Determining Subtalar Neutral Position

Determining Subtalar Neutral Position – The ICB Anterior Line Method (A.L.M)

How to find Sub Talar Neutral STN using the ICB ALM method. The Anterior Line Method (A. L. M) developed by Dr A. R .Najjarine – Podiatrist in 1995 as an extension of the Talar head palpation technique or Talo navicular method.

It is important that ICB Orthotics be fitted and moulded to the patient’s Subtalar Joint Neutral Position, which will assist in correcting and limiting excessive pronation. To find the subtalar neutral position you can use the ICB Anterior Line Method:

1. Locate the depression anterior to the medial malleolus by asking the patient to over pronate their foot.
2. Mark the depression
3. Repeat steps 1 & 2 for the lateral depression.
4. Bisect the lateral and medial depressions and mark the bisection.
5. Locate and mark the 2nd metatarsal head and join it with the bisection mark made in step 4.
6. Locate and mark a dotted line along the tibial crest to meet up with the bisection of the medial and lateral depressions.
7. To find subtalar joint neutral, ask the patient to roll their foot outwards – when the dotted line along the tibial crest down to the 2nd metatarsal head is straight, the foot is in the subtalar joint neutral position.

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