An Abductory twist is a sign of gait which is frequently seen by physical therapists. Lots of people when they are walking, as soon as the rearfoot lifts up off the ground there is a sudden and small motion of the rearfoot medially (abduction). Many physical therapists usually do not consider this to be of much relevance because it is simply a sign of an underlying issue instead of a problem on its own.

There are several causes of this abductory twist. The first is that the big toe joint must dorsiflex or bend just as the heel lifts up off the ground so that we can move ahead. If that joint doesn't want to bend, then the foot will abduct to bypass the block at the joint. Another prevalent cause is overpronation of the foot. This is when the foot is rolling inwards at the ankle joint and the lower leg is externally rotating attempting to roll the foot outwards. When the heel comes off the ground the foot suddenly abducts due to the twisting.

A medial heel whip is another entity that does get confused with an abdutcory twist, but they are distinct. The twist occurs just as the heel lifts up off the ground and the whip is more of a circumduction of the whole foot as it comes of the ground. While the twist and whip are in a similar course, they are very different things and brought on by distinct problems.

The abductory twist does not have to be treated as it is no problem by itself. It is due to something and that something is the cause of the problem, so that needs managing as opposed to just the abductory twist. The therapy will have to be directed at either the reason for a block in motion at the great toe or the reason for the overpronation of the foot. This means that the therapy usually takes on a variety of possible alternatives, so there isn't any one strategy for this.




Biomechanics of abductory twist