Forefoot Varus Predicts Subtalar Hyperpronation in Young People

The purpose of this study was to verify whether forefoot alignment can predict subtalar hyperpronation, measured using the rearfoot eversion angle test, the navicular drop test, and the Foot Posture Index (FPI), in young people.

The foot alignment measurements included forefoot angle, single-leg weightbearing rearfoot angle, navicular drop, and the FPI.

The forefoot varus angle was measured with a universal goniometer three times and an average was calculated for greater reliability.

The rearfoot angle was measured as the angle between bisections of the lower one-third of the leg and of the calcaneus, with the participant in single-leg relaxed stance.

For the navicular drop test, navicular height was measured with the subtalar joint in the neutral position and the participant in bipedal stance.

The difference in navicular height measured during bilateral and unilateral stance was defined as navicular drop.

Foot posture was evaluated using the FPI, while participants stood in a relaxed stance position with their arms by their side and looking straight ahead.

Each of the six clinical criteria of the FPI-6 was assessed and scored on a 5-point scale from -2 to 2.

The results show a high positive correlation between forefoot varus and the clinical measurements of subtalar hyperpronation (r = 0.76–0.86; P < .001).

Moreover, the forefoot varus variable could predict 74% of the variability in the rearfoot angle, 58% of the variability in the navicular drop, and 67% of the variability in the FPI.

These findings support previous assumptions that individuals with forefoot varus present increased subtalar pronation.


  1. Rodrigo Scattone Silva, Ana Luisa G. Ferreira, Livia M. Veronese, Fabio V. Serrao (2014) Forefoot Varus Predicts Subtalar Hyperpronation in Young People. Journal of the American Podiatric Medical Association: November/December 2014, Vol. 104, No. 6, pp. 594-600

Copyright 2016 MASS4D® All rights reserved. This article or any portion thereof may not be reproduced or used in any manner whatsoever without the prior written permission of MASS4D®