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The walking gait of patients of patients with pes cavus deformity and laterally deviated subtalar joint axes can be quite abnormal. Many of these patients demonstrate rapid subtalar joint supination at heel contact during walking which increases the shock of heel contact and causes abnormal rearfoot supination at a time when the subtalar joint of the foot should be pronating. This 31 year-old male, who was referred to Dr. Kirby's office for custom foot orthoses,complained of peroneal tendon pain at the peroneal tubercle area of the lateral calcaneus, peroneal muscle fatigue and ankle supination instability during walking over uneven terrain. Note the abnormal and rapid subtalar joint supination during the contact phase of walking and the supinated position of the subtalar joint throughout the stance phase of walking gait.
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