Wedges

Question 1

Normal stance

Answer 1

1. Pelvis should be parallel to the frontal and sagittal planes
2. Legs in the sagittal plane
3. Subtalar joint in neutral position
4. Midtarsal joint should be locked and maximally pronated
5. The full plantar surface of the foot rests on the ground
6. All metatarsal heads bear weight
7. The forefoot parallels the plantar aspect of the rearfoot
8. Muscle effort is not necessary to maintain the structural integrity of the foot
9. Gastrocnemius contraction occurs to plantarflex the ankle joint allowing for half of the body weight to be transferred to the forefoot

Question 2

What happens when you apply a 4° varus (medial) wedge to the forefoot?

Answer 2

The 1st ray dorsiflex, midtarsal joint needs to supinate

Question 3

How much supination from max pronation?

Answer 3

4-6º =enough motion

subtalar joint does not need to be involved

Question 4

What happens when you apply a 4º valgus (lateral ) wedge to the forefoot?

Answer 4

MIdtarsal joint is already maximally pronated-subtalar joint pronates .
Tibia and femur will internally rotate

Question 5

What if there is a 4° varus wedge to the rearfoot?

Answer 5

• Subtalar joint will supinate (because of calcaneal inversion)
• It will invert about 4°
• Decrease motion at the subtalar joint, can be more inverted
• Tib and femur externally rotates; knee extends
• Can rotate the pelvis back slightly

Question 6

What if there is a 4° valgus wedge to the rearfoot?

Answer 6

• Subtalar will pronate
• Midtarsal will supinate → forefoot supinatus
leg internally rotates