Current Pedorthics | November-December 2018 | Vol.50, Issue 6 | Page 36

Inverted posture ‘A Rearfoot good fit?’ Excessive rearfoot eversion is suggested to lead to tibial and femoral internal rotation, subsequently resulting in increased quadriceps angle and higher lateral PF cartilage stress [15] in accordance with “law of valgus” (i.e. varus alignment increases the medial PF force and valgus alignment increases the lateral PF force) [39]. If this biomechanical theory is correct, everted and inverted calcaneus are associated with lateral and medial PFOA, respectively. This theory is supported by the significant relationship between calcaneus inverted angle and the presence of medial PFOA shown by the findings. However, calcaneus inverted angle is likely associated with lateral PFOA given that the lower limit of 95% CI of OR is near 1.0. These findings do not clearly support a biomechanical link between inverted rearfoot alignment and medial compartment-specific PFOA. Thus, inverted calcaneus may represent a clinical feature of multicompartmental disease. Further studies examining the biomechanical link between rearfoot abnormality and PFOA are warranted to support the findings from this exploratory study. We found that calcaneus inverted angle was associated with a higher prevalence of medial PFOA. Conflicting evidence linking foot eversion and PF exists, although excessive foot eversion and its relationship to PF pain have been discussed in literature. For example, Powers et 34 Pedorthic Footcare Association | www.pedorthics.org "These findings do not clearly support a biomechanical link between inverted rearfoot alignment and medial compartment-specific PFOA. Thus, inverted calcaneus may represent a clinical feature of multicompartmental disease. Further studies examining the biomechanical link between rearfoot abnormality and PFOA are warranted to support the findings from this exploratory study." @Shutterstock.com/Sebastian and physical function between patients with PF pain and PFOA, none of the included studies examined rearfoot posture in patients with PFOA [18]. Thus, this study is the first to show that rearfoot posture may be a potential modifiable factor associated with PF joint disease.