Adolescent with rearfoot Valgus

The patient is a 12-year-old adolescent who swims and is athletic. He made an appointment with the podiatrist to renew his soles, adapted for a foot valgus, that he has had for 4 years.

PATIENT
Gender
Male
Age
12
Profession
Student
Size
-
Height
-
Consultation

Valgus

Biomechanical parameters

Gaitline

Swing phase

Ankle roll

What are the most frequently used parameters?

The sport podiatrist analyses the gait line, the swing phase, and the ankle roll (absolute)

  • The Gaitline provides a quick overall view of the walk and shows what abnormalities may be detected. The contact times are indicated by step phase, allowing one to visualise a potential difference between the two sides and monitor the evolution.
  • The swing phase is used to determine propulsion ratio and the muscles that create  the propulsion. In this way, the symmetry  between the two legs  can be verified. The swing phase is also used to analyse the length of  the stride and the similarity between the two sides. These data help in advising patients regarding daily exercises to avoid asymmetry (strength training, proprioceptivity, etc.).
  • The ankle roll allows for the visualisation angles when striking, flat footed, and during propulsion in specify corrections. The illustrative graphic is explained to patients, who can see their deformations and the differences between the two sides.

What information was collected for this patient?

We observed that the strike is roughly within the norms, and then there is a very quick collapse of the hindfoot. Then, the foot moves in supination, which can be explained by the fact that the patient corrects his gait.

The left foot is closed, which translates to a valgus of the foot, slightly less pronounced on the right. The strike angle is sharper on the left, which indicates that the step is more controlled on the left.

When running, there is higher contact time on the left, which is due to the fact that the left foot is more deformed.

The amplitude between the strike angle and the propulsion angle is more significant on the left, even if the strike angle is greater on the left. This can be explained by the fact that the patient tries to correct himself when he places his heel or because the deviation is primarily in the midfoot.

What examinations did you have to carry out to complete the analysis?

Fabrice Millet carried out his examinations in a conventional manner: questioning and examination while seated on a chair, examination standing and on one foot.

During the questioning, we learned that he was a child who had a tendency to fall by placing one foot on the other. When he was younger, he suffered from pain in the tuberosity of the posterior hamstring.

Standing, we observe a severe valgus of the midfoot and a slight valgus of the hindfoot, combined with a genu valgum.

Standing on one foot, the pronation is confirmed.

What diagnosis was made?

The pain and the falls are due to the deviation of the foot into valgus. At unipodal support, the pronation is confirmed.

What treatment or solution have you provided the patient with?

The podiatrist made thermoformed soles with high-density compressible material, and non-compressible under the heel. He positioned a PSW, as well as an arch support and piece under and over the first radius.

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