Manual Therapy for the Talocrural, Subtalar and Midfoot Joints

Dave starts with the talocrural posterior glide. Two common mistakes are a table set too high, which removes leverage, and staying superficial instead of reaching a grade 4 mobilization at end range with small oscillations. He adds sustained glides with active dorsiflexion and end-range isometrics. For the subtalar joint, with the patient side lying and a rolled towel under the distal tibia and fibula, he applies downward glides and rocking to the calcaneus to open the medial joint space and restore pronation. The table torsion test becomes a midfoot treatment by drawing the foot medially while the patient pushes the knee out, and can be combined with tibial internal rotation. Another technique holds tibial internal rotation while the patient draws slow six- to eight-second ankle circles, shaped like squares, so the tibia cannot compensate with external rotation. The part ends with closed chain mobilization on a box: the hand blocks the talus as the patient drives the knee forward, with the cue to push through the hand.