First Ray positions

First Ray positions:
The plantar surface of the first metatarsal heads should normally be on the same plane as the lessor metatarsals.


The neutral position is considered midway in its range of motion.

Clinical use:
• if first ray elevated  dorsiflexed first ray (metatarsus primus elevatus) or forefoot supinatus
• if first ray is plantarflexed  plantarflexed first ray (congenital or acquired), forefoot valgus or dorsiflexed lateral rays

Sources of error:
• STJ not in neutral and MTJ not pronated
• unequal amounts of pressure to dorsiflex and plantarflex the first ray

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