Correcting Duck Feet

I am trying to re-educate a client on proper biomechanics. The patient is in a re-conditioning program after extenseive back troubles including , laminectomy of l4-l5 and fusion at l3-s1. The patient complains that his feet flare to a significant angle when standing/walking (particularly his left)


""If I force myself to point my feet forward, then my knees are pointed unnaturally inward. It just seems that they grew this way for some reason.

Also, if I squat down, my knees don't come down to where they're over my feet, but are to the inside. If I do this with my feet pointed out straight, my toes just slide outwards as I squat down. If I put my feet together pointed forward and then squat down, my knees run into each other about halfway down and I can't go any further unless move my legs and feet apart.""

I've been asking my client to perform lunges, single leg squats, and walking with his feet pointed forward (and trying to maintainknee over foot).......unfortunatly in this position his knees are rotated inward......are these "corrective" exercise/stretchs appropriate (i.e corrective)??

have you tried and orthotic? also often "duck feet"" come from externally rotated hips, an issue i myself am also grappling with. i would also assess the pelvis see if there is any dysfunction leading to excessive hip external rotation. let me know how it goes...

dear colleague,
Have you checked the rotation of the tibia?
Some peoples feet are rotated so much because of ossal "differences". Nothing will change that if this is the case.

The other thing that puzzles me is, why do you want to change these feet? They could be the most perfect adaptation for this particular patient.
I would suggest you reassess and think carefully before giving a patient exercises that over-exert other joints.

esther

possibly the Hip problem, check the tension of Gluteus Medius, and the ITB, Q angle, if neccessary

Quote:

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Originally Posted by estherderu

dear colleague,
Have you checked the rotation of the tibia?
Some peoples feet are rotated so much because of ossal "differences". Nothing will change that if this is the case.

The other thing that puzzles me is, why do you want to change these feet? They could be the most perfect adaptation for this particular patient.
I would suggest you reassess and think carefully before giving a patient exercises that over-exert other joints.

esther

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I will do that, i appreciate your input. My tendancy to "correct" these feet is due to the LBP. I subscribe to the idea that walking is theraputic for these patients. I am concerned that the duck feet are hindering the patients efficacy. I do however agree that this adadptation maynot be "correctable", when he walks with feet pointed forward, his knees are rotated internally, do you suggest i encourage him to walk naturally?

Sorry that I have not responded earlier.... was on holidays and not always into PT related sites.

What I suggest is...

1st make sure what the problem is, assess carefully
- how (hyper-hypo) mobile are his hip joints?
- how stabile is he on one leg.
It sounds like instability to me if he cannot make a lunge without internally rotating his knees. What does his back (spine) do during this movement?Does he compensate a lot?
2nd make sure it isn´t an ossal "difference" in his hips and do not forget the tibia´s.

If there is instability and weakness, i suggest strengthening and coordination exercises.
If this is not the case, I would certainly start with walking normally.

Esther
NB if the problem remains, maybe making a little video of these movements and sending it, might be an option.