Forefoot Supinatus
An acquired, flexible inversion of the forefoot on the rearfoot: soft tissue that has adapted to years of rearfoot pronation, not a fixed osseous deformity. The strategy is to control the cause at the heel and let the medial column come back down, never to prop the deformity up.
The rearfoot corrections are modeled into the heel seat over the flat printed base. Critically, the top surface under the medial forefoot is kept low: the first ray must be free to plantarflex and find the ground as the supinatus stretches out.
What you'll see
- Forefoot inverted on the rearfoot with the subtalar joint held neutral
- Reducible on exam: the inversion gives under load, unlike a rigid forefoot varus
- A chronically pronating rearfoot underneath it: the driver
- Medial column symptoms: functional hallux limitus, first-ray hypermobility
- Frequently found alongside PTTD and adult-acquired flatfoot
The modifier package
Worth considering
Clinical note
The trap with supinatus is posting it like a true forefoot varus: a full medial forefoot wedge holds the soft tissue in its shortened position and makes the deformity permanent. Because the Rx is a file, tapering the forefoot support down at each reorder takes seconds, so plan for it. If the inversion is rigid and non-reducible, treat it as forefoot varus and post it deliberately instead.
Every template is a starting prescription, not a constraint. Each parameter stays fully editable in Rx Studio before you send the order.