One of the most important components of a foot evaluation is observing the patient's gait. Often, this will be the key to determining an effective treatment plan for biomechanical conditions.  Postural deformities, physical limitations, and the position of the foot at heel strike and through the gait cycle are identified by watching the patient walk. 

The foot has 26 bones, which along with ligaments, tendons, and muscles provide support and mobility.  There are 14 phalanxes (3 for each of the lesser toes and 2 for the great toe or hallux), 5 metatarsals, and 7 tarsal bones.  The talus, or ankle bone, supports the fibula laterally and the tibia medially.  It provides the fulcrum around which motion occurs. The talus is seated on the calcaneus, or heel bone. 


Motion occurs primarily around the subtalar, or talocalcaneal, joint.  This motion occurs in three planes and includes inversion-eversion, abduction-adduction, and dorsiflexion and plantar flexion.  A combination of dorsiflexion, abduction, and eversion is commonly referred to as pronation, while a combination of the opposite movements--plantar flexion, adduction, and inversion--is known as supination.  Any limitations of movement or crepitus should be recorded, as does the patient's foot type and shoe style.  The degree of pronation or supination must be determined.  This is achieved by evaluative measures performed by your chiropodist.

               Gait or Walking Cycle

The first cycle is known as heel strike. This is when the outside rear of your heel touches the ground (most shoes will have this wear pattern). During this period, the foot pronates causing the foot bones to become loose to adapt to the uneven walking surface and to act as a shock absorber.
The second period is known as mid-stance. At this point, leg is directly above the foot, and the bones and joints of the foot are now moving towards supination.
The third phase is propulsion, when the foot has supinated and acts as a rigid level for push-off.
The final period of gait is the swing phase when the foot swings forward to prepare for the next step