Forefoot Varus: Causes, Complications, Corrections
What Is Forefoot Varus?
Forefoot Varus is a condition in which there is angulation or inversion of the bones present in the front part of the foot when compared to the heel.1 In Forefoot Varus deformity, the bones present on the inside of the foot tend to become slightly high off the surface than the outer part of the foot at the time of weightbearing. In a normal position, there are three points that touch the ground during weightbearing which are the heel, the big toe joint, and the little toe joint. In Forefoot Varus deformity, there are only two points of contact which are the heel and the outer part of the foot and hence to compensate for this the foot becomes pronated causing the heel to evert even more so that the inner part of the foot touches the surface. This results in a couple of problems. First one is that the integrity of the arch of the foot is lost. The arch of the foot acts as a shock absorber and due to this deformity the function of the arch of the foot gets compromised. The second problem is the pronated foot impairs the natural alignment of the knee and the hip.
What Causes A Forefoot Varus?
One of the causes of a Forefoot Varus deformity can be an elevated first metatarsal head which causes the remaining metatarsal joints to become pronated and turn outward so as to get the first metatarsal head to the ground.
What Are Some Of The Complications Of Forefoot Varus?
A Forefoot Varus deformity can cause numerous pathological conditions like:
- Plantar fasciitis 2
- Tibialis posterior tendonitis
- Patellofemoral syndrome
- Hallux abductovalgus
- Severe low back pain
- Metatarsal stress fractures.
How Can Forefoot Varus Be Corrected?
Exercise for Forefoot Varus: Exercises are the best way to correct the Forefoot Varus deformity in case it is being caused by muscle weakness or soft tissue stiffness. Majority of the cases of Forefoot Varus deformity are caused due to this reason. If the deformity is rigid then it would likely not respond to corrective exercises.
The main aim of the exercise for forefoot varus is to strengthen the muscles which are responsible for pulling the big toe to the surface so as to stabilize the arch of the foot and keep the heel in a stabilized position and prevent it from eversion. This may involve strengthening muscles like flexor hallucis brevis and the calf muscles along with strengthening of the tendons like the peroneus longus. Once the muscles of the arch get enough strength then with passage of time there will be reversal of the soft tissue adaptation causing Forefoot Varus Deformity.