Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

The 5 great FALLACIES of podiatric biomechanics

Discussion in 'Biomechanics, Sports and Foot orthoses' started by AdamPhilps, Jul 7, 2007.

  1. 1. Podiatric "experts" in foot biomechanics come from the clinical world with no knowledge of basic biomechanical concepts such as moments, angular velocity, angular acceleration, moment of inertia, rotational equilbrium, stress, strain, elastic modulus, stiffness, modelling, and free-body diagrams.

    2. The origins of new ideas within podiatric biomechanics can always be traced back to "experts" in podiatric biomechanics that claim they were actually the ones that first thought of these new ideas but "never had the time" to publish them.

    3. The long leg causes foot pronation.

    4. A short leg can be manipulated to a longer length.

    5. In his quest to improve on the existing function of the Root Functional Orthosis, Richard Blake, DPM copied other existing inverted orthosis techniques in creating his Blake Inverted Orthosis Technique.
     
  2. Stanley

    Stanley Well-Known Member

    1.Podiatric students in foot biomechanics prior to 1978 had no knowledge of basic physics such as torque, angular velocity, angular acceleration, moment of inertia, rotational equilbrium, stress, strain, Young's modulus, and stiffness.

    2. The origins of some new ideas within podiatric biomechanics cannot be found in the literature.

    3. Any podiatric student that places a patient in neutral calcaneal stance position (from relaxed calcaneal stance position and notices a change in the height of one ilium will listen to his professor who tells him that the research shows that a long leg does not cause foot pronation or that foot pronation can cause a functional shortage of a limb.

    4. A functionally short leg cannot be manipulated to function longer.

    5. In his quest to improve on the existing function of the Root Functional Orthosis, Richard Blake, DPM did not talk to his good friend Dr. Richard Schuster who developed a supinated semi-weightbearing cast (and was lecturing about it at the time nationally) and applied it to off-weight bearing casting to create his Blake Inverted Orthosis Technique.
     
  3. Atlas

    Atlas Well-Known Member

    1. Peroneus longus plantarflexes the 1st ray.

    2. Rigid materials are needed to provide therapeutic forces

    3. All podiatric theory will allow you to assess and treat more than 60% of foot/ankle musculoskeletal conditions.

    4. Podiatric surgeons are more perfect than foot-ankle-orthopods when it comes to foot-ankle surgery.

    5a. Tarsal tunnel syndrome
    5b. Sinus tarsi pathology (to a lesser extent)

    6. The strong connection between low supination resistance to recurrent ankle sprains

    7. The first thing your patient should do when confronting you clinically with a biomechanical problem, is go out and purchase a (costly, heavy, bulky, overrated) pair of "supportive" runners.

    8. Evidence and literature and meta-analysis teaches you more about mechanical foot and ankle presentations than trial and error.

    9. Clinical ability is proportional to academic labels such as (Hons) after your title.






    There are so many, that 5 is the tip of the iceberg. In physiotherapy, there are even more; and what is worse is that 'we' swear by them.
     
  4. Ron McCulloch

    Ron McCulloch Welcome New Poster

    Re: The 5 great FACTS and FALLACIES of pedal BMX

    As a new member, I read these comments with interest. I wonder whether you could elaborate a little Dr Payne. i.e is your comment regarding forefoot varus specific to an osseous deformity or would you include forefoot supinatus in this statement ? Would you agree that normal ankle dorsiflexion should be 10 degrees or more ? Are you able to provide some references with regards to points 2,3 and 4 ?
     
  5. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Ron - welcome to Podiatry Arena!

    Do a search here and these have been discussed ad nauseum.

    By definition, forefoot varus and forefoot supinatus are 2 very different things - there are a number of threads discussing these (search for forefoot varus).

    10 degrees is not even close to being normal (there are several threads discussing this). Its very subject specific - for some people 0 degrees is normal; other need >15 degrees (search for ankle joint range).

    The foot pronation as a compensation for structural LLD is just another one of those podiatric myths - there are several threads discussing it (search for leg length difference)
     
  6. Wotcha Ron. Welcome to the world of turning everything you thought you knew upside down.

    I'll give you some hints.

    http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=892

    The thread on LLDs not having a direct causal link to Pronation. Yes i was surprised as well.

    http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=300&highlight=forefoot posting

    One of the threads on FF varus. The basic principle here is that FF Varus is the congenital abnormality thought to be caused by the talar head failing to unwind during Foetal development. Its a bony deformity and is, depending on who you talk to either very rare or mythical. I think i've seen one, but only one in 10 years. FF supinatus is the common as dirt aquired deformity caused by soft tissue contracture (davis law). When there are high levels of inversion force in the forefoot, over time the forefoot becomes inverted on the rearfoot and we have a forefoot supinatus (which some call functional ff varus). Different to ff varus. One of Craig's pet peeves.

    Obviously there are implications for tx here. If the ff supinatus is caused by increased GRF under the medial forefoot adding a forefoot post / ff varus extention which will increase it even more may not be the path to long term joy!

    This BTW was a page of the textbook that a prof B Rothbart has ignored / not read. Look up primus metatarsus supinatus or the rather arrogantly named "rothbarts foot type" if you want a laugh!

    The 10 degree rule is just one of those things which has long been taken for granted. As Craig says what is normal and healthy for a 55 yo accountant may not be adequate in a 25 yo sprinter. You need to think about what we mean by "normal". Average? minimum required limit? What.

    Have fun on the forum.

    Regards
    Robert
     
  7. Bit late but here's my 5 truths

    1. Anything you put in somebodies shoe can change function.

    2. Patients lie

    3. Honest podiatrists admit that they don't fully understand the function of the foot

    4. Dishonest podiatrists will take advantage of 3 and make huge piles of cash claiming that they DO.

    5. Orthotics could help a lot of people who will never wear them and are not helping a lot of people who are wearing them now.
     
  8. Stanley

    Stanley Well-Known Member

    Craig,

    What you are saying is not entirely accurate.
    Pronation is one of several compensations for a long leg. Another one happens to be equinus on the short side (which results in pronation of the short side).
    Your studies that show that there is not an increase in pronation on the long side does not mean that pronation cannot be a compensation for a long leg, but rather the frequncy of pronation as a compensation for a long leg happens close to the frequency of equinus with subsequent pronation (on the short side) being a compensation for a long leg.
    If you stand a patient up and put them in NCSP, and the ASIS raises unilaterally (unlevels) then pronation is a compensation for the long leg. I think most of us have seen this.

    Respectfully,

    Stanley
     
  9. Tylermarshall

    Tylermarshall Welcome New Poster

    Re: The 5 great FACTS of podiatric biomechanics

    As I am one of the victims of "emphasis on teaching surgery over biomechanics and a lack of post-graduate training programs in biomechanics within the podiatric medical educational system within the United States will result in, within the next two decades, a lack of US trained podiatrists that will be considered experts in podiatric biomechanics." What do you suggest for edification? One can read, but truly discussion and live patients is what teaches in my opinion Will Biomechanics fellowships ever exist? (Please forgive me if there are any as I have not found many if any biomechanical fellowships.)
     
Loading...

Share This Page