Clubfoot vs. PreClinical Clubfoot Deformity. A Technical Presentation
My research directly led to the discovery of the PreClinical Clubfoot Deformity. I was the first researcher to publish on this previously unknown foot deformity (Rothbart, 2002). Below is an embryological discussion on the differences between the Clubfoot and PreClinical Clubfoot Deformity.
This research was part of a series of discoveries that ultimately led to a therapy that, in many cases, permanently eliminates chronic musculoskeletal pain without the use of drugs or surgery. This therapy is called Rothbart Proprioceptive Therapy, in which I use a series of tests, proprietary computer analyses, custom designed Rothbart Proprioceptive Insoles and ongoing monitoring to address all of the changes in the patients condition and necessary changes in prescriptions, until the chronic muscle and/or joint pain is eliminated.
Clubfoot Deformity (redacted from Rothbart 2002. Medial Column Foot Systems)
If the calcaneus fails to unwind (remains in relative supinatus), the cuboid remains in supinatus, and with it, the lateral two cuneiforms, lesser four metatarsals and accompanying phalanges (Bohm,1929). The footplate unwinds heel to toe (Streeter, 1945, 1948, 1951), thus the maxim: as goes the calcaneus, so goes the talus.
Retention of calcaneal supinatus is always accompanied by talar supinatus, the Clubfoot deformity (Bohm 1929). In the postnatal (after birth) foot, the calcaneus articulates with the cuboid, which in turn articulates with the navicular, lateral cuneiform and lateral two metatarsals. From a structuralist viewpoint, one might conclude that the calcaneus only impacts these structures.
From an embryological prospective, this is not the case. Bohm (1929) describes how the ontogenetic unwinding of the calcaneus affects the lateral column of the embryonic foot. That is, the relative structural position of the cuboid, the lateral two cuneiforms and four lateral metatarsals/phalanges are determined by the sculpturing of the calcaneus. Retention of calcaneal supinatus in the prenatal foot is manifested as the Clubfoot Deformity in the postnatal foot (See photo below).
PreClinical Clubfoot Deformity
If the calcaneus has unwound enough, that is, where the cuboid is no longer in supinatus, but where the calcaneus is still in supinatus, the resulting foot structure is termed the PreClinical Clubfoot deformity. In this foot structure, the lesser four metatarsals and accompanying phalanges have assumed a plantargrade position. However, the heel bone is still in supinatus.
On weight bearing (e.g., standing), this foot structure forces the foot to excessively pronate to bring the medial surface of the heel bone down to the ground. This attenuates or obliterates the inner longitudinal arch. However, off weight bearing (e.g., sitting), where gravity is not acting/forcing the medial surface of the heel bone down to the ground, the foot is not excessively pronated and the inner longitudinal arch is visible (See animation below).
References:
PreClinical Clubfoot Deformity. When the foot is weight bearing, the inner longitudinal arch is collapsed. When the foot is taken off weight bearing, the inner longitudinal arch becomes visible. This is pathognomonic of the PreClinical Clubfoot Deformity.
Bohm M 1929 The embryologic origin of clubfoot. Journal Bone Joint Surgery, 11:2, 229
Rothbart BA, 2002. Medial Column Foot Systems. An Innovative Approach to Improving Posture. Journal of Bodywork and Movement Therapies (6)1:37-46
Streeter GL 1945, 1948, 1951 Developmental horizons in human embryos. In Contributions to Embryology, Vols. 21, 32, 34. Washington DC. Carnegie Institution of Washington
Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot and PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain
Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain
Posted by rothbart at 7/15/2009 9:01 PM 
Categories: Rothbarts Foot PreClinical Clubfoot Deformity, Rothartsfoot PreClinical Clubfoot Flatfoot
Tags: Rothbart Proprioceptive Insole PreClinical Clubfoot Clubfoot Rothbart Proprioceptive Therapy
Categories: Rothbarts Foot PreClinical Clubfoot Deformity, Rothartsfoot PreClinical Clubfoot Flatfoot
Tags: Rothbart Proprioceptive Insole PreClinical Clubfoot Clubfoot Rothbart Proprioceptive Therapy
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