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Old 4th January 2005, 04:50 PM
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Kevin Kirby Kevin Kirby is offline
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Default Orthosis function

Originally Posted by Robert D. Phillips, DPM
Hello Kevin,

As always, you have some good points to make. I do not disagree with the ideas about moments around the subtalar joint axis. I likewise utilize such thinking in many of my patients.

As I approach the patient, though, my thinking always goes like this: 1) what anatomical structure(s) are painful? 2) What type of mechanism could produce such pain? (i.e. tension, compression, etc.) 3) Why is the mostly likely mechanism occurring? (pronation of the STJ, weakness of the peronei, etc.) 4) What are the goals of the orthotic therapy? The more specific I can identify the goals of therapy, the more likely I am to achieve those goals and have a happy patient.

Good to hear about the grandchild being enjoyed by grandfather. My oldest son got married this summer so I'm probably not too far behind...but in no great rush at this time to reach your elder status. :)

Your approach to foot orthosis therapy is identical to the one that Eric Fuller and I are writing about currently in a chapter on Tissue Stress and STJ Rotational Equilibrium. Your paragraph above is almost identical to one of the tables included within the chapter. Seeing that we think nearly identically in this regard pleases me greatly. I greatly respect your knowledge and opinions and have always looked up to you as one of the leaders of biomechanics within podiatriy within the US, even though we have had our share of animated discussions in the past.

I don't have time now to answer your other questions but, when I have time, I will try to get around to doing so. Please give my regards to the family.


Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College


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