Holy Twisted Femurs, Batman. What is going on here?
So, this is what femoral antetorsion looks like!
Remember that ante torsion occurs during development and is when the neck of the femur makes greater than a 12 degree angle with the shaft. We did a great post on this a while ago, click here to read it.
If you remember that the femur heads point anteriorly in a standing position, this would accentuate that, so they stand with an increased progression angle (ie feet toed out; see 1st picture).
With the increased femoral neck angle, these folks have a greater range of internal rotation of the femur, and decreased external rotation. Can you see this in the pictures above? We have rotated her legs fully internally and externally.
A few questions for you:
if you look carefully at the 1st picture, you will note she has external tibial torsion. Why?
- this condition can develop in utero, but more commonly occurs postnatally with"W" sitting (sitting with knees together and legs abducted, with buttocks between the legs or feet. Think about that constant internal force on the femurs and external rotatory force on the lower tibia! Have your kids sit differently!
What type of shoe should this person be in?
- The condition itself does not dictate the type of shoe thay should be in. This individual has a rigid, cavus foot BUT has an uncompensated forefoot varus with a great deal of forefoot pronation. In addition to exercises to strengthen the external rotators of the thigh, and inverters of the foot, a shoe with some motion control features is indicated in this instance
The Gait Guys…..Twisted? Yes! And still bald, middle aged and geeky as well.
A bit confused? Dig into our blog more, or watch our youtube channel. Maybe it’s time to push your knowledge base to the next level and take the National Shoe Fit Program. email us at thegaitguys@gmail.com
