Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

Talar head congruence method of finding STJ neutral

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Robertisaacs, Oct 4, 2010.


  1. Members do not see these Ads. Sign Up.
    Who first posited the talar head congruence method for finding STJ neutral.

    I know that Root defined it as "the position in which the foot is neither supinated nor pronated" so I'm presuming it post dates 1971.

    I have a mention of it here

    ELVERU RA, ROTHSTEIN JM, LAMB RL, ET AL: Methods for taking subtalar joint measurements: a clinical report. Phys Ther 68: 678, 1988.

    But no access to the full text to see if this refers elsewhere.

    Can anyone antedate this technique back before Elveru 1988?
     
  2. Craig Payne

    Craig Payne Moderator

    I first came across it in a workshop with Sheldon Langer in about 1979 ... assume it was mentioned in the book that Langer Labs put out authored by Sheldon and Justin Wernick.
     
  3. Griff

    Griff Administrator

    Here you go squire

    http://physther.org/content/68/5/678.full.pdf+html

    IG
     
  4. You, sir, are a legend.

    So we have sheldon langer to thank then. Unless anyone can antedate it before that...
     
  5. Stanley

    Stanley Well-Known Member

    Richard Schuster and David Skliar taught this in class when I took it in 1972.
    Regards,
    Stanley
     
  6. Interesting.....so maybe this was a Schuster idea of how to find subtalar joint neutral. I always thought it was Sheldon Langer that thought up this idea. Root and Weed always taught that the "talar head palpation method" wouldn't work properly due the varied configurations of the talo-navicular joint in different subtalar joint rotational positions. Last time I checked, the subtalar joint didin't include the navicular bone.
     
  7. When was that kevin?

    I always thought that it was not in the seminal paper because it was invented after. Perhaps then it pre dated 1971 and was left out on purpose....
     
  8. For something written in the early 1900 it´s pretty bloody good, some intersting views about what we would call posting and maybe a skive. Would have been great to see some of the plates (orthosis) mentioned . Nice find
     
  9. Ian if you read the paper it might be the wet foot test but slightly different.

     
  10. Stanley

    Stanley Well-Known Member

    Schuster thought that neutral calcaneal stance position was an important measurement, and his casting position was also in neutral position. He palpated neutral to make sure that the patients were in neutral during these times.
    The lateral finger is over the sinus tarsi (talo calcaneal joint) during palpation.
    I did remember something about a talocalcaneonavicular articulation, so a quick search found this:
    http://en.wikipedia.org/wiki/Talocalcaneonavicular_articulation
    Regards,
    Stanley
     
  11. wdd

    wdd Well-Known Member

    What do you think is the rationale behind the 'assumption' that the subtalar joint should be in neutral when the talonavicular joint is congruent?

    wdd
     
  12. wdd

    wdd Well-Known Member

    I hoped I would get some kind of response to my genuine question re-palpating the talonavicular joint to assess the position of the the STJ.

    My own rationale or justification is that it is likely that there is a link between the magnitude of forces transmitted across a joint, the proportion of opposing surface areas in contact and the time that any part of the surface area is transmitting the highest forces. It seems to me that the magnitude of the forces and the surface area in contact are likely to be directly related and that the time any part of the joint surfaces transmits high forces is likely to be inversely related.

    In the case of the talonavicular joint and the STJ this hypothesis might be reasonable if their their temporal patterns of force transmission correspond?

    It may be that this is so obvious that it doesn't need stating or that it is abolute nonsense but I am certain that the question is one that at least 90% of students would like to have answered.

    Best wishes,

    Bill Donaldson
     
  13. Bill I guess the 1st problem is that a lot of us are not using STJ neutral as part of our thinking re foot mechanics.

    The other point why look at the talonavicular joint to assess the joint of the talus and calc.
     
  14. efuller

    efuller MVP

    My guess is that someone saw a Root disciple attempt to palpate for STJ congruency and then attempted the same thing and found the TN much easier to palpate. I have not read what people were thinking when they were looking for TN congruency.

    Eric
     
  15. efuller

    efuller MVP

    You do have to examine the forces that you are talking about if you want to make the assumption that forces are changed in various positions of the joint. Why can't the joint support the forces if there is less than full contact? Look at the ankle joint. It supports multiple times full body weight with a very small area of contact. You also need to look at the structures that will be stressed in various positions of the joint. Decreased surface contact will only effect the joint being discussed. What does T-N congruency and force across the joint have to do with STJ or 1st MPJ function? It makes more sense to examine the forces on the structure that hurts.


    Eric
     
  16. Bill:

    I never heard either Mert Root (attended about 10 of his lectures) or John Weed (attended every one of his 2 classes and spoke with him numerous times while working on various projects with him) say "the subtalar joint should be in neutral when the talonavicular joint is congruent". In fact, I did hear them say, on numerous occasions, that palpating the talonavicular joint is not a reliable method of assessing subtalar joint neutral position.

    Do you have any references that state that "the subtalar joint should be in neutral when the talonavicular joint is congruent"? I think this is another self-perpetuated podiatric myth created and spread by someone other than the originators of the concept of the subtalar joint neutral, ie. Root, Weed and Orien.
     
  17. Just quickly reviewed the x-rays we took for the STJ axis locator study. We shot plain films of the same feet in different subtalar rotational positions- strikes me that the talonavicular joint appears most "congruent" in relaxed calacaneal stance position in these couple of subjects.

    Also found a couple where we simulated low and high gear propulsion- I'd forgotten that we did these. Interesting, but perhaps for another thread. I think Craig mentioned low gear propulsion as an aetiology to interdigital neuroma somewhere. If someone can point me in the right direction, I'll post these up.
     
  18. Stanley

    Stanley Well-Known Member

    Hi Bill,

    I just checked on my skeleton, and when I palpate for concruency, my fingers lie over the talo calcaneal joint on both the medial and lateral aspects.
    Schuster (I think he was using Root's definition) stated that the subtalar joint is in neutral position when it is neither pronated or supinated. He went on to talk about how this is palable.
    As an aside, I have noticed that the subtalar joint naturally goes into this position when you lift the patient's foot with your hand cupped behind the calcaneus. I don't know if this means anything, but it is interesting.
    As a student this made more sense to me than the calculation of 2:1 or 3:1 depending on which year and which foot type.

    Regards,
    Stanley
     
Loading...

Share This Page