ETIOLOGY OF FOOT HYPERPRONATION – AN EMBRYOLOGICAL PERSPECTIVE
My research questions the validity of the traditional definition of forefoot varum [metatarsals 1-IV inverted relative to the midline of the calcaneus in STJ NP]. Embryological studies suggest/indicate that forefoot varum is limited to the first metatarsal only. Published clinical studies done at the Bellevue Foot and Ankle Center and GRD BioTech Laboratory, using postural insoles, collaborate this embryological viewpoint.
Based on embryological studies, I propose that hyperpronation in the adult [gaiting] foot is the result of an ontogenetic retention of talar torsion [termed talar supinatus] seen during weeks 6pf-8pf in the developing embryo. Clinically, talar supinatus is visualized as an elevation of the medial column of the foot [termed Primus Metatarsus Elevatus], in the standing/neutral positioned foot. I have devised a way to measure PME using microwedges with confirmed high interrator reliability. I have introduced a way to reduce hyperpronation resulting from PME using postural insoles [not orthotics which weaken the feet]. Postural insoles are based on Proprioceptive Feedback Stimulation, and are not used as supportive devices [e.g., arch supports/metatarsal bars or pads, etc].
My work has been published in the Journal of Bodywork and Movement Therapy [Harcourt Publishers, Leon Chaitow Editor, January 2002]. A redacted version of this paper is available at the following website:
If you would like an electronic [Email] copy [Acrobat Reader 4.0 format], please send me an Email. It is a fairly large file [2.3Mb], so make sure your IP server will forward it to you. Please note: Most free IP servers will not send a file this size to individual mailboxes.
For more information, visit the following website, run and maintained by Bjorn Svae:
This website describes my research [in laymen’s terminology] and offers a channel for the technology to be used in the medical community.
With Best Regards,
Brian A. Rothbart DPM, PhD, FACFO