Treatment of Instability of the First Ray:
New Strategies Using Applied Biomechanics in Clinical Practice

Douglas Richie, Jr, DPM

Douglas Richie, Jr, DPM
Clinical Associate Professor
California School of Podiatric Medicine
at Samuel Merritt University
Oakland, CA


Instability or dysfunction of the first ray is involved in more pathologies than any other segment of the human foot. Hallux abductovalgus, hallux rigidus, hammertoes, metatarsalgia and flatfoot deformity are all commonly associated with first ray dysfunction. This webinar will present the latest research on the pathomechanics of first ray pathologies and will dispel many accepted myths and misconceptions about this critical segment of the human foot. Practitioners can use this information to implement conservative and surgical treatment interventions which enhance stability of the first ray and optimize function of the foot during ambulation.

Learning Objectives:

  1. Review the kinematics of the medial column of the foot including specific joint rotations during loading and locomotion.
  2. Provide the latest information of the pathomechanics of hallux abductovalgus, hallux rigidus, and functional hallux limitus.
  3. Discuss the link between first ray instability and digital deformities, plantar plate pathology and metatarsalgia.
  4. Review results of surgical procedures intended to treat instability of the first ray.
  5. Introduce novel orthotic interventions designed to enhance stability of the first ray and effectively treat forefoot pathologies.
This Webinar is Approved for 1 CECH Credit Hour
PRESENT e-Learning Systems is approved by the Council on Podiatric Medical Education as a provider of continuing education in podiatric medicine. PRESENT e-Learning Systems has approved this activity for a maximum of 1 continuing education contact hour.

This free webinar is supported by an educational grant from: