The effect of subtalar joint posting on patellar glide position in subjects with excessive rearfoot pronation.

It has been postulated that patellar position is influenced by subtalar joint mechanics. The purpose of this study was to compare the patellar alignment observed by radiographic analysis in subjects with excessive rearfoot pronation, both pre- and post-placement of semirigid rearfoot posting. Sixteen asymptomatic patellofemoral joints were contributed from 12 female subjects (four bilaterally). The amount of subtalar joint posting each subject received was related to the amount of rearfoot pronation present. The subjects' patellofemoral joints were radiographed in full weight-bearing, tangential view, both pre- (resting calcaneal stance position) and post- (neutral calcaneal stance position) placement of the posting material. The paired t test revealed a statistically significant change in patellar positioning (medial glide) after placement of semirigid posting (p < or = .05). This finding has structural implications for utilization of orthotics in the treatment of patients with patellofemoral pain syndrome with requisite excessive rearfoot pronation.