Flexible Plantarflexed 1st Ray

A displacement of the 1st metatarsal bone below the level of the other metatarsal bones.

A first metatarsal bone is one whose neutral position is below the level of the lesser metatarsals, but can be moved back to or above that level by some force applied to its plantar aspect. Off weight-bearing examination produces the appearance of forefoot valgus. This type of foot functions like a subtalar varus or forefoot varus type deformity as the compensation takes place by dorsiflexing the 1st ray with subtalar joint pronation.

Clinical observations and symptoms

Dorso-medial bunion; hammer toes, HD 5th toe; leg fatigue; low back pain; plantar fasciitis; lateral knee pain.