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The Genesis of the Foot Orthotic Consensus Project

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Craig Payne, Jul 28, 2009.

  1. Brahim

    Brahim Member

    Simon,
    Apologies for late coming to this discussion but its pretty clear can see that not alot of traction has been gained on achieving a consensus on prescription variables. Its also clear that we are having a hard time figuring out how to go about tackling the problem.

    I like the idea of unpacking the discussion based on the plantar aspects of the orthoses as listed above:

    Heel Area Lateral
    Heel Area Central
    Heel Area Medial

    Midfoot Area Lateral
    Midfoot Area Central
    Midfoot Area Medial


    Metatarsal Area Lateral
    Metatarsal Area Central
    Metatarsal Area Medial

    Considering that that list represents an itemization of the tools that can be employed in any orthotic, it seems logical to limit the discussion to the biomechanical findings that can be manifested in that array of tools....

    However, what I find interesting is that the forefoot (toe area) seems to be getting so little attention in most of the discussion on the Arena and again in this thread.

    Does it make sense to agree on a framework that accommodates the entire plantar surface? I feel that limiting the discussion to heel, and metatarsal areas without also considering the toe area is implicit acceptance of the rigid 3/4 orthotic paradigm and predisposes the discussion to a more limited scope.

    We should frame this discussion to allow for tools to provide control across the entire plantar surface in keeping with an agnostic approach and try to put the prevailing dogmas in the industry aside while we are at it.
     
  2. Yeah, that's why I said: "Then the Forefoot extension area." in the post that you quoted above.
     
  3. Brahim

    Brahim Member

    I had noticed before that you added the forefoot extension area but did not provide the same level of breakdown as the other areas of the foot. I guess I perceived that as an omission. Is there any reason not to move forward with a list that looks like this?

    Heel Area Lateral
    Heel Area Central
    Heel Area Medial

    Midfoot Area Lateral
    Midfoot Area Central
    Midfoot Area Medial

    Metatarsal Area Lateral
    Metatarsal Area Central
    Metatarsal Area Medial

    Toe Area Lateral
    Toe Area Central
    Toe Area Medial

    In addition to the regions of the foot on which an orthotic could have an effect, we should also consider the prescription variables that will have a manifestation on the materials selected i.e. weight, intended activity of the patient, Hx ulcerations etc..
     
  4. drsha

    drsha Banned

    Ladies and Gentlemen:

    We are coming to The One Year Anniversary of Total Stagnation for The Genesis of the Foot Orthotic Consensus Project as I predicted.

    No closer to beginning a project that would take Biomechanics closer to Consensus.

    Tissue Stress going nowhere?? Not enough common ground? No Funding?
    Lots of Talk No Action? Too busy denying advances that others see as worth investigating.

    No new thoughts on what an orthotic is to promote into society?
    What it does? Why they work? How to PROVE IT?

    No new Level I evidence to set a path for consensus coming from all the brilliant Ph.D's?? No New Inventions?

    No Consensus from The International Biomechanics Commmunity?

    No new Clinical Applications? Wow, was it me who called you guyz/galz clinically inferior to FFT as you were calling MY parents mutants??

    I believe your true exercise on this multi-year, multi-participant thread revolves around your biased opinions and little else and for me, answers the question:
    How much hot air can one group collectively exhale in order to put out a fire burning on one pound of the B***S**T it rests on?

    I predict I'll post a similar text next year at the next anniversary of The Genesis of the Foot Orthotic Consensus Project Thread. Prove me wrong!

    Wishing you all Happy Holidays.

    Dennis
     
  5. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Sorry to disappoint you Dennis, but that is not the reason that the project has not progressed. Its simply a matter to time to move it forward and the lack of that time in the context of all the other things I working on (including keeping Podiatry Arena going -- its currently 7.00AM Sunday morning for me and I been at this since 5.00AM :bash: :boohoo: :craig: )
     
  6. drsha

    drsha Banned

    We have reached the two year Anniversary of Total Stagnation for The Genesis of the Foot Orthotic Consensus Project as I predicted. ;)

    No closer to beginning a project that would take Biomechanics closer to Consensus.

    Tissue Stress going nowhere?? Not enough common ground? No Funding?
    Lots of Talk No Action? Too busy denying advances that others see as worth investigating?

    No new thoughts on what an orthotic is to promote into society?
    What it does? Why they work? How to PROVE IT?

    No new Level I evidence to set a path for consensus coming from all The Arena Members? No New Inventions?

    No Consensus from The International Biomechanics Commmunity?

    No new Clinical Applications? No new treatment advances?

    Craig:
    Are you going to give another posting stating that you are too busy?
    How long does it take before it will get tired and the truth will surface?

    I predict I'll post a similar text next year at the next anniversary of The Genesis of the Foot Orthotic Consensus Project Thread. Prove me wrong as you have not done for another year.

    Dennis
     
  7. Griff

    Griff Moderator

    Dennis,

    You wrote on 19th November 2011:

    Then on 3rd January 2012 (just 6 weeks later):

    It seems your knowledge of the Gregorian calendar is as lacking as your knowledge of Podiatric Biomechanics. Chin up old bean.
     
  8. drsha

    drsha Banned

    OOOOOOOOps...

    you are so right.

    Didn't mean to put pressure on you blokes who have so little time.

    No one, including The Arena ever said I was perfect.

    I'll just save it for next year.;)

    Dennis
     
  9. drsha

    drsha Banned

    Another three months has gone by and still total stagnation without input from anyone.

    How are Tissue Stress, SALRE and Scientific Modelling assisting you in finding a direction for consensus on foot orthotics and therefore how they work?

    Maybe you're spending too much time looking for holes in The Foot Centering Theory of Structure and Function (LOL)?

    Dennis
     
  10. cpoc103

    cpoc103 Active Member

    Dennis might I suggest a couple of things for you to ponder!!
    To your questions, a name for orthoses, what they do, why do they work and how to prove it.
    Well how about this- orthoses are a Neuromuscular interface, between ground and foot. They work by altering ground reaction forces through neuro feedback loops, which inturn alter muscle function. The fundamentals of physics mass, moments and lever actions combined with biomedical structures.
    Something unfortunately architecture does not have, and therefore in my opinion I'm finding it difficult to use your foot centering theory.

    Col.
     
  11. drsha

    drsha Banned

    1. what do you mean or define as Biomedical Structures

    2. when you say use foot centering theory, seriously have you actually tried it?
    because if you haven't, then you really mean visit or test out.

    I would love to mentor you through the process if you are game.

    Dennis
     
  12. cpoc103

    cpoc103 Active Member

    Hi Dennis, sorry for late reply have been away.
    Sorry probably wrong word to use, it was late and the brain wasn't working, but I was referring to living cells nerve arteries and so on which also play a part.
    I haven't used the centering theory just been reading the research I can find. I would love to try it Dennis, I'm all up for new trying new things and especially if it helps my pts, always learning.
    Only problem is I'm living down under!!
     
  13. drsha

    drsha Banned

    Your definition of an Orthotic is, IMHO, a fantastic place to start developing consensus.
    It reveals a call for blending, amalgamating and massaging the current trends and paradigms.

    I certainly agree with you that our custom devices impact biomedical structures at a cellular and tissue level such as your examples of cells, nerves and arteries. In addition, your definition also includes muscles.
    But
    Isn't "THE" Biomedical Structure we are applying the laws of physics, mass, moments and lever actions to "The Architectural Structure of the Truss-Tie Beam Model provided by the bones of the foot and the plantar fascia and friends"?
    (see illustration)

    Dennis

    as to working together, please email me at drsha@foothelpers.com so that we may start a global relationship for visiting The Foot Centering Theory of Structure and Function.
     

    Attached Files:

  14. drsha

    drsha Banned

    We are coming to The 2012 One Year Anniversary of Total Stagnation for The Genesis of the Foot Orthotic Consensus Project as I predicted.

    This is now the third year.

    Perhaps it is time to stop calling everything else snake oil and admit that your work belongs in the group as well..................................

    After another year:
    No closer to beginning a project that would take Biomechanics closer to Consensus.

    Tissue Stress going nowhere?? Not enough common ground? No Funding?
    Lots of Talk No Action? Too busy blasting potential advances from others rather than simply investigating them fairly as scientists.
    (Eric Fuller has asked me to fund his research on Present Podiatry!!!! and calls me illogical)

    No new thoughts on what an orthotic is to promote into society?
    What it does? Why they work? How to PROVE Them? How to generate EBM?

    No new Level I evidence to set a path for consensus coming from all the brilliant Ph.D's who prefer personal attacks?? No New Inventions? Still can't locate the STJ Axis Interpersonally?

    No Consensus from The International Biomechanics Commmunity?

    No new Clinical Applications? No new diagnostic advancements?

    I predict I'll post a similar text next year at the next anniversary of The Genesis of the Foot Orthotic Consensus Project Thread as I did the last. Prove me wrong!

    Wishing you all Happy Holidays.

    Dennis
     
  15. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    The the project is actually moving along quite nicely at the moment.
     
  16. drsha

    drsha Banned

    Thanks thanks for the annual report.

    Dennis
     
  17. Dennis

    Sometimes one creates a dynamic impression by saying something, and sometimes one creates as significant an impression by saying nothing at all. Have a good new year.
     
  18. drsha

    drsha Banned

    and sometimes one says nothing at all because one has nothing at all to counter with :rolleyes:
    and a good new year to you
    Dennis
     
  19. Tariff Hogan Jinn

    Tariff Hogan Jinn Welcome New Poster

    Sorry to bother you Craig, any update on this project?

    TA
     
  20. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    It stalled because of the almost impossibility of reconciling some views.

    However, still collecting info and trying to reconcile views - have added in running shoes ... it just a matter of time before I get to it!
     
  21. carol.yuen

    carol.yuen Member

    As technology improve, would you consider to use plantar pressure plate as part of clinical test to help us to deflect and redistribute the plantar pressure when we prescribe orthoses for accommodate the lesion or offload the plantar pressure.
     
  22. efuller

    efuller MVP

    The technology was good enough in the early 1990's. I had an insensate patient with a recurrent ulcer and partial foot amputation. I made a device and measured the plantar pressure. It did not look like much pressure reduction on the ulcer site. I modified the device and measured the plantar pressure again and the plantar pressure was lower.

    Since the foot was insensate, there was no other way to get some feedback on whether my modification was correct or not. That is the point here. The pressure measurement system provides some feed back that we can make some decisions on. However, in the foot with sensation we can get feedback and in fact the patient may alter their gait in response to high pressures.

    We don't know if the gait causes the pain, or the pain causes the gait. This is the problem with using pressure distribution alone. There are some places for its use, but you have to remember that their is a brain attached to the foot that sends signals to the muscles. Different muscle function will cause different plantar pressures.

    Eric
     
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