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SUBTALAR ARTHRITIS

Arthritis of the subtalar joint frequently follows trauma, such as a fracture of the calcaneous (heel).

Pain is felt on motion of the subtalar joint and x-rays will reveal irregularity of the bones between the talus and the calcaneous.  There may be crepitus (a grinding sound) upon moving the joint along with tenderness with pressure over the sinus tarsi in front of the lateral malleolus (outside ankle bone).  If splinting is part of the treatment plan, the peroneal muscles will likely spasm.

Weight bearing is painful with relief upon non-weight bearing and rest.  This is a hard condition to manage satisfactorily.  For chronic cases, surgical fusion is an option.

Other names or similar foot conditions:

• Calcaneal arthritis

Symptoms:

• Pain below the lateral malleolus (outside ankle bone)
• Grinding upon moving the subtalar joint
• Pain upon weight bearing

Signs to look for:

• History of calcaneal fracture
• Pain in the heel and/or below the lateral malleolus
• Grinding upon moving the subtalar joint
• Pain upon weight bearing

Possible Causes:

• Injury
• Systemic arthritis

Goals:

• Medical care as required
• Reduce stress on the heel
• Control motion of the foot 
• Footwear that moves the foot forward with as little lateral movement as possible

Solutions:

Arch Supports:

• Bio-Orthotics Winstep or Sundance exercising support with metatarsal lift under a Plastazote cushion

• Lower and thinner arch support with longitudinal and metatarsal support, such as the Bio-Orthotics Journey or Silhouette, for use when shoes cannot accommodate the Winstep or Sundance exercising support

• Extra depth shoes with firm heel counter, high toe box, rocker sole and connecting shank

• MBT physiological footwear

• Plastazote cushion in shoe

• Wear heels and pumps only as long as absolutely necessary

• For exercising, wear shoes with titanium springs

• Avoid going barefoot or do so on a minimal basis only

Other:

Compression hosiery products

Activities:

• Medical treatment

• Rotate weight bearing exercises, such as walking or jogging, with non-weight bearing exercising, such as swimming or bicycling

This information does not constitute a diagnosis of your condition and does not take the place of a doctor’s care.  The information has been compiled from sources available to the general public and referenced below.  Copyright 2005 Carole Romig

Sources  Image:  I. Alexander, The Foot: Exam &Diagnosis  Text:  R. Cailliet, MD, Foot and Ankle Pain, I. Alexander, The Foot: Exam & Diagnosis