Forefoot Varus


Forefoot varus is apparent when the hindfoot and ankle are in neutral alignment and the ball of the foot is not. The forefoot varus condition is such that the 1st toe joint is positioned off the ground.  As body weight transfers onto the 1st toe joint, the ankle rolls inward and downward. This causes overpronation (rolling in) of the foot.


The most common symptoms associated with forefoot varus include:

  • Pain in the heel and ball of the foot and arch.
  • Ankle pain.
  • Achilles tendon pain.
  • Shin splints / shin pain.
  • Muscle fatigue in lower leg (shin calf).
  • Knee pain
  • Generally start with mild symptoms but progress with age and activity.

The most common causes of forefoot varus include:

  • Present from birth (congenital) – bony block in the mid-tarsals (arch) of the foot.
  • Acquired forefoot varus – bony block due to trauma or injury.

Orthotics (Orthoses) – Must be prescribed by a physician
It is imperative that the orthotics have a forefoot post.  An over the counter insole will not correct this condition.
Custom made orthotics support the skeleton, muscles and fascia in the correct position. Orthotics are a long- term solution to prevent reoccurrence by controlling and / or correcting the mechanics that cause the problem. Orthotics for forefoot varus should include:

  • Heel cup and medial longitudinal arch support to align forefoot to hindfoot.
  • Posting or wedging under the 1st metatarsal head.



Footwear including therapeutic and orthopaedic shoes, are integral to the treatment process. Certified Pedorthists are trained to fit patients with appropriate footwear. BioPed offers many types of footwear into which an orthotic device may be placed or worn alone.