Femoral-Tibial Rotation

The opposite rotational pattern — loss of hip internal rotation with internally rotated tibia — requires a reversed intervention strategy. When the femur and tibia are biased in opposing rotational directions, the medial tibia experiences excessive mechanical stress. The therapeutic goal is to untwist the knee relationship so that force is distributed more appropriately through the tibia. An arch support may help create tibial internal rotation in athletes with high arches who cannot achieve adequate pronation through movement alone.