Compensated & Uncompensated rearfoot varus

Rearfoot Varus 

Rearfoot varus is a condition where the rearfoot is in an inverted position in relationship to the ground when the subtalar joint is in a neutral position. Rearfoot varus can be broadly categorized as compensated and uncompensated. The common theory with compensated rearfoot varus is that the subtalar joint will attempt to compensate for the inverted calcaneal position by pronating beyond the "normal" range to enable the calcaneus to meet the ground and stabilize the foot. Other compensatory mechanisms may occur including plantar flexion of the first ray and abduction of the foot. In the compensated rearfoot varus, a common site for callus to develop is plantar to the second metatarsal head as shown in Figure 5. Treatment for compensated rearfoot varus involves the use of a medial heel wedge to reduce the compensatory pronation occurring at the subtalar joint. 

Uncompensated rearfoot varus is an uncommon condition. In the uncompensated rearfoot varus, the subtalar joint does not pronate leaving the heel and the foot in an inverted position during stance. Common distribution of callus in the uncompensated, rearfoot varus occurs under the fifth metatarsal head as shown in Figure 6. Treatment for uncompensated rearfoot varus is directed toward increasing shock absorption and redistributing plantar pressure more evenly. This can be achieved using accommodative, cushioned orthotics and footwear.