The Subtalar Joint
Last week I wrote a post about how the foot is complex yet simple to treat. Did you read it?
If you haven’t you can by Clicking Here.
Anyways…
I learned a long time ago during my fellowship with the Gray Institute to always check the subtalar joint.
This is because the subtalar joint “sets-up” or “controls” much of what happens at the rest of the foot and even body.
This joint is often misunderstood and neglected clinically because many don’t know the importance nor how to assess and treat this joint.
In this post….
I’ll show you just that.
[headline style=”1″ align=”center” headline_tag=”h2″]Anatomy Of the Subtalar Joint
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[img_text_aside style=”1″ image=”https://www.scottgraypt.com/wp-content/uploads/2017/08/Greys-Anatomy-.jpeg” image_alignment=”right” headline=”The%20Subtalar%20Joint%20″ alignment=”center”]The subtalar joint consists of three facet articulations. It’s primary motions are pronation and supination but usually the transverse and sagittal plane is negible. For this reason, inversion and eversion are usually also adopted to describe its motion.
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[headline style=”1″ align=”center” headline_tag=”h2″]Assessing the Subtalar Joint
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When assessing the subtlar joint you need to keep in mind some patient’s will have less motion while others may have excessive.
This is because the joint articulation of the subtalar joints aren’t the same.
For this reason, don’ get caught up in the TOTAL amount of motion. Rather ….
Look for a 2:1 ratio of inversion to eversion.
If your patients have this then the subtalar joint is moving optimally. If your patient’s don’t, then you will need to mobilize their joint.
Something else to keep in mind is that although mainly inversion and eversion occurs at this joint, don’t forget that the axis of motion may lie more in the transverse plane. Hence, you may want to adduct or abduct the calcaneus instead. This is rare based on my clinical experience.
I found this information in Merton Root’s classic text. If you’re interested in learning some of this information you can check it our by Clicking Here.
[headline style=”2″ align=”center” headline_tag=”h2″]Functional Assessment
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Here are some quick ways to assess the foot functionally and non-functionally.
[headline style=”2″ align=”center” headline_tag=”h2″]Table Assessment:
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[headline style=”1″ align=”center” headline_tag=”h2″]Treating the Subtalar Joint
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[headline style=”1″ align=”center” headline_tag=”h2″]Exercise Strategies For the Subtalar Joint
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Now that you have gained the mobility of the subtalar joint, you will need to use this new motion to keep it.
Here are a few that you can use for your HEP’s.
Key point: as long as you know what you’re after, you can create your own exercise strategy. Relate it back to your patient’s function.
[headline style=”1″ align=”center” headline_tag=”h2″]Concluding Thoughts On the Subtalar Joint
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There you have it….
How you should assess and treat the subtalar joint.
It really isn’t that complex is it?
Be sure to always assess this joint first when treating foot, ankle, knee, or hip dysfunction.
