How does pronation twist of the tarsometatarsal (TMT) joints relate to supination of the subtalar joint?
What will be an ideal response?
ANS:
When the subtalar joint is supinated, the transverse tarsal (TT) joint is also supinated. The locked hindfoot tends to press the lateral side of the foot into the ground. The fifth ray is pushed upward into dorsiflexion, and the first ray plantarflexes to get back to the ground. Fifth ray dorsiflexion and first ray plantarflexion result in the four outer rays rotating into eversion. This "pronation twist" of the TMTs is restricted in range but helps adapt the forefoot to the ground when the TT joint is not able to. Similarly, when the TT is fully supinated or pronated and more supination or pronation is required, the TMT will be called in to contribute.
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