Ankle
Subtalar Arthritis
About Your Condition
The subtalar joint sits between the ankle bone (talus) and the heel bone (calcaneus) and is responsible for the side-to-side tilting motion of the hindfoot — the movement that allows the foot to adapt to uneven ground. Arthritis in this joint causes pain, stiffness, and swelling on the outer side of the hindfoot, typically worsened by walking on uneven surfaces, hills, and stairs.
Subtalar arthritis most commonly develops following a previous heel bone (calcaneal) fracture — the degree of cartilage damage at the time of the original fracture largely determines the risk and timing of arthritis development — though it can also arise from inflammatory arthritis, prolonged flatfoot deformity, or without a clear precipitating cause.
Non-Operative Management
Non-operative management focuses on reducing load through the hindfoot and managing symptomatic flares.
Footwear
- Stiff-soled or rocker-bottom footwear reduces the demand on the subtalar joint during walking.
- A stability jogger with a wide flared sole provides a broader, more stable base and reduces hindfoot tilting load.
Activity Modification
- Avoiding prolonged walking on uneven or sloped ground reduces symptom flares.
- High-impact activities such as running and jumping sports should be avoided, as they load the arthritic joint directly. Low-impact alternatives — swimming, cycling, and the cross-trainer or elliptical — maintain fitness without aggravating the joint.
Strengthening
- Lower limb strengthening, particularly of the calf and peroneal muscles, improves dynamic hindfoot stability.
Corticosteroid Injection
- An injection of cortisone into the subtalar joint can provide useful temporary relief as a one-off during a painful flare, though it is not a long-term solution and the benefit varies between patients.
When to Consider Surgery
Surgery is considered when symptoms significantly limit your daily activities despite an adequate trial of non-operative treatment. The standard operation for subtalar arthritis is a subtalar arthrodesis (fusion) — a reliable and durable procedure with high patient satisfaction in appropriately selected patients.
Fusion eliminates the tilting motion of the hindfoot — most patients adapt well, and walking on reasonably uneven ground remains possible, though challenging terrain such as steep slopes may be more difficult.