Anglia Ruskin University
Morgan_et_al_2022.pdf (1.68 MB)

Is the Planus Foot Type Associated With First Ray Hypermobility?

Download (1.68 MB)
journal contribution
posted on 2023-07-26, 15:44 authored by Oliver J. Morgan, Rajshree Hillstrom, Robert Turner, Jonathan Day, Ibadet Thaqi, Kristin Caolo, Scott Ellis, Jonathan T. Deland, Howard J. Hillstrom
Background: Many foot pathologies have been associated with foot type. However, the association of first ray hypermobility remains enigmatic. The purpose of this study was to investigate first ray hypermobility among participants with planus and rectus foot types and its influence on static measures of foot structure. Methods: Twenty asymptomatic participants with planus (n = 23 feet) and rectus (n = 17 feet) foot types were enrolled. Several parameters of static foot structure (arch height index, arch height flexibility, first metatarsophalangeal joint flexibility, and first ray mobility) were measured. Participants were further stratified into groups with nonhypermobile (n = 26 feet) and hypermobile (n = 14 feet) first rays. First ray mobility ≥8 mm was used to define “first ray hypermobility”. Generalized estimating equations, best-fit regression lines, and stepwise linear regression were used to identify significant differences and predictors between the study variables. Results: Overall, 86% of subjects categorized with first ray hypermobility exhibited a planus foot type. Arch height flexibility, weightbearing first ray mobility, and first metatarsophalangeal joint flexibility showed no significant between-group differences. However, weightbearing ray mobility and first metatarsophalangeal joint laxity were associated with partial weightbearing first ray mobility, accounting for 38% of the model variance. Conclusion: The planus foot type was found to be associated with first ray hypermobility. Furthermore, weightbearing first ray mobility and first metatarsophalangeal joint laxity were predictive of partial weightbearing first ray mobility, demonstrating an interaction between the translation and rotational mechanics of the first ray. Clinical Relevance: Association of first ray hypermobility with foot type and first metatarsophalangeal joint flexibility may help understand the sequela to symptomatic pathologies of the foot.



  • Yes



Issue number


Page range


Publication title

Foot and Ankle Orthopaedics





File version

  • Published version


  • eng

Legacy posted date


Legacy creation date


Legacy Faculty/School/Department

Faculty of Health, Education, Medicine & Social Care

Usage metrics

    ARU Outputs


    No categories selected