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Midtarsal joint locking

Discussion in 'Biomechanics, Sports and Foot orthoses' started by mike weber, Nov 19, 2009.

  1. Just read the paper. When, in the second paragraph of the paper, the authors stated "The idea of a locking and unlocking mechanism in the foot has been previously explained using the convex curvature axes of the talonavicular and calcaneocuboid articular surfaces (Elftman,1960). Inversion or eversion of the subtalar joint changes the direction of the convex curvature axes of the talonavicular and calcaneocuboid articular surfaces, which might lock or unlock the midtarsal joint and contribute to either a rigid or flexible foot structure (Tweed et al., 2008;Elftman, 1960)", I immediately lost much interest in the paper. Elftman? Really! The paper by Elftman was a joke and would never be published today. Yet, Elftman's paper forms the basis for the authors' contention that the midtarsal joint "locks". In the Journal of Biomechanics, no less!

    For those of you not familiar with Elftman's often-quoted 1960 paper, Elftman used his eye of a connoisseur method to inspect the joint morphology of the midtarsal joint visually and claimed there was a major and minor “axis of curvature” in both the talonavicular joint and calcaneocuboid joint (Elftman H. The transverse tarsal joint and its control. Clin Orthop. 1960; 16:41-44). He proposed that when the major axes of the talonavicular joint and calcaneocuboid joint were parallel to each other with the subtalar joint pronated, there would be more midtarsal joint motion available. Unfortunately, podiatric schools around the world are still teaching this idea that alignment of visually determined midtarsal joint “axes” are what make the midtarsal joint more compliant in pronated feet, even though there is not a shred of research evidence that supports Elftman’s theory.

    In addition, there was no mention of the windlass effect of Hicks to explain the MTJ plantarflexion during propulsion and there was not a single mention of the mechanical effect of the plantar fascia in stiffening (i.e. "locking") the midtarsal joint. Disappointed!
     
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