Subtalar instability may cause pain, dysfunction and deformities and eventually might increase the onset of degenerative changes. Clinicians have problems in accurately establishing this diagnosis, since it is difficult to distinguish between ankle instability and subtalar joint instability in a physical exam and subtalar ligamentous injuries often occur in combination with injuries of other ankle ligaments.
In the present study, the anterior talofibular, calcaneofibular, cervical and interosseous talocalcaneal ligaments were consecutively sectioned and the resultant kinematic changes were investigated. The interosseous ligament had the greatest contribution to stability of the subtalar joint; the calcaneofibular joint is also presumed to be a supporting structure for the subtalar joint, but no clinically relevant changes in mobility were found after its sectioning. The anterior talofibular and calcaneofibular ligaments were major contributors to ankle joint stability.
None of the applied testing motions was able to detect subtalar joint instability; the anterior drawer maneuver however significantly increased when the interosseous ligament was sectioned, therefore the possibility of detecting subtalar instability with the anterior drawer test should be investigated further. From: Ringleb SI, et al. J Orthop Res 2011; 29:1459-1464. All rights reserved to the Orthopaedic Research Society (published by Wiley Periodicals, Inc.).
Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice.
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