I have embraced the paradigm concerning foot orthotics that the aim or intervention goal is to ‘bring the ground up’ to accommodate the dysfunctional foot. In other words change the ground to accommodate the foot. This has presented me with difficulties when addressing a rigid foot type such as an uncompensated rear foot varus.
When changing this paradigm to ‘consider modifying the orthotic to change the foot before it hits the ground, options seem to present themselves. In other words change the foot to accommodate the ground. Here is an example.
If I have a foot type where the subtalar joint does not evert, how can I change ‘the ground’ to make the subtalar joint evert?
I do know that when you see an everted subtalar joint in stance then the problem is with the forefoot. Therefore the forefoot can create and influence frontal plane load on the rearfoot during stance.
So If I have a subtalar joint that will not evert, what if I create a forefoot varus? Depending on the degree of post I introduce under the forefoot I should be able to introduce a rectus position to the calcaneus and provide a stimulus of eversion when transitioning from heel strike -> to foot flat -> to midstance.
No I can attack those pesky IT-Band issues with greater efficacy! Hooray!
Changing the paradigm of ‘bringing the ground up’ to ‘changing the foot type’ opens up possibilities in fabrication of orthotics. Subtalar eversion would then require me to create a forefoot varus by essentially looking from the ground up as though I were creating a forefoot valgus. Probably why the body adapts by creating plantarflexed first ray’s in the presence of a rearfoot varus.
This post is truly ‘thinking out loud’. I ultimately believe creating dysfunction to address dysfunction is not the right way, yet I do feel that continuing to creatively problem solve and entertain ‘out of the box’ thinking is important.