Ankle & Subtalar Joint Motion Function Explained Biomechanic of the Foot - Pronation & Supination

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Dr. Glass DPM Podiatry Resource Network
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This video illustration depicts the ankle joint complex which includes the tibial talar and subtalar joint in human anatomy.
Dr. Glass DPM - This is an illustration that depicts the cardinal plane movements of the lower extremity. This is a biomechanical demonstration of the functional orthopedic nature of podiatry

[@MaximumAaron]

I know this is an old video and my use of it has nothing to do with the intent, but I just wanted to comment and say I appreciate the hell out of this video. I've been working on a 3d character for a comic I want to make, and I'm going into WAY too much detail with it(fully rigging all of the bones, muscles, and fat. Most of it will never be seen in the finished product, I just like knowing it's all there). I refuse to make all of the foot bones act as one static piece, but it's been hard to find reference that shows how the tarsals actually move in relation to each other, until this. This is GOLD.

[@MDHossain-yj4db]

For those complaining about the VIDEO SPEED. On the lower right corner of the video screen, there is a settings button. click on it, then select a slower speed. Thank you Dr. Glass. Very helpful.

[@justpde]

Thanks !!

[@rockngrannyroadwarrior8807]

Thanks. Learn something new every day.

[@smileandbreathe5315]

That was just incredible (with slower speed ha ha) with everything explained while getting the perfect visual in real time.. BRAVO and THANK YOU!!!

[@gauravsahu9160]

Very informative animation and narration. One of the best I've ever watched.

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8

[@yvettecrites2839]

This was perfect! I broke my ankle & was looking for understanding of ROM and why some ROM hurts and others don't. Thank you for this video!

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8 gait quadriceps

[@bingobangobongo5]

Great video. Good speed of audio too, gets the information out quickly and clearly. Screw those plebs below that don't know how to use a pause button. I came to visually learn about how the bones function throughout movement and you gave me everything I needed. Thank you!!

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8 gait quadriceps

[@Muuip]

Excellent presentation! Our anatomie is simply amazing.

[@DrGlassDPM]

We hope to be making some more Orthopedic related videos in the future. 3D is a great way to tell the story, indeed. Thanks!

[@martianrocket]

Thank you Dr Glass for your effort to illustrate this complex part of the human anatomy.

[@maxjunaid7407]

For subtalar joint: OS: open chain supination For OS remember IPAD i.e Inversion, plantarflexion, adduction OP:open chain Pronation For OP Remember EDAB i.e eversion, dorsiflexion, abduction CS: closed chain supination For CS remember IDAB i.e inversion, dorsiflexion, abduction CP: closed chain Pronation For CP remember EPAD i.e eversion ,plantarflexion, adduction. Hope this helps if you get question from subtalar biomechanics in NPTE

[@kavijawa]

very helpful

[@kweelingliew7930]

Ankle examination

[@AyshaVA]

Thanks a lot for this.

[@otiskylo1038]

i know it's kinda off topic but do anybody know of a good place to stream newly released series online?

[@josiedunnington184]

Do you have transcripts for any of your presentations? I think the speed is just fine for individual learners, who can pause, replay, etc. Having a transcript would help with the process, and for quick reference.

[@universalcuriosity]

AMAZING VIDEO AND EXPLANATION!

[@palteonato]

By far this the best video .congrats

[@ryguy985]

Thanks, I'm a Physical therapy student and this is helpful in understanding the complexities of ankle motion.

[@emilykuta4512]

THANK YOU. learned more from this video than class!!

[@LITG7000]

Great videos, great explanation, LOVE THIS, thanks for your time with these

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8 gait quadriceps

[@kmcapello23]

Wonderful explanation. I've always found the ankle complex to be super confusing due to multiple joints/things happening at forefoot vs midfoot vs rearfoot. After watching this video, it is starting to make sense!!!

[@MrCraigblaze]

I am glad to you it does !! Xd

[@sarahjanewalls7210]

Really got a lot from this. I am Podiatry student so this was spot on. Speed I found ideal - I generally have to speed videos up as they drive me crazy playing slow

[@Jess-eu4uw]

I actually didn't find it too fast and there's an option to slow down/speed up anyways. Speed was perfect for quick revision! Great video

[@010ChrisisCool]

this animation is incredibly useful! thank you!

[@AndreaGonzalez-dp5uv]

Could this have been any more rushed

[@guri009bajwa1]

True

[@crikeymos22]

@@guri009bajwa1 you can slow it down with the 3 little dots. You’re welcome.

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8 gait quadriceps

[@Dfhjjfdxgnk]

Amazingly concise and well articulated explanation of ankle biomechanics! I like your fast rate of speech, it is helping me improve my fluency with ankle terminology. It complements my coursework beautifully.

[@wildbob]

Excellent. I learned a lot from this.

[@ThrowPunches]

Play the video at x0.75 speed... she sounds a bit drunk but it's way more comprehensible and easier to follow than the actual speed

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8

[@henrycfronc3943]

I've been a practicing physician for slightly over 34 years.. This presentations' delivery was FAR too fast for any student or house-staff in training or even fora young graduate to assimilate in any way , much less with any degree of retention.Upon review of other practitioners ' comments which echo my same sentiments , have you considered slowing down the rate of the audio ?? I tried x 3 to listen to this , but finally gave up inspite of the excellent content..

[@DrGlassDPM]

I'm sorry about the speed. I've tried not to repeat those sorts of beginner mistakes with my subsequent work

[@rokhard24seven]

DrGlassDPM I LOVED IT!!! Granted, I'm an SPT (Student of Physical Therapy) in a DPT program. I had to re-watch it a few times to confirm it was inline with my biomechanics note packet and textbook. Great news! It is! :-) Great presentation. Thank you.

[@matthewhornback9933]

+DrGlassDPM Open in VLC and slow the playback speed. I had the same problem, but now I find this video very helpful in my PT program.

[@sallyyendlenson909]

I think the speed is a touch fast, but relatively in line with other educational videos that I have watched. The main issue that I have with this video, which makes it very tough to follow, is that it is a very flat reading. The speaker sounds very robotic and doesn't seem to know the material that she is reading with a level of understanding that she should, if she were to teach it. There isn't enough emphasis in the right spots to elicit "wonder"... which is a big part of learning

[@katherinecalacday2620]

You can adjust the speed to 0.75x in the gear shape button on the lower right side of the youtube video.

[@DrGlassDPM]

Not neccessarily, Alexander. The hips work in synergy with the muscles of the leg and feet to alter the posture and provide propulsive leverage during walking, etc. In fact, at closed chain ambulation, the calcaneus moves very, VERY, little. Have you ever examined a live flouroscopy of the foot during a gait cycle?

[@WrinkleTimeFilms]

Excellent video, though I echo the others who have said that the narration was too quick. I'm on my first leg (so to speak) of my PT training. I wish there was an overall resource like this for personal trainers in training. Thanks for posting this.

[@xThexBestxDamnxThing]

Can you please explain the concave-convex rule of the talocrural joint? Because I think it's pretty difficult than the other joints in our body because of the open en closed chain movements. How is the concave-convex rule in open chain movement and how is it in the closed chain movement?

[@rokhard24seven]

I don't thing this rule applies here since it's a plane joint. That conVex-concave rule applies to the GH where the humeral head is conVex moving on a fixed concave glenoid fossa of scapula.

[@pokegowalking2792]

so, is Dorsi flexion in the Front plane? and axis? because I have a presentation to do and I'm slightly confused of what the plane is

[@DrGlassDPM]

A full transcript is on the website. The data is published in Valmasseys lower extremity biomechanics.

[@auxiliator1975]

@5'42'' you say that supination is caused by the calceneus. It is not a cause but a result of endorotation in the hip which causes the knee to rotate inwards with shear on the meniscii and endorotation in the lower leg, the calceneus is forced to go inward and causes the foot to pronate. Also the first toe is predisponed to get in bad 'valgus' position.

[@enoforewopeht]

These videos have been helpful during some of my teaching in our Orthopedic Residency program for physical therapy students and residents!

[@DrGlassDPM]

No, I suggest you review the wikipedia article for Pronation of the Foot. (/Pronation)

[@MrKnottyFit]

Saw a Dr snap the subtalar joint on IG so now im convinced I should have been a bone doctor. This is pretty cool!

[@nanalisebroch3082]

Nice video. Is it practical possible for the subtalar axis to deviate 48 degrees from the frontal plane, at the same time as it deviates 16 degrees from the sagittal plane? The two planes in the video makes 90 degrees to each other. The explanation of the joint motion is perfect!

[@daniel27ad]

How can the video say at 3:06 that open chain occurs with the talus and leg being fixed, and yet I can clearly see the talus moving at that time? I apreciatte the help in advance!!

[@DrGlassDPM]

Daniel Arroyo Good question. The terminology is based on anatomic (and sometimes cadaveric) studies. In this, motion was analyzed from limbs that were "fixed" in a vice or fixated to an apparatus which held the leg steady while the foot was manipulated.

[@skiwhh]

+Daniel Arroyo to do an open chain evaluation of lower joint, you hold the leg and talus fixed to measure the ranges of the subtler joint.

[@gracelee6876]

This vido is very useful and interesting, but the biomechanics reference URL is not availible. So could you share the reference material again?

[@alexcolin949]

I honestly love the complexity of the foot

[@auxiliator1975]

art. calcaneonavicularis is a stabilizing joint but the calcaneus moves a lot compared to the tibia, the calceneus moves together with other joints and is connected to a complex kinematic chain. it begins at art. talonavicularis and the cuneiforms where the movement is converted. the calcaneus has an important function in guiding forces from foot to the leg. that's why the calceneus does make little movements, it's stabilizing nature.

[@chelseaguzman4511]

it took me a lot of time to understand what was being said but it was worth it:))) thankss

[@MrCraigblaze]

Thanks for the upload 👍 !! I just had a retrograde ankle fusion 6 months ago !!

[@DrGlassDPM]

Have you considered publishing a controlled study on your findings? Indeed it would be nice to see how well it compares to medical literature.

[@bryanchabolla195]

I wanted to understand movement of the foot better to apply to my walking but all I got was that calcaneous moves around a stationary talus during pronation and supination, which actually was very useful to me, but I want to apply that to walking.... I will rewatch it in a slower speed. I also recently learned of the transverse arch in the foot and have come to question how weight should be transferred over the toes along the tranzverse arch. In my walking the jointz of my pointer and middle finger fall down and touch the ground and it feels uncomfortable and it begs the question if my feet need strengthening along thay arch. Anyways thanks for the awesome video I didnt think I would find something this informative.

[@biomechanicsconcept9428]

great video your video quality is also good and explanation way too

[@speedchain111]

What program are you using to create these wonderful animations?

[@mathewaz1507]

Sweet! I'm a PT student trying to get normal dorsiflexion back 3 mo after a fibular fracture. The limitation feels like there's more strain in the talofibular jt (anterior ankle) instead instead of in the achilles T.

[@ruksih]

loved this - thought that the speaking was a little too fast though... brilliant graphics :)

[@Roadracer987654321]

How Much Motion is Taken away by a Sub Talar Fusion and with a repositioning of the Calcaneus ?

[@MrMetalheadtildeath]

@eyesandy1 i need replacements on both very soon.i am pretty scared.i have had two subtalar fusion surgeries and three hardware removal surgeries to take 4in screws out of both.how is your mobility and the pain afterwords.i am 41 and have been hurting since i was 13 from what i thought was cartilage tears,but,it turned out to be birth deformalities.let me know how it went,please. thanks

[@DrGlassDPM]

Posterior Tibial Pathology can have a wide range of presentations and severity. A subtalar fusion is not always the first line treatment for this condition, but when performed, will help to reduce the valgus strain on the rearfoot. It may be done in conjunction with a tendon transfer, augmentation or Talo-navicular joint fusion.

[@functionfirst]

Dr. Glass, this is great stuff! Thank you so much for posting. It is an amazing teaching tool with the visuals.

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8 gait quadriceps

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8 gait quadriceps

[@Roadracer987654321]

Would a Subtalar Arthroresis help or worsen Posterior Tibial Tendon Tendonitis in someone who is Flat Footed. ?

[@DrGlassDPM]

@sickofdao motion of inversion and eversion is in the frontal/coronal plane. This plane is perpendicular to the longitudinal axis of the foot.

[@JBitzz]

Thank you for this video! Just please slow down for the next ones? Or have more pauses to let our brains absorb what you say. Information overload!

[@teamtrickceratops2795]

great video. ill watch this every day until i understand

[@querida1314]

this video is simply awesome!!!! very very helpful! =)

[@DrGlassDPM]

I'm glad you enjoyed this video. We hope it will be useful to you in your career.

[@auxiliator1975]

try this; stand as you set your feet exactly straight forward, pull your toes up but keep the ball of the first toe on the floor. while standing, rotate the kneecaps outward but keep the feet in their position. the foot will be in supination while stabilizing on the heel. the vmo will be activated at the knee and the hips are in exorotation to keep supination in the feet. the ankles, knees and hips are activated. try this just a couple of minutes a day and solve a lot of foot- and kneeproblems

[@sickofdao]

why is subtalar inversion eversion in the longitudinal axis?

[@Roadracer987654321]

What would cause Bone Chips to develop between the Navicular Bone and the Posterior Tibial Tendon ? The person has Flat Feet (Like Me ). The Patient was in early Adolescence at the time. Does having a Flat Foot condition place pressure on the Navicular Bone and cause it to push outwards ?

[@TheBWC2011]

How can the axis be 82 degrees from the sagittal plane and 20 to 30 degrees from the frontal plane when those two planes are 90 degrees from each other? The math does not seem to add up. Am I missing something?

[@DrGlassDPM]

@kcampbell10408 Remember: the other joints in the foot will be able to take up the slack once the Subtalar is fused. Not all motion is lost.

[@DrGlassDPM]

@cr0uchingtiger This and the cardinal anatomical planes are all we've done. It would be nice to make more of these, but the "DrGlass video podcast is focused on the lower extremity, primarily.

[@stevenb5778]

Question: What does distal tib fib mob help increase and what does proximal tib fib mob help increase (anterior to posterior)??????????

[@cr0uchingtiger]

Can anyone tell me if this series is done on the whole body? I'd love a video series like this as I'm a personal trainer.

[@auxiliator1975]

My reference is not a single article, it is a conclusion from neurology, embryology, kinesiology and biomechanic as well as orthopedic anatomy. Learned from prof Rozendaal and dr jaap van der wal. I was first educated in physical therapy and after that I've studied movement science.

[@DrGlassDPM]

I can understand. What we do is record the audio and then go back through it and take out the areas of "dead space" in order to condense. The reason is that our videos are rendered at 30 frames per second, and each frame can take upwards of 4 minutes to render. Do the math, and you'll see that a 7 minutes worth of audio are a lot easier to do than 9 or 10. We might have got a little over zealous with it this time, but our most recent two videos were edited a little better in my opinion.

[@naturalmovementsystm]

that was a very helpful demonstration, thank you!

[@biomechanicsconcept9428]

kzbin.info/www/bejne/ZpuYl6KJitxkaK8

[@ellankavi]

Hello DrGlass! Thanks for the very informative video. Your website contains some amazing videos and images; are they free to use non-commercially, say for presentations? I am a researcher in the field of prosthesis design and simulation. It'd be helpful if you can let me know which tool/software you used to create this video. Thanks again :)

[@keyurgandhi4355]

what do you think about eversion exercises for osteoarthritis of knee??are they helpful??

[@angelzeitoune9120]

Hi Dr Glass, could you tell me from where you got the references of the degrees of ankle joint center ? Thanks

[@farhanbutt3387]

4/-?.^-y

[@DrGlassDPM]

It's difficult to say, without an xray or clinical exam. I would suggest they followup with a foot and ankle specialist. Chances are, though, that the "bone chips" you're referring to are either arthritic osteophytes or an accessory bone (ie Os Tibiale Externum)

[@auxiliator1975]

Dr Glass, when you speak of rotation of the leg, it specifically indicates te movements of the hip. It is silly to use shoes or soles to stabilise the foot, instead of giving support, you have to train the hip rotators and the lower leg muscles and the footmuscles. by giving the feet stability, the problems will insist and even get worse. stand on your extended legs with your feet exactly straight forward and press the first joint of the first toe hard down while rotating the kneecaps outward..

[@DrGlassDPM]

I agree a lot with what you are saying. I feel orthotics are able to help many biomechanical scenarios, however, there are some conditions in which they may provide minimal assistance at best. The forces through the hips and upper kinetic components is very powerful. I would like to know which textbooks or published literature you reference for this discussion. My work is derived from Dr. Roots Biomechanics and Valmassy's Textbook.

[@insidexistance]

I think there is something very wrong with my body symmetry, with my foot being the root source of the problem. Who can help with this? I've never really looked into it.

[@DrGlassDPM]

@DrGlassDPM Motion about an axis is perpendicular to the plane itself.

[@Therealzerocool]

Gracias por el video ¡ Thanks for the video, its very helpfull.

[@catharsis68]

really good animations! very helpful for a PT student. The speech was delivered too quickly though.

[@drvikas24feb]

how to demonstrate subtalar joint movement ????

[@chelibile]

After replaying and reviewing, I couldn't quite grasp talar role in subtalar closed kinematic chain of pronation and supination May I have some easier explanation for this. Like for pronation calcaneum everts and leg internally rotates but didn't get what talus does similarly for supination calcaneum inverts and leg externally rotates but was clueless what talus is up to. Please help

[@antonior1908]

Shruti Rathod ok.it was hard to understand. calcaneus motion at the frontal plain remains the same. close chain pronation calcaneus will still Evert, but adduction & dorsiflexion are perform by talar plantar flexion & adduction in internal rotation of the leg

[@antonior1908]

Shruti Rathod she talks too fast. In close chain dorsiflexion the leg is brought to a fix foot adduction that occurs in the open chain is seeing as internal rotation of the leg. In close chain plantar flexion the leg is moving away from the fix foot adduction that occurs in open chain now exist as external rotation of the foot, close chain is a function of lower extremities

[@antonior1908]

Shruti Rathod note subtalar does does dorsiflexion and plantar flexion and in frontal horizontal motion it does the same motion double check this answer , but the other stuff is just exactly what she said.... the speedy talker lady

[@antonior1908]

I hope that help

[@antonior1908]

I will comment in more detail later on

[@DrGlassDPM]

Thanks ryguy!. We're currently working on the joints in the forefoot. Stay tuned, because we hope to have the next orthopedics video out before long.

[@asimazizwaqas]

Intelligent design!!

[@78ylo]

Cool!! We are amazingly made!! :)

[@DrGlassDPM]

A successful subtalar fusion, will eliminate all subtalar motion. The foot, leg and knee can compensate to some degree, thereafter

[@DrGlassDPM]

I can agree with your notion, to some extent. I feel it is a combination of intrinsic and extrinsic muscle strength to condition good, functional posture. Hip and core muscle strength are under appreciated in patients and care providers alike.

[@DrGlassDPM]

@scavenski It's a lot to take in. Biomechanics is arguably the most complex subject in Podiatric Medical school.

[@DrGlassDPM]

@alo0o0sh1 I'm glad you enjoyed it. I hope the exam went well!

[@DrGlassDPM]

@Adomiso You may benefit from strengthening and physical therapy. An ankle, after a break, is not likely to be 100% thereafter

[@beautifulbutterfly140]

What about pronation? Can u pls tell us

[@palteonato]

The foot is a masterpiece of the Nature.

[@khushboodalal3587]

beautiful and amazing video..! great help..! thnk u

[@GodFuryNA]

One movement that is almost never talked about is the combination of plantar flexion and eversion. This motion is always used when turning while walking or running about.

[@Sabina_8]

Видеоряд отличный, но таблица со всеми углами обоих суставов в зависимости от открытой и закрытой цепи сделало бы общую картину более ясной. Качество перевода сети оставляет желать много лучшего.

[@TheVishu27]

Absolutely nailed it!!!!

[@DrGlassDPM]

I can't post a direct link in response (youtube rules), but I can reccomend you watch the Subtalar axis locator video by Kevin Kirby. It demonstrates this motion very well, from multiple angles.

[@DrGlassDPM]

@ing13920 The transcript for the video is over at the DrGlass(dot)org page associated with that video. It has all the narration available. Thanks!

[@Jamez4757]

my doc gave me an ultra sound scan and told me i had subtalar joint dysfunction :( what can i do

[@TheReader19]

Dr Glass, I do enjoy your videos, however you do speak quite fast which makes it a little difficult to keep up with you. However video's are very educational and informative. Thank you

[@pooln80]

its just awesome.......................

[@DrGlassDPM]

Yeah, we learned a LOT of lessons from this video. Namely the speed and pace of the narration. If you look at some of our recent videos, you'll notice we tried to improve this aspect. Live and learn