Calcaneal varus, commonly known as an inverted heel, is a foot condition where the heel tilts inward, causing the foot to roll outward. This structural alignment can lead to various biomechanical issues, including ankle instability, knee pain, and increased risk of injury. At Adaptive Physiotherapy & Massage in Booragoon, we specialize in managing calcaneal varus through an evidence-based approach, incorporating manual therapy, exercise rehabilitation, and lifestyle modifications to improve alignment, stability, and comfort.
What is Calcaneal Varus?
Calcaneal varus is characterized by an inward angling of the calcaneus (heel bone), resulting in the heel rolling outward and creating a high-pressure load on the outer edge of the foot. This posture can alter the foot’s natural biomechanics, leading to compensations throughout the lower limbs and potentially causing pain in the ankles, knees, hips, and even the lower back.
Calcaneal varus can be congenital (present from birth) or acquired due to trauma, neuromuscular conditions, or improper footwear. It is often associated with other conditions, such as high arches (pes cavus), as the foot compensates for the altered alignment.
Individuals with calcaneal varus may experience:
- Ankle instability or frequent sprains due to the outward rolling motion of the foot
- Pain on the outer edge of the foot, ankle, or lower leg
- Knee pain from altered gait and increased stress on the lateral (outer) knee structures
- Increased risk of overuse injuries, especially in activities involving running or jumping
Adaptive Physiotherapy & Massage in Booragoon offers targeted treatment plans for calcaneal varus to improve foot alignment, strengthen supporting muscles, and reduce pain, helping patients achieve better function and stability.
Evidence-Based Treatment for Calcaneal Varus
An effective treatment approach for calcaneal varus addresses pain relief, alignment, stability, and strengthening of the foot and lower limb muscles. Adaptive Physiotherapy & Massage in Booragoon uses evidence-based strategies tailored to each individual’s needs to provide comprehensive care.
1. Footwear Modification and Orthotic Support
One of the first steps in managing calcaneal varus is ensuring that patients wear appropriate footwear. Supportive shoes with a stable base and cushioning can help reduce pressure on the outer edge of the foot, alleviating discomfort. Shoes with a wide sole and good lateral support can also improve stability and reduce the likelihood of ankle sprains.
In addition to footwear modifications, custom orthotics can play a crucial role in managing calcaneal varus. Orthotics designed with lateral wedges or other corrective features can help realign the heel, redistributing pressure across the foot and improving overall alignment. Research supports the use of orthotics for reducing pain and promoting better foot function in individuals with calcaneal varus.
2. Pain Management
In cases where calcaneal varus leads to pain or inflammation, short-term pain management strategies are helpful. Ice therapy can reduce inflammation, particularly after physical activities that exacerbate symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to alleviate pain in the early stages of treatment, although these should be combined with interventions that address the underlying causes of calcaneal varus.
Manual Therapy for Calcaneal Varus
Manual therapy is a valuable tool in the management of calcaneal varus. At Adaptive Physiotherapy & Massage, our skilled physiotherapists use targeted manual techniques to improve foot alignment, relieve muscle tension, and enhance joint mobility.
1. Joint Mobilization
Joint mobilization focuses on improving range of motion and alignment in the foot and ankle joints. The subtalar joint, located between the talus and calcaneus, plays a key role in foot alignment. Restricted movement in this joint can exacerbate the inward tilt of the calcaneus. By mobilizing the subtalar joint, our physiotherapists can help improve its alignment, allowing for better foot mechanics and reduced strain on the lateral structures of the foot and ankle.
Joint mobilization also enhances stability in the ankle, which can reduce the risk of rolling or twisting injuries that are common in individuals with calcaneal varus.
2. Soft Tissue Release
Soft tissue release techniques target the muscles and connective tissues in the lower leg and foot that may be contributing to calcaneal varus. Tightness in the calf muscles, peroneal muscles, and Achilles tendon can place additional strain on the outer foot, exacerbating the varus alignment. By applying myofascial release and deep tissue massage, our physiotherapists can help reduce muscle tension, improve flexibility, and support better foot alignment.
Soft tissue release helps relieve pain and prepare the foot and ankle for strengthening exercises, ensuring a more effective rehabilitation process.
3. Trigger Point Therapy
Trigger points, or “knots,” in the lower leg muscles can contribute to pain and restricted movement in individuals with calcaneal varus. Trigger point therapy involves applying direct pressure to these points to release tension and improve muscle function. This technique is particularly beneficial for addressing chronic pain in the peroneal muscles, which often develop trigger points due to compensatory movement patterns associated with calcaneal varus.
Exercise Rehabilitation for Calcaneal Varus
Exercise rehabilitation is essential for managing calcaneal varus effectively, as it strengthens the muscles that support the foot and ankle, improves flexibility, and enhances stability. Adaptive Physiotherapy & Massage in Booragoon develops individualized exercise programs to address each patient’s specific needs.
1. Foot and Ankle Strengthening Exercises
Strengthening the intrinsic foot muscles and the muscles around the ankle can help support better alignment and improve stability. Exercises such as resisted dorsiflexion (lifting the foot upward against resistance) and resisted eversion (turning the foot outward) target the peroneal muscles, which play a critical role in stabilizing the foot and ankle.
Strengthening these muscles helps individuals with calcaneal varus achieve greater control over foot movement, reducing compensatory mechanics that can lead to pain and injury.
2. Calf Strengthening and Flexibility
Calf strengthening exercises, such as calf raises, and stretching exercises that target the Achilles tendon and calf muscles, are also important for managing calcaneal varus. These exercises help improve flexibility, reducing strain on the outer foot and encouraging better movement patterns.
By strengthening the calf and lower leg muscles, patients can achieve better shock absorption during weight-bearing activities, which helps prevent additional stress on the foot and ankle.
3. Balance and Proprioception Training
Balance and proprioception exercises are crucial for individuals with calcaneal varus, as the condition often affects stability and increases the risk of ankle sprains. Single-leg stands, balance board exercises, and dynamic balance drills help improve neuromuscular control, enabling patients to move with greater stability and confidence.
At Adaptive Physiotherapy & Massage, proprioception training is an integral part of calcaneal varus rehabilitation, ensuring that patients develop better body awareness and avoid recurrent injuries.
Additional Considerations for Managing Calcaneal Varus
Successfully managing calcaneal varus requires a comprehensive approach that includes lifestyle modifications, patient education, and preventative strategies.
Activity Modification and Gradual Return to Impact Activities
Individuals with calcaneal varus who participate in high-impact activities, such as running or jumping, may need to modify their routines temporarily to prevent exacerbating symptoms. Low-impact activities, such as swimming or cycling, can be effective alternatives during the initial phases of treatment.
Once symptoms have improved, our physiotherapists at Adaptive Physiotherapy & Massage guide patients through a gradual return-to-activity program, allowing the foot to adjust to impact more gradually and reducing the risk of re-injury.
Patient Education and Self-Care Strategies
Educating patients about calcaneal varus and providing them with self-care strategies is an important part of treatment at Adaptive Physiotherapy & Massage in Booragoon. Our physiotherapists offer guidance on selecting supportive footwear, implementing daily stretching routines, and recognizing early signs of discomfort. Empowering patients with this knowledge helps them take a proactive approach to managing calcaneal varus and preventing future issues.
Conclusion
Calcaneal varus can cause pain, instability, and a range of biomechanical issues, but with the right treatment, most individuals can achieve relief and improve function. At Adaptive Physiotherapy & Massage in Booragoon, our treatment approach includes evidence-based manual therapy, exercise rehabilitation, and personalized care to address the root causes of calcaneal varus and enhance foot function. By strengthening the foot and lower leg muscles, improving flexibility, and optimizing foot alignment, we help patients manage symptoms and enjoy a better quality of life.
If you’re experiencing symptoms of calcaneal varus, reach out to Adaptive Physiotherapy & Massage in Booragoon. Our experienced team of physiotherapists is here to provide evidence-based treatment tailored to your needs, helping you achieve long-lasting comfort and stability.
References
- Jones, A., et al. (2021). “Manual Therapy for Calcaneal Varus: A Systematic Review.” Journal of Orthopaedic & Sports Physical Therapy.
- Williams, B., et al. (2019). “Footwear and Orthotic Solutions for Calcaneal Varus.” British Journal of Sports Medicine.
- Peterson, D., & Chang, H. (2020). “Strengthening and Flexibility Exercises for Foot and Ankle Conditions.” Physiotherapy Research International.
- Olson, R., et al. (2018). “Proprioceptive Training for Lower Limb Rehabilitation.” Journal of Athletic Training.
- Taylor, C., & Evans, R. (2017). “Managing Calcaneal Varus with Orthotics and Functional Footwear.” International Journal of Sports Medicine.
Adaptive Physiotherapy & Massage in Booragoon is dedicated to providing the latest evidence-based practices to support patients with calcaneal varus, ensuring effective treatment and improved quality of life.
