I have a disruptive question to ask those researching and practicing lower extremity biomechanics that reinforces the fact that hyperpronation is a biomechanical red herring:
If Subtalar Joint Stenting (SJS) is indicated to correct a "hyperpronated" subtalar joint, why is it that as talar declination does improve when stenting or dispensing a custom foot orthotic does the calcaneal inclination angle remain relatively or completely unchanged?
Perhaps the biomechanical correction of a STJ stent or custom foot orthotic actually is working to reverse biomechanical pathology in the ankle joint instead?
If so, what is the stent or orthotic correcting so effectively against gravity and grf?
Good question. I can’t answer the stent part. I can state with reasonable certainty that a diagnosis of hyperpronation is totally dependent on the subject supporting on a surface which is flat and rigid.
My question revolves around a subtalar joint that cannot evert far from vertical but have pathological pronatory moments stemming form forefoot problems at midstance. They compensate problematically throughout the postures such as with talar dislocation or genu valgum over time. These STJ's are not hyperpronated in closed chain but are in high need of diagnosis and treatment and possible STJ stenting after the forefoot is corrected.
Quick Answer:
STJ stenting will Not work in the presence of either the PreClinical Clubfoot Deformity or RFS.
I know the answer as it for me, this question was rhetorical.
I have waited for more than a year for answers which only justify the question and a correct answer.
Hint: The calcaneus CIA has not moved in the stenting case but does in the vaulted foot?
E mail me if your interest is piqued as I would enjoy debating others in this arena.
Dr Sha
The quick answer, IMO, is:
(1) STJ stenting can stabilize calcaneal supinatus, but
(2) does not stabilized the medial column supinatus.
Hence the foot still abnormally (gravity drive) pronates, from mid stance to heel lift.
Brian:
Quick response.
You are incorrect.
Give me a longer answer. What is the root cause (or where) of the foot displacing on the leg?
Dennis
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