#483 What is a subtalar joint sprain in a runner? - DOC

#483 What is a subtalar joint sprain in a runner?

What is a subtalar joint sprain in a runner? Well, that’s what we’re talking about today on the Doc On The Run Podcast.


Everybody knows what an ankle sprain is. Ankle sprains are incredibly common, in fact, they’re about 10% of all musculoskeletal injuries that show up in the emergency room. So, it’s a very frequent injury and a lot of times, when people get a sprain in their ankle or they roll the ankle and they hurt themselves, they start to think that it just must be an ankle sprain.

But there is another thing that can happen that is sort of like an ankle sprain has symptoms, kind of like an ankle sprain, it’s in the same area but it’s actually different and that’s a subtalar joint sprain.

The subtalar joint is the joint in your foot that’s actually responsible for pronation and supination. And those are the motions that’ll actually allow you to change the position of your foot, tilting from side to side, that make your foot adapt to uneven surfaces and then convert to a rigid lever to let you push off when you run. It sounds complicated but it’s really not.

What it is, is a subtalar joint sprain is actually a sprain of a ligament or an injury to a ligament called the talo, the interosseous talocalcaneal ligament. That’s a long name, but I’ll explain it, don’t worry. So, interosseous just means between two bones. Osseous refers to bone and inter is between. So, it’s between two bones and it’s the interosseous talocalcaneal ligament. Talo refers to talus and calcaneous refers, or calcaneal refers to calcaneous. The interosseous calcaneal ligament is in here in between the heel bone and the talus.

The talus sits underneath your ankle and the talus sits on top of the heel bone. And so, in between those two, you actually have a ligament called the interosseous talocalcaneal ligament inside your subtalar joint. If you sprain it, like if we hold your foot and we actually brace it and we hold the talus in place and then try to push your heel bone back and forth, it’ll move a little bit and that indicates to us as physicians that you’ve actually had a sprain of this interosseous talocalcaneal ligament. And a subtalar joint sprain can cause pain that seems like a recurring ankle sprain if it’s been misdiagnosed as an ankle sprain. So, you’ve got to get it checked out.

Now, it doesn’t show up on an x-ray, but you don’t really want to have excess motion like that in your subtalar joint because it can lead to arthritis and you do not want that. The subtalar joint sprain does happen and it can happen if you really roll your ankle forcefully, like if you’re running on a trail and you trip on a root or some rocks or something like that, it can happen.

So, if you get an ankle sprain and you’ve done the usual stuff to treat the ankle sprain and it’s not getting better, it’s best to have an evaluation by an expert, preferably somebody that understands running injuries. But that is what a subtalar joint sprain is in a runner.