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In 2002, a paper was published (Rothbart 2002) in the Journal of Bodywork and Movement Therapies describing a previously unreported embryological foot structure, the Primus Metatarsus Supinatus foot structure (AKA Rothbarts Foot).  The etiology of this foot structure is linked to an incomplete embryological development of the talar head (the bone that sits on top of the heel bone).

3 Minute Screening

Below is a screening protocol to determine the level of confidence (LC) of whether the Rothbarts Foot is present or not:

  • (1)  A positive Knee Bend Test indicated by an inward and downward twisting of the ankle when the knees are bent (see animation below).
  • (2)  Uneven wear patterns in the heels and/or soles of the shoes (see animation below).
  • (3)  A deep 1st web space


Interpretation of Findings:

  • If one of the three screening tests is positive, there is a 65% Level of Confidence that the individual has Rothbarts Foot.
  • If two of the three screening tests are positive, there is a 75% Level of Confidence that the individual has Rothbarts Foot.
  • If all three of the the screening tests are positive, there is a 85% Level of Confidence that the individual has Rothbarts Foot.


[1] Positive Knee Bend Test

KBT Kn Str
















KBT Kn Bent
















Valgus rotation (pronation) of the heel bones only with knees bent


[2]  Uneven wear patterns on the soles of your shoes

Uneven Shoe Wear Patterns

















[3]  Deep 1st Web Space

Deep Web space















Gold Standard for determining the presence of Rothbarts Foot (or not):

Measure the Primus Metatarsus Supinatus Value (PMs Value).  The protocol for taking this measurement is described in  Medial Column Foot Systems: An Innovative Tool for Improving Posture, or on my research blog.  

False Negative can occur with a plantarflexed first ray.

Rothbart BA, 2002. Medial Column Foot Systems: An Innovative Tool for Improving Posture. Journal of Bodywork and Movement Therapies (6)1:37-46

Gold Standard for RF

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