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Friday, December 20, 2019

Varus Support for Forefoot Strike Running Pattern


     Biomechanics is all about experimentation. This runner is very fast and a forefoot striker. In designing support for runners, you have to control the motion at the point of strike: rear foot, mid foot, or fore foot in this case. We are between seasons: cross country and track. That is the perfect time to make biomechanical changes. After my first visit that analyzed the problem as a pronatory mechanical fault, and that he was a fore foot striker, I had him bring in 3 OTC inserts that I could experiment with at the 2nd visit. Today I placed different wedges of 2, 3, and 4 degrees of varus to the forefoot . I watched him run and none of the inserts caused more pronation or lateral instability. All three inserts controlled the pronation at strike in different amounts. Since one foot pronates more than the other side, I advised the patient that he may end up deciding that one side felt the best with a higher control amount. I however did not want to influence the situation my telling him my expectations of what may happen. He will run two weeks with 2 degree fore foot varus wedges, then two weeks with 3 degree fore foot varus wedges, and finally two weeks with 4 degrees fore foot varus wedges. This of course may change if he feels uncomfortable as he increases on both sides. I advised him that it is okay to increase only side for the two weeks. I plan to see him in 6 weeks to see where he is. His coach had wanted him to run one day a week in the off season, but I need 2-3 days per week so we will have at least 5 runs at each level. Rich


1/8 inch poron used for my varus wedging

3 Pairs of Inserts each with different corrections

Isolated view of 4 Degree Varus Wedging with beveling laterally, distally, and proximally

Closer View of the Beveling Needed for 4 Degree Varus Wedge

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.