Which talus dysfunction is more common and what is a contributing factor?

• A. Posterior dysfunction is more common due to deep plantarflexion
• B. Posterior dysfunction is more common due to running in shoes
• C. Anterior dysfunction is more common due to tight gastrocnemius
• D. Anterior dysfunction is more common due to wearing heels

Answer: (D)

Talar dysfunction direction reflects how the talus moves within the ankle mortise during weight-bearing. Wearing high heels keeps the ankle in a pointed-plantarflexion position and shifts most of the load to the forefoot. This sustained plantarflexed posture alters how the tibia moves over the talus during gait, making anterior translation of the talus in the mortise more likely. In other words, the habitual plantarflexed stance produced by heel wear predisposes to anterior talar dysfunction, making it the more common pattern in people who regularly wear heels.

The other scenarios don’t fit as well: deep plantarflexion tends to encourage posterior talar movement rather than anterior; simply running in shoes isn’t a specific factor driving anterior versus posterior talar dysfunction; and tight gastrocnemius tends to limit dorsiflexion and is more associated with changes in the posterior aspects of the ankle mechanics, not a predisposition to anterior dysfunction from heel wear.