The video demonstrates excessive supination left side worse than the right clearly demonstrated by Tiffany. This is the first of a series of videos on supination and what orthotic modifications are utilized to treat it. Here also the varus thrust at the knee is shown in the left knee, a potentially disabling force. As the tibia moves on the femur after heel contact in a varus direction, at a time when the knee should be flexing and tibia becoming more valgus, the medial knee joint compartment gets beat up.
This second video shows Tiffany with orthotic devices to prevent supination. A separate video showed the components of this orthotic device. The supination seen in the first video is eliminated after heel strike, and the varus thrust greatly reduced at the knee. There are patients who have foot pronation whom also exhibit varus thrust at the knee.
Tiffany here is seen without the Denton Modification (one of the simple orthotic modifications used to prevent excessive supination). Without the Denton Modification (and there is a separate video on its manufacture), Tiffany definitely supinates more following heel contact.
The components of gait evaluation are demonstrated by Tiffany Hoh, 3rd Year Podiatric Medical Student at Samuel Merritt University in Oakland, California. The findings include:
- Little Head Tilt to Right
- Little Dominance or Drift to the Left
- Slight Left Shoulder Drop
- Left Arm Swing Greater
- Outwing to Left Hip
- Leads with Left Hip
- Increased Internal Patellar Rotation
- Excessive Supination following heel contact left greater than right
- Digital Clawing (toe gripping)
Here Liz is seen excessive supinating with a running gait pattern. Excessive Supination is also called under pronation or lateral instability.