Compensatory forefoot supination. With subtalar joint corrected, the first ray is rotated upward. If the forefoot is found to be supinated in this corrected position, it indicates that a great deal of weight bearing is being done on a valgus foot. With the patient standing, a view of the heel cord and any abnormal lateral curvature from behind helps determine more subtle varus or valgus alignment. In severe valgus, the talus may be subluxed and directly bearing weight medially, with a rocker-bottom appearance to the foot. The heel cord may be extremely short and tight despite having a plantargrade appearance with heel contact to the floor.
Source: Mitra R. Principles of Rehabilitation Medicine; 2019.
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