February 16, 2023
Did you know that the subtalar joint is essential for walking and balancing on uneven ground? If the subtalar joint is not moving properly, then there can be a wide variety of issues for the foot or even further up into the leg! Let’s talk about the subtalar joint and shoe wear.
Proper footwear is so important for foot and gait biomechanics. The subtalar joint is between the calcaneus and the talus, and it is your “heel.” It is a joint that helps with foot motion and how we walk. It is a tri-planar joint which means it moves in all cardinal planes. During pronation, the subtalar joint is responsible for “unlocking” the foot. If the subtalar joint is not able to pronate, then all motions of the gait are compromised. The subtalar joint has four motions (external and internal rotation, eversion, and internal talar tilt). Most people are restricted to internal rotation and eversion, so their gait will be compromised, which can lead to injury and improper biomechanics.
With footwear, most shoes restrict the motion of the subtalar joint. If you twist your shoes (like wringing out a towel), you can see if they are restrictive or not. If you have shoes that are flat, wide, and have no elevation (zero drops), then the subtalar joint will be able to freely move as long as it is moving properly.
“Cool” shoes that are narrow and have high lifts and heels on them are like birthday cake. Birthday cake is special and is only eaten every once in a while. This is how you should think about your shoes too! The healthy lifestyle diet is like the flat, wide, and no elevation shoe; you wear them all the time every day to keep your foot and gait healthy.
How do you know you have a wide enough shoe? Take out the insole and place it on the ground. Stand on the insole and look at the perimeter of your foot and insole. Are your toes able to splay comfortably without going outside the insole border? If not, then they are birthday cake shoes.
Exercise for the subtalar joint: Once you get your subtalar joint adjusted by a chiropractor (if it needs it), then making sure to strengthen the foot is essential. Doing toe yoga is a great way to get the foot stronger and to keep moving in the subtalar joint. Stretching out the calf muscles is a great way to get more motion in the subtalar joint as well.
✒️ Chief Editor: Dr. Bill Moreau | DC, DACBSP, FACSM | Chief Medical Officer