The Morton’s Foot creates foot pain. The Rothbarts Foot creates chronic musculoskeletal pain and other problems throughout the entire body. The PreClinical Clubfoot Deformity – the worst of the three – causes severe, disabling chronic pain and a body wracked with a myriad of other problems as well.

To help you determine which of these four-foot structures might be yours, following is an explanation of their structure, function, appearance, symptoms, prevalence and treatment.

Structure

A plantar grade foot is structurally stable. The calcaneus and talus bones have completed their normal development during pregnancy. These bones do not maintain an abnormal torsion (twist).

The Morton’s Foot (also known as Morton’s Toe and Greek Foot) was discovered by Dudley Morton. It has a congenital short first metatarsal bone, hypermobile (too much motion) first metatarsal segment and posteriorly located sesamoid bones.

The Rothbarts Foot (originally termed ‘Primus Metatarsus Supinatus’) was discovered by Professor/Dr. Brian A. Rothbart in 1988. It is an unstable, inherited abnormal foot structure – the result of an incomplete torsional development of the talus (the bone that sits on top of your heel bone).

The PreClinical Clubfoot Deformity was discovered by Professor/Dr. Brian A. Rothbart in 2002. Also an unstable inherited, abnormal foot structure, it has a more pronounced structural deformity than the Rothbarts Foot. Specifically; the Preclinical Clubfoot Deformity is the result of an incomplete torsional development of both the calcaneal (heel) and talar bones.

Function

A plantar grade foot is functionally stable. The first metatarsal head bears most of your body´s weight in preparation for pushing off the big toe as you walk. The bottom of your foot makes contact with the ground without twisting inward and downward (without abnormally pronating).

The Morton’s Foot has a first metatarsal that is shorter than the second metatarsal. When you walk, the body’s weight is automatically transferred to the longer second metatarsal head.

The Rothbarts Foot is not functionally stable. The big toe and adjoining first metatarsal are both elevated and twisted inwards relative to the ground when the rear foot (subtalar joint) is placed in its anatomical neutral (correct) position*.

As your body’s weight shifts from your heel to the front of your foot (standing or walking), gravity forces your elevated big toe and adjoining the first metatarsal to twist inward, forward and downward until they rest on the ground (abnormal pronation).

The PreClinical Clubfoot Deformity is not functionally stable. It produces more severe and prolonged foot twist (when you stand or walk) than a Rothbarts Foot.

The result of the incomplete ontogenetic development of the calcaneus and talus is that when your rear foot is placed in its anatomical neutral position*, both the inside bottom surface of your heel bone and big toe and its adjoining metatarsal, are elevated and inverted relative to the ground.

As your body’s weight lands on the heel, gravity forces your heel bone to twist inward and downward until the entire heel bone rests on the ground. This motion collapses the arch of your foot as your body’s weight is transferred to the front of your foot.  Gravity then forces the elevated big toe and adjoining metatarsal to roll inward, forward and downward until they also rest on the ground.

Note – Because the Rothbarts Foot and PreClinical Clubfoot Deformity can functionally look very similar, the only way to determine which of the two structures you actually have, is by running specific computer and video analyses.

Appearance

A plantar grade foot has no elevation of the big toe.  That is, when your foot is placed in its anatomical neutral position*, your big toe and adjoining metatarsal rest on the ground. Walking, there is no visible foot twist as the weight of your body is transferred from the heel bone, across the midfoot to the forefoot.

The Morton’s Foot has a big toe that is more than 2mm shorter than the second toe.

The Rothbarts Foot is not easy to see by simply looking at your feet. The elevated and inwardly twisted big toe and first metatarsal that characterize the Rothbarts Foot can only be seen when the (subtalar joint (rearfoot) is placed in its anatomical neutral position*.

The only way to 100% determine that you have a Rothbarts Foot is by looking at the bones inside your feet. Theoretically, a radiographic profile of the talar head and a protocol for measuring the talar head would provide a definitive diagnosis, but no such test has yet been developed.

However, there are signs that you may have a Rothbarts Foot, such as;


  1. Your responses to the questions in the Rothbarts Foot Questionnaire and in my patient profile (during your Initial Phone Consultation).
  2. The BioVector Measurement Test and the Three Minute Screening for Rothbarts Foot, both of which I developed, quantify (show) the presence of the elevated big toe and first metatarsal when your foot has been placed in its anatomical neutral position.* Only a qualified professional should run these tests.
  3. My computerized gait analyses rule in (or out) whether you walk in a certain way (consistent with the walking motion of a person with a Rothbarts Foot).


The PreClinical Clubfoot Deformity is also not easy to see by simply looking at your feet. The inwardly twisted and elevated calcaneus, first metatarsal and hallux (big toe) that characterizes the PreClinical Clubfoot Deformity can only be seen when the rearfoot (subtalar joint) is placed in its anatomical neutral position*.

The only way to 100% determine that you have a PreClinical Clubfoot Deformity  is by looking at the bones inside your feet. Theoretically, a radiographic profile of the posterior aspect of the calcaneus and talar head would provide a definitive diagnosis, but no such test has yet been developed.

However, there are signs that you may have a PreClinical Clubfoot Deformity, such as;

1. Your responses to the questions in the Rothbarts Foot Questionnaire and in my patient profile (during your Initial Phone Consultation).
2. The BioVector Measurement test quantifies the presence of the elevated big toe and first metatarsal when your foot has been placed in its anatomical neutral position.
3. My computerized gait analyses rule in (or out) whether you walk in a certain way (consistent with the walking motion of a person with a PreClinical Clubfoot Deformity).

Note – Because the Rothbarts Foot and PreClinical Clubfoot Deformity can visually look very similar, the only way to determine which of the two structures you actually have, is by running specific computer and video analyses.

Symptoms

If you have a plantar grade foot you will have healthy feet – free from foot pain, bunions, calluses, corns, hammer toes, neuromas and plantar fasciitis. You will also have good posture, and because of this, you’ll most likely never suffer with chronic musculoskeletal pain or other health problems that are caused by poor posture.

If you have a Morton’s Foot, you will have foot pain. This is because the second metatarsal head (due to its smaller size) is not meant to support the majority of the body’s weight. The results can be:


  1. Your body protects the (smaller and more fragile) second metatarsal head by building up callus tissue, which feels like a pebble imbedded in the skin and creates pain as you walk.
  2. The second metatarsal head may fracture because it’s not strong enough to take your body’s weight.
  3. The second metatarsal head might become inflamed.


Note – My research is consistent with Dr. Morton’s findings, in that the Morton’s Foot predominantly produces painful symptoms in the feet.  But recently, some internet sites (talking about the Morton’s Foot/Morton’s Toe) have cited Janet Travell’s earlier work, which suggests that Morton’s Foot is a common perpetuator of chronic muscle and joint pan throughout the entire body.

It needs to be clarified; when I worked with Travell in her later years, she told me that what she thought was Morton’s Foot, was in fact the Rothbarts Foot.  This is because; in a Morton’s Foot, the first metatarsal is shorter than the second metatarsal, and in a Rothbarts Foot, the first metatarsal is elevated and twisted inward (so it may appear shorter than the second metatarsal – when in actuality it is not).

If you have a Rothbarts Foot you may or may not have foot pain, but you will be predisposed to having poor posture. This bad posture leads to chronic muscle and joint pain, as well as other problems throughout your body.

If you have PreClinical Clubfoot Deformity your posture will be worse than if you have a Rothbarts Foot. The result is severe, debilitating chronic musculoskeletal pain and a myriad of chronic problems throughout your entire body.

Prevalence

The plantar grade foot is not very common. About 10% of the world population is lucky enough to have this foot structure.

The Morton’s Foot is relatively uncommon. Although Morton’s Foot is a disorder, many healthcare practitioners simply believe it to be a normal variant of foot shape, affecting 30-50% (depending on the author) of the population.

My experience has shown that it’s not a common variant of foot shape, but an uncommon foot abnormality; affecting approximately 10% of the population (more common in some parts of the world than others).

The Rothbarts Foot is a relatively common foot structure. According to my findings, based on 45 years of research and clinical experience, it affects approximately 15 – 20% of the world population.

The PreClinical Clubfoot Deformity is a common foot structure. My findings show that it affects upwards of 70% of the world population.

Treatment

The plantar grade foot – because it’s a healthy foot – needs no treatment or therapy.

The Morton’s Foot is treated by using an extension pad extending from the 1st metatarsal head, past the big toe. The experts in the treatment of Morton’s Foot, claim that the result is the reduction or elimination of foot pain.

The Rothbarts Foot can only be effectively treated by using Rothbart Proprioceptive Therapy. The length of therapy can be less than six months.  The result is permanent elimination of chronic muscle and joint pain, as well as other symptoms that were created by this foot structure.

The PreClinical Clubfoot Deformity can only be effectively treated by using Rothbart Proprioceptive Therapy. The length of therapy can be between twelve and eighteen months. The result is the permanent elimination of chronic muscle and joint pain, as well as other symptoms that were created by this foot structure.

You may have found your foot structure in one of the four above.  If you think you may have a Rothbarts Foot or PreClinical Clubfoot Deformity, you’ll find the solution to your chronic pain problem on this site.

*   Anatomical neutral position – The subtalar joint is in its anatomical neutral position when its joint spaces from front to back and side to side are uniform and even. That is, there is no deviation or variance in the thickness of the joint space from side to side and front to back.


Reading the Curing Chronic Pain website will give you more information about the abnormal foot structures Professor/Dr. Rothbart discovered that cause many forms of chronic muscle and joint pain and help you determine whether an Initial Phone Consultation with him might be helpful.

Three Foot Structures That Cause Chronic Pain

The type of foot (the foot structure) you were born with greatly determines the health of your entire body, as foot structure has the potential to cause chronic pain.

A plantar grade foot (what you would think of as being a ‘normal’ foot) is linked to having a healthy body, including healthy muscles and joints. Whereas three other foot structures can cause all kinds of problems, from mild to debilitating: