Lecture 1 - Subtalar Joint

Question 1

Purpose of the Subtalar Joint

Answer 1

Allows for shock absorption during gait

Question 2

Location of Subtalar

Answer 2

Articulation between the Talus and the Calcaneus

facets
Anterior
Middle
Posterior

Question 3

Limits inversion and eversion but mostly eversion

Answer 3

Interosseous ligament

Question 4

Limits inversion

Answer 4

Cervical ligament

Question 5

STJ Axis

Answer 5

42˚ inclination from the transverse plane

16˚ medial deviation from sagittal plane

Question 6

STJ normal motion

Answer 6

Almost equal ration of inversion-eversion to abduction-adduction.

Little dorsiflexion-plantarflexion available comparatively

(3:1)transverse and frontal: sagittal

Has triplanar motion due to motion in all planes
Pronation and supination

Question 7

Open Kinetic Chain

Inversion, plantarflexion and adduction

Answer 7

Supination

Question 8

Open Kinetic Chain

Eversion, dorsiflexion and abduction

Answer 8

Pronation

Question 9

The subtalar joint _____during 1st half of OKC during gait

Answer 9

Pronates

-This allows for ground clearance

Question 10

During last half of OKC it starts to ______

Answer 10

Supinate

-STJ is in neutral just before heel strike

Question 11

At heel strike, STJ is _______

Answer 11

Supinated

Question 12

Closed Kinetic Chain

Answer 12

• during stance phase of gait

- Will only externally see inversion and eversion of calcaneus

Question 13

Closed Kinetic Chain

Supination

Answer 13

Calcaneal inversion
talar dorsiflexion and abduction
Tibial external rotation

Question 14

Closed Kinetic Chain

Pronation

Answer 14

calcaneal eversion
talar plantarflexion and adduction
Tibial internal rotation

Like a cork screw

Question 15

_____ acts as an extension of the leg and will follow its motion

Answer 15

Talus

Question 16

Internal leg rotation – _______

External leg rotation –_______

Answer 16

talar adduction

talar abduction

Question 17

Because talus and leg are proximal to axis, will act ______ motion of the calcaneus

Answer 17

Opposite

Question 18

What allows foot to become “mobile adaptor” and allows for shock absorption

Answer 18

At heel strike STJ is supinated but quickly starts to pronate

Question 19

During midstance STJ starts to ______ to allow for heel off

Answer 19

supinate

• Foot becomes rigid lever

–> Excessive –> High arch

Question 20

____ allows for shock absorption as foot strikes the ground

Answer 20

Pronation

– Excessive –> Pes Planus

Question 21

Point at which STJ is neither supinated or pronated

Answer 21

STJ neutral

• Palpate talar neck and move foot back and forth until it feels equal medially and laterally

Question 22

STJ ROM

Total ROM?
Supination: Pronation?
Degree of Inversion?
Degree of Eversion ?

Answer 22

30˚ total ROM

2:1 ratio supination (calcaneal inversion) to pronation (calcaneal eversion)
20˚ inversion
10˚ eversion

Question 23

Calculating STJ neutral through ROM

Answer 23

Place prone –> Bisect Calcaneous –> Invert, Evert, –> Add together –> divide by 3 –> subtract from measured EVERSION –> This number is your calculated STJ Neutral

(Total ROM/3) – Eversion = neutral position

Question 24

STJ neutral calculation

___if your STJ Neutal < Eversion

____ if your STJ Neutral > Eversion

Answer 24

Varus

Valgus

I + E = Total Range of Motion

Total ROM/3) – Eversion = neutral position

Question 25

Kirby method Method to map out deviated stj axis?

Answer 25

Place STJ neutral --> push medial and lateral until foot doesnt move --> Do at least 3 points Assumes that the normal STJ axis passes through the posterior-lateral heel posteriorly and through the first intermetatarsal space of the plantar foot anteriorly

Question 26

STJ axis STJ laterally located: foot _____ more easily

Answer 26

supinates

Question 27

STJ axis STJ medially located (axis passes directly over the medial aspect of the navicular): foot _____more easily

Answer 27

Pronate

Question 28

Position of STJ (calcaneus) when patient is fully compensated in midstance

Answer 28

Relaxed Calcaneal Stance Position (RCSP)

Question 29

Bisect calcaneus --> Have patient stand and march in place to get them into angle and base of gait----> Measure calcaneal bisection in relation to the weightbearing surface

Answer 29

Measuring RCSP

Question 30

RCSP Varus in calcaneous Valgus?

Answer 30

Inverted position | Everted position

Question 31

RCSP Normal position

Answer 31

2˚ varus to 2˚ valgus

Question 32

RCSP If neutral position >2 but< 10˚, the foot will pronate/evert to maximum rom If over 10˚ then talar head hits ground and prevents further pronation

Answer 32

Rearfoot valgus

Question 33

Position of the STJ (calcaneus) when patient is placed in neutral position while standing

Answer 33

Neutral Calcaneal Stance Position (NCSP)

Question 34

Measuring NCSP

Answer 34

Bisect calcaneus Place patient in angle and base of gait Have patient slowly invert and evert foot until neutral talus is palpated Have patient hold position Measure calcaneal bisection in relation to the weightbearing surface

Question 35

Normally tibia in 0-4˚ ____

Answer 35

Varus | - Can add this value to STJ neutral to find neutral calcaneal stance position

Question 36

If the pitch of the STJ is higher than normal, where what type of increased motion will be seen? - Inversion and eversion - Dorsiflexion and plantarflexion - Abduction and adduction

Answer 36

Abduction and adduction Pitch is axis

Question 37

A patient has 22 degrees inversion, 14 degrees eversion, what is their neutral position? 0 degrees 2 degrees inverted 2 degrees everted 4 degrees everted

Answer 37

-- 2 degrees everted

Question 38

During CKC pronation, the calcaneus . .

Answer 38

Everts