There is a common misconception that chiropractors are just “spine doctors”. However, from the very beginning, chiropractic adjustments have been delivered to the nonspinal joints as well. The nonspinal joints include the temporamandibular (TMJ), shoulder, elbow, wrist, hand, hip, knee, ankle and foot. For example, D.D. Palmer, the founder of the chiropractic profession described his treatment of the feet in 1910. In fact, applying manual procedures to the peripheral (nonspinal) joints is taught in all accredited chiropractic programs.
In this post, we explain about Chiropractic West Palm Beach: 3 Foot Conditions Caused by Forefoot Varus.
What is forefoot varus?
Sometimes a forefoot (front) varus (turned inward) deformity develops. It is an osseous (bony) structural abnormality in which the plantar (bottom) forefoot remains inverted (rolled inward) relative to the plantar rearfoot. And this is when the foot is in a neutral position. The condition causes some of the most severe overpronation problems. So pronation refers to the way your foot rolls inward for impact distribution upon landing.
A forefoot varus deformity is said to be congenital (condition present from birth). Research has postulated many reasons as to why infants develop a forefoot varus deformity. It is most likely the result of osseous abnormalities in the talonavicular and calcaneocuboid articulations (foot joints).
However, you can also have a functional forefoot varus. Here the forefoot appears inverted relative to the rearfoot, but this position is the result of soft tissue restriction. It is not a congenital osseous malalignment deformity.
In either case, the biomechanical defect present in the arch of the foot is the basic cause for many postural problems, hip/ back problems, and injuries of the lower extremity (limb). Below are 3 possible injuries due to a forefoot varus.
Entrapment of Medial and Lateral Plantar Nerves (Jogger’s Foot)
Because of the forefoot varus there will be excessive calcaneal (heel) eversion (rotating the sole of the foot away from the body’s midline) as heel lift occurs during the gait. This causes injury to the foot by overstretching of the muscles involved. So the muscles working during the stance phase that help with deceleration loose their ability to stabilize the foot/ankle. In other words, after being “overly stretched” the muscles can’t generate enough force for the next part of the gait.
Finally, the intrinsic muscles try to compensate in an attempt to decrease the strains placed upon the stabilizing ligaments/soft tissue. In conclusion, this may lead to hyperactivity (overworking) specifically of abductor hallucis (intrinsic muscle of great toe) throughout the gait. Therefore, this may result in entrapment neuropathy of the medial and lateral plantar nerves (branches of the tibial nerve) underneath the deep fascia of the Abductor Hallucis muscle.
Plantar Fasciatiis
The plantar fascia is often injured due to a forefoot varus. Because the forefoot varus tends to collapse into a pronated position, there is repeated dorsiflexion (lifting up) of the great toe during the propulsive period of the gait. Next, this generates a lot of strain on the plantar fascia. The plantar fascia is mostly elastic which takes the force generated by this. Then this force is transferred to the bony attachment (of planta fascia) at the calcaneaus (heel). Also, it’s been noted in research that enough strain/force can be put on by the plantar fascia to even cause a stress fracture.
Achilles Tendinitis/Peritendinitis (Tendon inflammation)
Achilles tendinitis is another common injury due to forefoot varus. Again, this is due to excessive pronation because of forefoot varus during the propulsive phase of the Gait. If excessive subtalar (one of ankle joints) pronation maintains the entire lower extremity (limb) in an internally rotated position, this twists the achilles tendon. As a result, this twisting of the achilles places more strain on it during early propulsion of the gait. Research has shown that forefoot varus is a frequent cause of “snapping injuries” of the achilles tendon.
Chiropractic West Palm Beach: Chiropractic Care for Forefoot Varus and 3 Foot Conditions.
Firstly, as mentioned previously, in a functional forefoot varus the forefoot appears inverted relative to the rearfoot. The culprit is the soft tissue restriction and not a congenital (a structural birth) deformity. In other words, the soft tissue contracture occurred over time.
Secondly, Chiropractic Manipulative Therapy should be delivered to the joints associated with the forefoot varus. For example, adjustments to the ankle and foot joints.
Thirdly, stretching and strengthening exercises are important. Specifically, the muscles involved would be the peroneus longus (muscle in the lower leg that moves foot and ankle) and flexor hallucis brevis (big toe muscle) muscles to help stabilize the forefoot.
Fourthly, an orthotic may also provide additional support for a forefoot varus deformity. Certainly, a well designed shoe even without an orthotic has the ability to support the forefoot varus.
Treatment of Forefoot Varus at Meiri Chiropractic in West Palm Beach
As is the case with the spine, a detailed examination is necessary to determine the diagnosis and treatment plan for your forefoot varus and foot injury. In addition to joint manipulation and adjustments to the extremity (limb) joints, at Meiri Chiropractic, we use soft tissue procedures, hot and cold modalities, stretching exercises, and rehabilitation exercises.
At Meiri Chiropractic in West Palm Beach we spend the time necessary to examine, diagnose and treat every neuromusculoskeletal condition and various ailments you have. Through regular chiropractic visits, you can get pain relief and improve function. Chiropractic is a holistic and natural way to not only treat existing conditions, but to keep your body in its best working condition. Meiri Chiropractic has been offering effective chiropractic care in Palm Beach County since 2006. Many of our patient reviews note our excellence. Call us today at 561-253-8984 in West Palm Beach to make an appointment or to find out more about Chiropractic West Palm Beach: 3 Foot Conditions Caused by Forefoot Varus.
References: Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011
Warren Hammer, Functional Soft Tissue Examination and Treatment by Manual Methods, 2nd edition 1999