Clinical principles for controlling subtalar joint motion through strategic orthotic posting and biomechanical moment management.
Subtalar joint access refers to the orthotic's ability to influence STJ motion through strategic posting. Medial posting creates a supination moment while lateral posting creates a pronation moment, allowing clinicians to control excessive or insufficient STJ motion patterns.
Creates supination moment, reduces excessive pronation, supports medial arch structures
Creates pronation moment, addresses excessive supination, improves shock absorption
| Indication | Use When | Avoid If |
|---|---|---|
| Medial Posting | Excessive pronation, PTTD, medial arch collapse | Rigid supinated foot, lateral ankle instability |
| Lateral Posting | Excessive supination, lateral foot pain, poor shock absorption | Medial arch collapse, excessive pronation |
| Neutral Posting | Normal STJ motion, cushioning focus | Significant biomechanical dysfunction |
Consider referral for complex multiplanar deformities, rigid structural abnormalities, or when STJ access alone is insufficient to address the presenting pathology.