Thursday's Biomechanics Discussion of the Week: Possible Left Posterior Tibial Tendon Rupture

Boy, there are many hours of discussion here but I will stick to the obvious. This video shows a collapsed left arch probably following a posterior tibial tendon rupture. The posterior tibial tendon can no longer support the arch, so there she goes. Even though the patient is shown demonstrating the ability to do a double toe raise, I seriously doubt the patient could do a single leg toe raise. This helps in the diagnosis of posterior tibial rupture. The pronation force is so great, I would go right to a 35 degree inverted orthotic device on the left side only, and a more normal device on the right. 35 degrees is my highest starting point. 

Here an Inverted Orthotic Positive Device is being made for the right side. See how the high point of the arch under the first cuneiform, not the first metatarsal base. This is crucial at not blocking first ray range of motion.

This is opposite of our video where the left is flatter. Here is a pair of orthotic devices designed to correct more for the right side with an Inverted Orthotic, over the more traditional Root Balanced Technique on the left.