Calcaneus Position

An everted calcaneus and dorsiflexed first ray can limit big toe extension through passive insufficiency because tissues are already elongated. An everted calcaneus can push the first ray into the ground and make it dorsiflex because ground contact drives it upward. An inverted calcaneus and plantarflexed first ray can limit big toe extension because bottom-of-foot tissues are shortened or engaged and may not release enough. An inverted calcaneus may plantarflex the first ray to create an arch and reduce ankle sprain risk. An outward-flared foot pattern can pair an externally rotated tibia with a relatively internally rotated femur. If the calcaneus is inverted, intervention should drive calcaneal eversion. Intervention moves the calcaneus toward the opposite strategy from the one currently being used after proximal influences are addressed.