Role of the intrinsic subtalar ligaments in subtalar instability and consequences for clinical practice

Review written by Dr Carlo Wood info

Key Points

  1. The cervical ligament, interosseous talocalcaneal ligament and calcaneofibular ligament play a key function in the normal kinematics, pathomechanics and stability of the subtalar joint.
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25% of ankle sprain patients develop chronic hindfoot instability. The literature is limited on subtalar instability (STI). Confusion exists over names, location, and contribution of ligaments. The two most important being the calcaneofibular ligament (CFL) (as it stabilizes the tibiotalar and subtalar joint) and the interosseous talocalcaneal ligament (ITCL). This creates difficulty discerning talocrural instability with STI.

The purpose of this review is to provide an update of the current literature related to the pathophysiology of STI. The hypothesis is that the intrinsic subtalar ligaments play an important role in the subtalar joint.

25% of ankle sprain patients develop chronic hindfoot instability.
The most common symptoms of subtalar instability are recurrent ankle sprains and giving way.


  • A literature review was conducted for the pathophysiology, diagnosis, and treatment of STI, as well as anatomical and biomechanical properties of the intrinsic subtalar ligaments.
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