and foot wear modifications achieved best outcome in terms of pain relief, gait improvement, and decrease in the FPI and valgus index. CONCLUSION. The great toe extension test was the best screening tool. The FPI was a good tool for diagnosing and grading of flatfoot and evaluating treatment progress. Combining foot exercises and foot wear modifications achieved the best outcome.

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