The abductory twist is an observation made during a gait analysis

An Abductory Twist is a sign of the way we walk which is often seen by podiatrists. Many people when they are walking, as soon as the heel lifts up off the ground there is a sudden and small movement of the rearfoot medially abduction. Many clinicians don't look at this to be of much importance since it is only a sign of an underlying problem rather than a disorder by itself.

There are numerous causes of this abductory twist. The first is that the great toe or hallux joint must dorsiflex or bend just as the rearfoot lifts up off the ground so that we can move ahead. If that joint doesn't want to flex, then the foot will abduct to circumvent the block at the joint. Another prevalent cause is overpronation of the foot. This is where the foot is rolling inwards at the rearfoot and the leg is externally rotating wanting to roll the foot outwards. As soon as the heel lifts up off the ground the foot abruptly abducts due to the twisting.

A medial heel whip is another entity that does get confused with an abdutcory twist, however they are distinct. The twist occurs just as the heel lifts up off the ground and the whip is more of a circumduction of the whole foot as it comes of the ground. While the twist and whip are in a similar course, they are very different things and caused by distinct issues.

The abductory twist doesn't need to be treated because it is no problem by itself. It is a result of something and that something is the reason for the problem, so that needs managing as opposed to just the abductory twist. The treatment will need to be directed at either the cause of a block in movement at the great toe or the cause of the overpronation of the foot. Consequently the treatment might take on many different possible options, so there isn't any one treatment for this.