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Runners World article!!!!

Discussion in 'United Kingdom' started by CEM, Oct 29, 2005.

  1. CEM

    CEM Active Member


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    Has anyone read the recent article in runners world called "footing the bill"
    where a journalist visited 9 podiatry practices round london (STANGELY ONLY ONE WHO ADVERTISES WITH THEM, AND PROBABLY WON'T AFTER THIS!!) whilst they tried to to show that orthotics are not for every one they created a completely inconclusive article. The only thing they did show was the conflict of opinions within the podiatry proffession, the variation in charging (from £25 - £80) the most expensive of these stating ' you over pronate but we are unable to say more until we do further investigations, video gait analysis, pressure analysis etc, etc.' at further cost! WHAT EXACTLY DID THE £80 GET :confused: :confused:

    As a pedorthist I deal with several podiatrists on a weekly basis, all of which think the article made horrific reading, I even contacted the magazine with regard to a follow up article and was told that they had no space to even consider this as they has achieved what they wanted.
    To make matters worse they had the nerve to call me and ask if I wanted to commit several hundred pounds in advertising my clinic (strange, i did not take them up on the offer!)

    OK rant over,
    but has anyone had clients call them up wanting reassurance about the orthotics that you are prescribing to them, or questioning your diagnosis.
     
  2. Admin2

    Admin2 Administrator Staff Member

    I went to look for the article online and its not availale, but did find this thread at the Runners World UK forum:
    http://www.runnersworld.co.uk/forum/forummessages.asp?dt=4&UTN=69860&last=1&V=1&SP=

    Me thinks the profession in the UK has got a bit of PR to do to catch up from the fall out of this one.
    eg
     
  3. CEM

    CEM Active Member

    the forum is one thing! try to get a copy of the mag article, i think if my clinic was listed i might have closed by now (or started more education)
     
  4. davidh

    davidh Podiatry Arena Veteran

    Hi,

    I was their podiatric consultant for a while (answered the foot problem letters in their injury clinic slot etc), and perhaps I still am, although I haven't heard from them for a while.

    It was very clear to me that they were/are hugely interested in promoting clothing and running shoes and very disinterested in podiatry or orthoses.
    Check out the adverts in Runners World. Which are bigger and bring in more revenue?
    Footwear/clothing ads, or Podiatrists ads?
    Might they have vested interests :eek: ?

    I'm sure they found some dodgy practitioners, but equally I think we can be sure that the article was biased.

    Regards,
    davidh
     
  5. Craig Payne

    Craig Payne Moderator

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    Having not seen the article and just reading CEM's comments and what I have seen in the past of these types of story's, I am not sure "biased" is the right word .... I just think its a matter of someone having some sort of agenda and the setting out to support it.....however some would call that 'biased'.

    Its just like the left/liberal vs the right/conservative journalists or talking heads ... you can build a case to support your agenda ... the difference in politics is that the agenda is made explicit, so you know the perspective beng taken (eg left or right)

    Another eg is the detective who is so convinced that someone is guilty and they set out on a path (sometimes an obsessive path) to proove it ... and ignore or dismiss contradictory evidence ..... does that sound familiar in this case to those who have read the story?
     
  6. CEM

    CEM Active Member

    thanks for your comments Craig, and others.

    i think the term parasitic life form could replace journalist in this case!!
     
  7. davidh

    davidh Podiatry Arena Veteran

    Hi CEM,

    I think you're being a little unfair to parasitic life forms there.

    :)

    Cheers,
    davidh
     
  8. A few points that should be made about an article like this:

    1. Many points of the article are probably true.
    2. It is very good for all podiatrists to try to understand the opinions expressed in the article that obviously come from a patient's perspective who doesn't comprehend that clinical medicine is not an exact science.
    3. The article is probably no more biased than the podiatrists who read the article and say that the article is biased.
    4. If the article has the effect of making those podiatrists who don't know much about running injuries attend a sports medicine seminar for the first time and actually learn more about running injuries (rather than just telling the patient something they aren't sure of or making something up) then maybe the article has done a job for the profession that it may never have intended to do.

    The problem with podiatry, as is the problem with all medical professions, is that there is a wide range of knowledge between different individuals within the profession. This will be certainly be made glaringly evident when an investigative reporter goes to a number of clinicians within the same profession and reports on the widely ranging diagnoses, costs and treatment plans with each clinician. This would be very true here in Sacramento, California, as it was shown to be true in London.

    This is why many patients, and especially runners, tend to use "word of mouth" advertising since I believe that they intrinsically understand this aspect of clinical medicine and would prefer to only go to the clinician that will be the best for them, get their problem better, and with a minimum of expense. Ever wonder why a few clinicians are always so busy and others are always struggling to keep their schedules full??

    An article like this doesn't surprise me a bit, since I'm sure it is a fairly accurate portrayal of the state of podiatry in a certain region regarding foot orthoses and running injuries. If someone is mad enough about it, then I suggest that they should send an intelligently written letter to the editor of Runner's World, and point out how such an article does not give both sides to the argument and is, therefore, not a balanced view of podiatry as a whole.
     
  9. Craig Payne

    Craig Payne Moderator

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    Does anyone have access to the article? Can you scan it and email it to me: c.payne@latrobe.edu.au or fax it to me +61 3 9479 5784 or anyone going to PFOLA from the UK that can bring it with them next weekend.... I have something I can do with it .... much appreciated.
     
  10. Craig Payne

    Craig Payne Moderator

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    Thanks to Jamie @ Algeos for a copy of the article.
     
  11. CEM

    CEM Active Member

    thanks Jamie,

    my computer had a failure to cope :eek: :eek: trying to compress the files to send them to craig, if anyone wants a really hi res copy and doesn't mind clogging their e-mail let me know!!
     
  12. Craig Payne

    Craig Payne Moderator

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    Now that I have had a chance to read it .... as bad as what it is, it probably reflects reality with differing level of competences of the practitioners. It is a shame that the co-called biomechanics expert was not really the most appropriate person to comment (just do a medline search for their one publication and it not even on foot orthoses!). There many factual errors and bad advice in the article ... I can only assume that "magazines" such as RW do not have a peer review process in place to prevent crap getting published.

    For me, things are really exciting at the moment, especially on just how much our foot orthoses knowledge and theory have improved in the recent years (if not months) ... its a shame that the author and "expert" witness have not caught up with that new knowledge (let alone some of the practitioners the author went to).

    What the author found is a salient reminder that representative bodies have in bringing people up to standard and individual practitioners have in bringing themselves up to speed (after all its their responsibility).

    7-8 years ago, APodC in Australia developed the National Guidelines for Foot Orthotic Therapy to deal with this type of issue. At LTU we use them to underpin our foot orthoses teaching and assessment ... problem is that in the curret context, the guidelines are dated and plain wrong in a few places.

    Incidently, this RW issue reminds me of the "orthoses" vs "arch supports" expose from 1981 in a consumer magazine in the USA (...they got over it).... shame there is not more responsibility in dealing with the issues.
     
    Last edited: Nov 1, 2005
  13. I thought the article was not that bad, especially considering it came from a non-scientific sports magazine. Wake up podiatry....this may be how the public views us and the extreme difference of opinions that we may provide to a patient. There are valuable lessons in this article for all of us. Maybe we should be looking closer at our profession and see what we can do do to remedy this problem that Runner's World magazine found about it (which is not unique only to podiatry) rather than to get "mad" at the author of the article or the magazine.

    On the positive side, I agree with Craig that foot orthosis knowledge and theory is much better now than it has been in the history of our profession. The only problem is that only about 5% of our profession really stays on top of the research and understands the theory. Whose fault is this, Runner's World??
     
  14. Craig Payne

    Craig Payne Moderator

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    I sent a copy of the article to a physiotherapy friend and this was his reponse:
     
  15. CEM

    CEM Active Member

    As Craig's physio fried said,

    "what exactly were runners world trying to acheive" :confused:
    the only thing i can see is confusion both from the readers point of view and by the looks of things the practitioners

    one point that seems to be common amongst all the practitioners is that they all (those who are suggesting orthotics) appear to be precribing rigid devices irrespective of the forces involved. There seems to be, and tell me if i am wrong a culture of presribing the same style of orthotic for all, is this the fault of the labs not teaching the practitioners about the differing styles of product that they provide (they do all offer differing styles of devices don't they)

    Maybe they would have better success with runners with no apparent injury by using a selection of differing orthtotics depending on the problem??? prehaps a semi rigid or soft device would be better tolerated by the patient and possibly offer enough support to reduce any symptoms.

    i know that if i run in my rigid corrective orthotics then my feet ache, if i use a slightly more flexible device i have no problems (but hey that is just me, and i run like a clydesdale with a speech impediment (no offence to clydesdales))
     
  16. CEM

    CEM Active Member

    Hi All,

    just picked up the next issue of runners world, don't worry they are not on the foot thing again, this month the same journalist is giving advice on all sorts of other injuries (not my area so do not want to comment, leave this one to the physios)

    last months article has stirred up some good reaction, a reader has written in to say that they had had a great experience at one of the clinics mentioned and the orthotics she got are great, at least the public are supporting the profession, even if the magazine is not.
     
  17. Craig Payne

    Craig Payne Moderator

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  18. I liked this response from Craig's physiotherapy friend. I think, as a profession, we should strive to offer more uniform opinions on how best to treat different pathologies. However, the opinions and treatments offered to patients will always be quite clinician dependent, especially when it comes to foot and lower extremity biomechanics, where we are making approximations with our measurements. Even three dimensional gait analysis, pressure mats and force plates are approximations of reality and are open to subjective analysis.

    I really don't think that an article, such as the one from the UK Runner's World, will do much harm to the profession. It may in fact start discussion that will show that as far as injured runners seeking medical advice and treatment, the sports medicine podiatrist is usually the best specialist to use as a primary healthcare provider.

    Wouldn't it be interesting if a runner that said they had "vague foot pain" went to 10 orthopedic surgeons or to 10 rheumatologists or to 10 physiotherapists and then listed out the varied diagnoses that would be gathered by the "patient". Maybe the UK Runner's World will use that as one of their next articles, or do you think they will just "pick on" podiatry with their "fake patients".
     
  19. CEM

    CEM Active Member

    Sorry Kevin they couldn't possibly go to all these other professions, they blew the annual buget on podiatry : :rolleyes:
     
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