It has now been 17 years since I first reported on the following inaccuracies in the dogma taught by the proponents of the subtalar joint neutral theory (Kirby KA: Foot and Lower Extremity Biomechanics: A Ten Year Collection of Precision Intricast Newsletters. Precision Intricast, Inc., Payson, Arizona, 1997, pp. 7-12). Does anyone have any more inaccuracies to add to my list or does anyone disagree with any of these observations I made way back in 1990. (You old-timers may need to help out the younger podiatrists/students who weren't taught this stuff like I was back in the 1980s.)
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By the way, is subtalar joint neutral theory still being taught in any podiatry schools still? :confused:
1. The calcaneus must be in the vertical position while in relaxed calcaneal stance position in order for the foot to function normally during gait.
2. Each foot has only one correct heel bisection.
3. If a calcaneus is everted by more than two degrees then it will continue pronating until the maximally pronated position of the STJ is reached.
4. A functional foot orthosis made from a cast of the foot held in the STJ neutral position will position the subtalar joint in the neutral position while in stance and/or in gait.
5. The standard biomechanical examination yields sufficient information to predict how that particular individual's lower extremity will function during gait.
6. Forefoot deformities (i.e. forefoot varus, forefoot valgus) are congenital disorders.
7. A functional foot orthosis must be made from a rigid thermoplastic without forefoot extensions. Cork and leather orthoses are not functional foot orthoses.
8. If a patient stands in relaxed calcaneal stance position with the calcaneus inverted then there must be some abnormality causing the calcaneus to not be vertical (i.e. an inverted calcaneus is always abnormal)
9. A foot with an everted forefoot to rearfoot relationship should be treated with an orthosis which is balanced with the heel vertical.
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