The Rothbarts Foot Questionnaire is like a prescreening. By asking questions about symptoms that may be occurring in your body, it helps you determine if you may have a Rothbarts Foot or PreClinical Clubfoot Deformity.
My purpose in this post is to educate you a bit on the science behind the specific questions in the Rothbarts Foot Questionnaire so that you can better understand the connection between your feet and the symptoms you are experiencing.
In order to understand the questions on the questionnaire, we need to start with a basic understanding of the Rothbarts Foot and PreClinical Clubfoot Deformity.
The Rothbarts Foot is the result of an incomplete torsional development of the talus (the bone that sits on top of the heel bone) that occurs in the womb. Due to this incomplete development, the big toe and its’ adjoining metatarsal are structurally inwardly twisted. This causes the big toe to be elevated off the ground when the foot is placed into its’ anatomical neutral (correct) position.
Because of the elevated big toe; as you stand or walk, a rotation occurs within the subtalar joint (referred to as abnormal pronation) causing the entire foot to abnormally rotate inward, forward and downward until the big toe and adjoining metatarsal rests on the ground. This is known as foot twist.
The PreClinical Clubfoot Deformity is the more severe abnormal foot structure, in which the calcaneus (heel), talus (bone sitting on top of the heel) and metatarsals (bones in the front part of the foot) are structurally inwardly twisted.
When weight is applied to this foot, gravity forces the heel bone to rotate until the entire bottom surface of the heel bone rests on the ground. The rotation then continues in the subtalar joint (abnormal pronation) until the big toe and first metatarsal rest on the ground. This can be seen as a severely dropped or flat inner arch and is the hallmark of a PreClinical Clubfoot Deformity.
Both the Rothbarts Foot and the PreClinical Deformity force the feet to abnormally pronate. It is this abnormal pronation that results in chronic pain and many of the symptoms you will see on the Rothbarts Foot Questionnaire.
Understanding What’s Behind Your Chronic Pain Symptoms
Are the heels on my oldest pair of shoes worn unevenly?
If the bottom of your heels is worn unevenly, this means that your heel to toe motion is twisted.
If you have a Rothbarts Foot or PreClinical Clubfoot Deformity your heels will twist, typically first to the outside and then to the inside. This is reflected in the uneven heel wear pattern (more worn on one side than the other).
Do I have calluses on the bottom of my feet?
Calluses on the bottom of your feet is the result of shearing (rubbing back and forth). Shearing occurs when the foot twists. The location and severity of the callus formation and how quickly it builds is an indication of how your foot is moving.
If you have a Rothbarts Foot or PreClinical Clubfoot Deformity your feet will most likely have callus buildup underneath the heel bone and underneath the metatarsal heads (ball of the foot).
Do I have bunions?
Bunions are the result of forefoot instability (the joints in the front of the foot move around too much). One of the main causes of forefoot instability is excessive subtalar joint pronation. (i.e. the joint under the ankles moves too forward, too inward and too downward). When the back of the foot moves too much, the front of the foot moves too much.
Both the Rothbarts Foot and PreClinical Clubfoot Deformity produce significant abnormal subtalar joint pronation, which frequently results in a bunion.
Do I have a forward head position?
Head motion and foot motion are linked. A forward position of the head is frequently the result of an excessive forward rotation in the subtalar joint in the feet.
A forward head position is a common result of having a Rothbarts Foot or PreClincal Clubfoot Deformity.
Do I have bad posture?
Bad posture is an indication of excessive subtalar joint pronation. When the subtalar joint is excessively moving forward, inward and downward, all the weight-bearing joints above the foot will move excessively forward, inward and downward. This produces a mal-alignment within these joints, the result is referred to as bad posture.
Excessive subtalar joint pronation (and the resulting bad posture) is frequently caused by the Rothbarts Foot and PreClinical Clubfoot Deformity.
Do I have scoliosis?
Scoliosis is a condition in which the spine is excessively curved from side to side and the individual vertebrae are abnormally twisted (relative to one another). The excessive curving and abnormal twisting of the spine can be the result of an excessive inward rotation occurring within the subtalar joint.
The excessive inward rotation of the subtalar joint (and resulting scoliosis) is frequently caused by the Rothbarts Foot and PreCinical Clubfoot Deformity.
Was I clumsy or awkward as a child? and Do I Have Poor Balance?
Within the temporal bone lies the inner ear balance center (labyrinth). This balance center contains three fluid containing sacs (semicircular canals). When your head moves, the fluid in these sacs moves; placing pressure on the hairs within your inner ears. This pressure produces a pattern of stimulation that sends signals to the cerebellum regarding the position of your head and body relative to the ground. The cerebellum acts on these signals to help your body maintain your balance.
The inner ear balance center sits level to the ground when the ears are level to the ground. If you have a Rothbarts Foot or PreClinical Clubfoot Deformity, your abnormal foot pronation unlevels your ears (relative to the ground), which, in turn, distorts the position of the inner ear balance center.
This distortion results in distorted (faulty) signals being sent from the inner ear to the cerebellum. The cerebellum acts on these faulty signals and this results in an unstable, unbalanced position of the body (poor balance).
Typically this produces a clumsy or awkward gait in a child. In time the child learns to compensate for this inner ear imbalance and their gait becomes less clumsy as they get older.
Are my shoulders rounded?
The body, in a gravitational field, follows the motion of the feet. When your feet twist (rotate) forward and inward, your body’s position shifts forward and your shoulders rotate forward and inward (they become rounded).
The Rothbarts Foot and PreClinical Clubfoot Deformity cause the feet to twist (rotate) forward and inward, resulting in rounded shoulders.
Do I have crooked teeth? and Did I wear braces to straighten my teeth?
Abnormal pronation can shift the position of the maxilla and result in a malocclusion (unlevel bite) and crooked teeth.
The Rothbarts Foot and PreClinical Clubfoot Deformity produce abnormal pronation, which moves the temporal bone, which moves the sphenoid bone, which moves the maxilla. The exact mechanism of how this happens has not yet been determined.
Do I have a tipped pelvis (swayback)?
Downward and forward rotation of the foot (abnormal pronation) draws the hips forward and downward, creating a tipped (unlevel) pelvis, known as swayback.
The most common patterns are:
- The left foot is more pronated than the right foot and the left hip bone is rotated forward (relative to the right hip).
- The right foot is more pronated than the left foot and the right hip bone is rotated forward (relative to the left hip).
The Rothbarts Foot and PreClinical Clubfoot Deformity cause abnormal pronation, resulting in a sway back.
When I walk with someone side by side, do I have a tendency to bump into them?
Because abnormal pronation causes the foot to twist when you walk, it will be difficult for you to walk in a straight line. You will have a tendency to veer off to one side or the other.
The most common veering patterns seen with abnormal pronation are:
- The left foot is more pronated than the right foot and you will have a tendency to bump into people on the left side of your body.
- The right foot is more pronated than the left foot and you will have a tendency to bump into people on the right side of your body.
Has my chiropractor told me that I have one leg shorter than the other?
Abnormal pronation can rotate the hip bone forward, which, in turn, elevates the acetabulum (hip socket). This elevation of the hip socket can result in a functionally short leg.
The most common patterns seen with abnormal pronation are:
- The left foot is more pronated than the right foot and the left leg functions shorter (clinically diagnosed as a left functional leg length discrepancy) and
- The right foot is more pronated than the left foot and the right leg functions shorter (clinically diagnosed as a right functional leg length discrepancy).
One leg shorter than the other (a result of abnormal pronation) is frequently caused by the Rothbarts Foot and PreClinical Clubfoot Deformity.
Do I have pains that come and go in different joints?
Pain coming and going in different joints is common if you have a Rothbarts Foot or PreClinical Clubfoot Deformity because these abnormal foot structures distort the posture (misalign the joints) and over time will cause inflammation and pain in practically every joint of the body.
Initially, the pain will come and go depending on your activity levels, nutrition, stress levels and overall health. However, as the joint inflammation becomes more severe, the pain becomes more constant and severe with fewer and shorter remissions.
Do I prefer to walk barefoot around the house?
Abnormal pronation causes the foot to twist. When the foot twists it becomes wider and longer as the day wears on, causing shoe wear to be increasingly uncomfortable.
Do I have tight and/or stiff muscles?
Stiff muscles (hypertonicity) are a compensation that the muscles undergo in order to maintain an upright posture in the presence of foot twist.
I hope that the above information has given you a better understanding of the reasons for your chronic pain symptoms and a better understanding of how the Rothbarts Foot and PreClinical Clubfoot Deformity cause them to occur.
Understanding The Symptoms Of Your Chronic Pain
If you find your efforts in looking for an answer on how resolve your chronic pain have been proven futile, this is because so few doctors recognize and have been trained to screen for two common abnormal foot structures that cause chronic muscle and joint pain – the Rothbarts Foot and PreClinical Clubfoot Deformity
So rather than waiting for your doctor to get some education on the subject, it’s probably a good idea to educate yourself. A good place to start is with the Rothbarts Foot Questionnaire.