Forefoot supinatus is a common foot type in which the forefoot is inverted relative to the rearfoot. In comparison o a bony foefoot varus, the supinatus is a soft tissue contracture.

Forefoot supinatus is a positional deformity of the forefoot, commonly seen in patients with flatfoot (pes planus) or other structural imbalances. It refers specifically to the inversion (upward and inward tilt) of the forefoot relative to the rearfoot, not due to a bony abnormality but rather due to soft tissue adaptation. It’s often a flexible deformity, meaning that the bones are not fixed in this position and the forefoot can be manually corrected to a neutral or pronated position. This makes it different from rigid forefoot varus, which is a structural and non-reducible condition.

The key thing with forefoot supinatus is that it’s usually a compensatory mechanism. When someone has excessive rearfoot pronation—basically, their heel rolls inward too much during walking—the forefoot can adapt by inverting to try and keep the medial column (the inner part of the foot) in contact with the ground. Over time, soft tissues on the lateral (outer) side of the forefoot can tighten, leading to a maintained supinated position even when the person is non-weight bearing. This is often assessed clinically by checking the flexibility of the forefoot in a non-weight-bearing position.

Diagnosing forefoot supinatus involves a combination of physical examination and sometimes gait analysis. A podiatrist or orthopedist might look at the subtalar joint, assess rearfoot and forefoot alignment, and determine whether the forefoot can be corrected manually to a neutral or pronated position. A positive “Hubscher maneuver” (also known as the Jack test) can indicate flexibility in the arch, which may help distinguish supinatus from more rigid deformities. It’s also important to differentiate it from forefoot varus, as the treatment approach differs significantly.

Treatment for forefoot supinatus focuses on addressing the root cause, typically the excessive rearfoot pronation. Custom foot orthoses with medial arch support and possibly forefoot posting can help realign the foot and offload stress from compensatory structures. In some cases, stretching and strengthening exercises are prescribed to restore muscular balance and improve flexibility. Since the condition is positional and soft-tissue based, early intervention can often correct or significantly improve the deformity without the need for surgery.

Most Useful Resources:
Forefoot Supinatus (PodiaPaedia)
Help needed with forefoot supinatus? (Podiatry Arena)
Forefoot Supinatus (Foot Health Forum)
Student with questions on forefoot varus and supinatus (Podiatry Arena)
The effect of forefoot varus on the hip and knee and the effect of the hip and knee on forefoot supinatus … (Running Research Junkie)