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During my two year fellowship (guest researcher) at the Istituto Superiore di Sanita (www.iss.com) in Rome Italy, I had the opportunity to evaluate the connection (if any) between infertility in women and abnormal foot motion (at first glance a seemingly impossible connection). A great deal has been written about the retroverted uterus (and the so called Isthmus Block) vs. ideopathic infertility in women (See cited references below)

Pope CS (Consulting Staff, Department of Obstetrics and Gynecology, St. Luke's Hospital), O'Grady JP(Professor of Obstetrics and Gynecology, Tufts University School of Medicine 2003. Malposition of the Uterus, Emedicine (WEBMD).
Barr SJ, Barr KJ 1983. Retroversion and infertility. Am J Obstet Gynecol, Aug 15; 146(8): 990-1
Longo LD 1978. Classic pages in obstetrics and gynecology. On retroversion of the uterus. William Hunter. Medical Observations and Inquiries, vol. 4, pp. 400-409, 1771. Am J Obstet Gynecol, May 1; 131(1): 95-6
O'Grady JP 1997. Uterine Incarceration. In: Obstetric Syndromes and Conditions. New York, NY: Parthenon

On three occasions working at a multidisciplinary clinic (which had several gynocologists on staff), I had the opportunity to fit proprioceptive insoles on women having problems conceiving. In all three cases, the women became pregnant within 3 months (after dispensing the insoles), where they had failed to do so for the previous 3 years. Coincidence, maybe so. But I suggest an anterior rotation of the innominates can place the patient at higher risk for the development of an isthmus block. If this block has developed, by reversing the anterior pelvic rotation, you can (theoretically) reverse the isthmus block, which in turn, facilitates conception. I believe this is what occurred with the three women I treated. You can see the dynamics of this dysfunctional shift in the pelvis at the following URL: http://www.rothbartsfoot.info/CanHelpYou.html

Granted, my explanation is theoretical. The concept of an anterior rotated pelvis preventing conception is not new and pretty much accepted. However, the hypothesis of abnormal foot motion initiating the development of an Isthmus Block, is a new concept. More research needs to be done in this area. But my experiences have made me think more about the correlation between abnormal foot motion and postural distortion, and the link between postural distortions and changes in physiological function.

Comments/observations?

Hello Brian

Are you talking about the same orthoses we discussed last weekend - the Posture Control Insoles manufactured by Posture Dynamics? If so, I remain to be convinced but retain an open mind! I hadn't seen your insoles when we debated but I have now taken delivery of a pair to try on a patient with an elevated first metatarsal - and I shall report back here with my findings next month.

I have to say however that a flat rubber foot-bed with just slight wedging under the first metatarsal seems (to me anyhow) overly simplistic to effect some of the claims you make - like improving the chances of conception. Were the women you mention undertaking fertility treatment or IVF? Could their pregnancies simple be coincidental with the use of these insoles? Three years ago I fitted a simple pair of poron insoles to a patient in the UK as she had lost most of the plantar adipose tissue over the metatarsal heads and the following weekend she won over £5 million on the National Lottery. Some months later another patient and another pair of poron insoles and he won over £300 in the self-same Lottery. If I were to publicise this I would be inundated by superstitious folks and the sales of poron would rocket, but I'm not sure I would retain what - if any - professional integrity and respect I still hold these days.

Not being condescending I hope, but I would like to hear more indepth explanations as to how these simple devices might do all the things you say.

Kind regards

Mark Russell

PS: I asked the same question of Kevin Kirby last week and think it only right and proper to address it to you now. What relationship do you have with the manufacturers of the posture control insoles - i.e. Posture Dynamics of Olympia, WA? Do you have any fiduciary, propriety or financial interests resulting from the sale and promotion of these devices or is your relationship with them simply academic and altruistic?

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Dear Mark,

Your questions are very reasonable and certainly deserve a response.

First, the term proprioceptive insole is a generic term. It does not refer to any particular manufacturers insole. A company by the name of Vabrena in BC Canada sells proprioceptive insoles, as well as Fusco in Italy and Postural Dynamics in Washington. I am very careful not to promote any particular manufacturer's insole, although when it comes to the PMs foot type, I have engineered a specific proprioceptive insole to reverse the postural distortions resulting from this foot type. This particular insole is only manufactured by a company in Tacoma Washington.

Second, regarding my interests in any insole manufacturing company. Approximately 10 years ago I formed a research corporation with three other investors. The sole purpose of this company was to secure patent rights on my inventions and then market the technology to different shoe companies and/or insole manufacturers (like Dr Scholls insoles). Subsequently this company was sold to Postural Dynamics. which then assumed the committment of my royalty rights. I am paid forty cents (or less) per pair, for every pair sold.

I am very careful about what I say on my website. Obviously, there is a potential comflict of interest. In an attempt to attenuate the question of potential conflict of interest, I have been very careful not to have any DIRECT link on my website to the company that manufacturers my technology. (Having said this, there is one link on my site that takes the reader to a copy of my published paper in the JBMT. This site is maintained by the manufacturing company in Washington).

Just recently, a very large and respected research facility in the United States decided to run a double blind study on my invention. In order for them to come up to speed on how to use the technology, I was recruited as a consultant for the two year project. As such I am paid a very small sum of money by the manufacturing company to work with the research facility in supplying my expertise and time.

Regarding the link between infertility and abnormal foot motion, the 'jury is still out'. The three women that I fitted with proprioceptive insoles, were in fertility treatment before I saw them.

Please understand, at this time I am only suggesting a link exists between abnormal foot motion and infertility (via changes in the pelvic position). The link between pelvic position and infertility has already been established (see my references on my website).

Thanks for your inquiries, very stimulating.

Brian

We have already had one thread on these insoles that has been locked as enough has been said and all points and counterpoints made, making it a valuable resource on the topic. Locking of a thread is not an invitation to reopen the same old discussion and issues in a new thread (ie this thread). Several messages in this thread have been deleted as they just repeat or rehash what was said in the previous thread. This makes for a boring same old, same old type of thread that is not of a lot of interest.

Any other posts in this thread that are not on the topic of the thread will be deleted. Only posts that add new information will be permited. Please stay on the topic of this thread (ie infertility and foot function).

Having said that, this thread is so close to being "over the line" for a professional forum such this, it has come close to being permanently deleted. We have already had other crank pot theories deleted (who remembers the one on Alzheimers and Footwear?)

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Please before you read the following be warned it does contain reference to material which some may find offensive. The intention is not to alarm netizens but merely to respond to an interesting theme.

Brian

My research area relates to the psycho-social and psycho-sexual aspects of shoe designs in the Middle Ages in occidental and oriental societies in the presence of sexually transmitted disease epidemics. To be frank shoes were used as a form of safe sex. From the 11th century in Europoean society long toed shoes were almost certainly used as dildos and in oriental society the bound foot when put together (sole to sole) became a second vagina. Something that was referred to but was never actually confirmed by independent research is the effects of foot binding on pelvic musculature. Rossi does cite it was commonly thought foot binding left muscles of the vagina tight for life. The common belief was the changed gait pattern caused by smaller feet (3 inches) had the required effect. In Chinese society up to the 16th century coitus was considered the highest form of worship and a sacred act of medictation.

There are now ethical ways and means of testing this theory which will hopefully form part of my doctral thesis (when I get round to it), so I certainly would accept there may well be a potential association between feet and genitalia. The sensory supply oringinates for adjacent areas of the brain and 'neural print through,' is thought to provide one explanation why some people find their feet titilating in a sexual sense.

So any hypothesis involving walking and infertility is not so fantastic as to be dismissed lightly, I would conclude.


Cheers
Cameron

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Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

Brian

Playing devil’s advocate again, I think the problem many of our colleagues have is that you tend not to answer some of the questions asked of you but direct them instead to your website, which I think is aimed at the less academically minded. The various animations are all very well but even I have to make a great leap of faith when trying to reconcile some of the claims you make with the insoles I have in front of me now.

If I may be so impertinent and suggest your initial post in this stream as a case and point. You make a valid suggestion regarding infertility and the possible link to conception by women who were supplied with posture control insoles. But I would have given you greater credibility if you had mentioned in the original post that these same women were receiving infertility treatment at the same time. I’m not an expert in these matters, but it would appear to me that there is a stronger probability that their success in conceiving may have more to do with the latter than with your insoles. Don’t you agree?

Although I can understand where you’re coming from with the theoretical argument, I remain to be convinced that these simple devices will do what you claim. A semi-compressible rubber insole with a marginal post to the medial forefoot border really can’t make that much difference surely? When I think back to all the simple insoles I have made during my career, I would never have considered that they might be able to cure so many systemic conditions - but I might be wrong! I remember a seventy-two year-old chap that I fitted with an insole six months back who claimed his erectile dysfunction had been cured - but he had started taking sildenafil at the same time!

I’m not sure that our colleagues fully understand the concept behind these insoles so I’ll try an upload some photographs later for ease of reference.

Best wishes

Mark Russell

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I think the closest thing that I have seen in 21 years of podiatric practice to a link between feet and infertility are in the married patients that I have prescribed plantar fasciitis night splints to who state that this device is one of the greatest birth control devices available. :p

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Sincerely,

Kevin

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

e-mail: kevinakirby@comcast.net

Private Practice:
107 Scripps Drive, Suite 200
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Mark,

I am sorry, but obviously I did not make myself clear. All three women had gone through infertility Tx with no success (one was in treatment for 3 years). All three had been diagnosed with a retroverted uterus, and at the point I saw these women, surgery was being advised as a means to reposition the uterus. What I noted was (1) all 3 were severe abnormal pronators, and (2) all 3 had a moderate to severe anterior pelvic rotation (which we now recognize is linked to abnormal foot motion). At the time I suggested, before surgical intervention, to try insole therapy. Because the gynocologists were DOs, the concept that form can drive function was well understood by them, so they agreed. Within 3 months after dispensing the insoles, all three women were pregnant (very surprising to all of us). However, later (at the same clinic) another women was fitted with prostims by the gynocologist and the insoles did absolutely nothing for her. But, that patient, interesting enough was not an abnormal pronator. So, does all this prove anything, absolutely not! However, it does suggest, in my opinion, that this possible link between abnormal foot motion and fertility needs to be further investigated.

The comments I have read on this forum regarding my research on other visceral reactions that I SUGGEST are linked to abnormal foot motion, indicates to me (and please read that as TO ME) that some of the members may have had very little clinical training in Osteopathy (I have worked closely, in the same office, with American Osteopaths for over 10 years). Possibly we should invite an Osteopath on this thread for his opinion. We could also ask him to comment on my webpage entitled 'Proprioceptive Stimulation can Help You' (http://www.rothbartsfoot.info/CanHelpYou.html).

What do you think?

Brian

I don't see why not. I have an experienced osteopath at my practice and (although he doesn't know it yet) he's about to have a lot of paperwork dumped on him in the morning. He will also help evaluate the insoles that we will trial with my patient, and of course I'll submit his views and opinions when I have them to hand. I also have a contact at the Royal College of Obs & Gynaecology and I shall ask her to comment on your suggested link between abnormal pronators and infertility. The more views on this subject, the better.

Best wishes

Mark Russell

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Great, let's do it.

Brian

Dear Admin.........what's happened to my posting on this thread. It's dissapeared

Mark,

Since you have graciously offered to bring experts in Gynocology and Obstetrics into this discussion (which I believe is an excellent idea), I would like to make my webpage at http://www.rothbartsfoot.info/CanHelpYou.html the springboard for all futher discussions. This webpage provides an animated model of my proposed link between abnormal foot motion and infertility.

Is this agreeable with you?

best regards,
Brian

I'm quite happy to refer to this webpage along with the comments on this site.

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It was deleted along with a number of other messages. It was nothing more than a rehash of what was said in the previous thread, added nothing new and was not related to the topic of this thread. See my warning above.

ADDED: On a general note, I have never been under as much pressure through emails and private messages to remove/delete a thread as I am for this one.

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Thank you to Mark for this pictures:

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I detest censorship unless there are disparaging personal comments or insults being traded between the parties. Whatever the views on Brian Rothbart, there are a number of other serious issues under discussion here that are fundamental to much of podiatric practice today - both in the US and elsewhere. It would be highly regrettable if these threads were deleted or censored in any way as this would only give rise to deep suspicions on the motive of the protagonists who advocate such a move. It would also prevent us from fully reaching a conclusion of the efficacy of these insoles.

I have had a number of anonymous emails warning me off this subject since last Friday. Perhaps if the correspondents used their energies more constructively and participated in the debate instead of trying to manipulate it from the shadows, we might reach a more satisfactory conclusion all round.

Sincerely

Mark Russell

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Thanks Mark ... a few more posts have been deleted. Please everyone see my warning above and behave yourselves.

The only posts deleted in this thread have been "throw away lines"; rehashed from the previous thread; and contribute nothing new (Mark has seen all/most of them before they got deleted).

Passions run high on this topic - I have had PM's and emails demanding this topic be deleted and other asking to let it run its course. .... this puts me in a awkward position.

I do not want to (as its more work for me), but I can change this thread to pre-moderation (ie no posts will appear after posting until I approve them), so please from this point forward, please stay on topic for this thread; do not rehash what has been done to death in the other threads; only post useful contributions. PLEASE.

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I really don't mind censorship as long as the moderators feel the topic is inappropriate for Podiatry Arena. You all must remember that things have been free so far for us with Podiatry Arena. In other words, currently, 99% of what we write ends up being able to be viewed within seconds by hundreds of like-minded individuals around the world. That is a really great thing in addition to the very good academic content on Podiatry Arena. Much of this information, such as the Thought Experiments, can not be purchased in book form anywhere in the world or can not be obtained by attending the best podiatric or biomechanics seminars in the world. Having been involved in educating and being educated by electronic academic forums now for the past decade, I would say that Podiatry Arena is the best academic forum for podiatrists in the world, almost like a supercharged Podiatry Mailbase, with the ability to post drawings and photos and with many threads every week that stimulate good discussion.

However, and this is a big however, in regards to the latest topics that have sparked some controversy, I personally don't want to see our moderators lose any more precious hair from their heads by needing to pre-screen all of our messages. The prescreening of postings would greatly reduce the fun of this electronic academic community by taking away the spontaneous nature of postings. So we must all behave, because if we don't, we may be losing a very good thing. And that would be a shame and a great loss for podiatrists worldwide.

Finally, much to the consternation of a few contributors who I disagree with, I will still continue to voice my sharp opinions. But hopefully, the great majority of lurkers that read these stinging opinions will realize that they are being made with the sole intent to improve the academic excellence of the podiatry profession worldwide.

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Sincerely,

Kevin

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

e-mail: kevinakirby@comcast.net

Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
My location

Voice: (916) 925-8111 Fax: (916) 925-8136
**************************************************

My work certainly has stirred up a great deal of passion. Not a bad thing, it shows that Podiatrists have strong beliefs about what is correct or not. Bravo for us!

We are discussing a very important issue in this thread, which goes beyond the obvious (the possible link between feet and fertility). The more basic issue - does foot motion impact the health of the entire body including the viscera? This is question that needs to be addressed, and this thread is a start.

I have contacted several well respected and known physicians, one a well published gynocologist and the other a associate professor teaching clinical medicine at a medical school. I have asked them to comment on the link between the position of the pelvis and infertility. I am waiting for their reply.

Let's try to keep our passions in control, no personal attacks, simply stay to the issues. I agree very much with Mark. We are discussing issues very central to the core of biomechanics. These issues may not always be comfortable to look at, but we must do it, if our profession is to continue to grow.

One last point, the literature produced by Postural Control Inc, is marketing. Do not confuse marketing with my research.

Brian Rothbart

Mark,

It is not the complexity of the insole that makes it effective, it is the expertise and know how of the healthcare provider on how to use the insole, and what type is indicated, that makes the therapy effective.

For example, look how effective the simple paper clip is in holding paper together. But a paper clip would be totally ineffective in sealing a package (e.g., instead of using scotchtape).

The appearance of the type of Proprioceptive insole I invented is deceptive. It looks too simple to be effective (like the paper clip). But I will be very interested in hearing your experiences after using them on a selective number of patients WITH the PMs foot type.

Brian

Kevin,

I find your comments very insightful and thought provoking. Please do not stop. However, in all due respect, no personal slams. We can disagree with each other, ADAMANTLY, but still remain civil. Don't you agree?

Brian

There are other documented cases of apparently infertile women conceiving, despite all previous tretament failing. Unfortunately I don't have references, but I did hear an interesting radio programme some time ago which included specialists working in the field of obs & gynae talking about the phenomenon of women giving up on fertility treatment (often having spent all of their life-savings on trying to conceive) and then conceiving, & also the women who conceive with fertility treatment, and go on to have more children without treatment. I recall that they also mentioned a similar effect with infertile couples who adopt later going on to conceive. The suggestion is that perhaps the psychological effect of being unable to conceive can in some cases affect a woman's ability to conceive.

My point (finally I get to it!) is that I feel that there is one question overlooked here:

Is it the insoles that make the difference, or the psychological effects of accepting the inability to conceive?

How many of the participants truly believe that an insole in their shoe would solve their problems, when the latest in fertility technology had not succeeded?

For the record, i know of three couples whose apparent 'infertility' was 'cured' by adopting a child in order to fulfill thier dream of having a family. But I don't think I'd go so far as to believe that the adoption had any direct physiological or mechanical effect on the reproductive systems of either parent!

As a practicing chiropractor for 15 years I have helped scores of women with fertility/gyno problems by adjusting or stabilizing their pelvis and spinal column. My question to you pod's is, Does your work affect the pelvis or spinal column? If your answer is yes then, of course, you've helped fertility problems. You just haven't gotten credit.

David,

Of course our work affects the pelvis. I have a paper in press in which we did a statistical study to determine if abnormal pronation had an impact on the pelvis. Conclusion: Statistically, a positive correlation was demonstrated between abnormal foot pronation and anterior rotation of the innominates.

Thank you for your input.

Brian

David

What verifiable evidence do you have that supports your contention?

Regards
Mark Russell

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Craig's requests are germane and very reasonable. We need to keep to the subject and not rehash the discussion already completed.

Brian

I too would like to hear of the evidence to suport this conjecture especially since chiropractic techniques have been shown to be ineffective at treating other, perhaps more straight-forward mechanical problems
http://news.bbc.co.uk/1/hi/health/4824594.stm

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Hello!

I am new to this Forum but run a similiar Forum for chiropractors at Yahoo Groups. It is called the Sacro Occipital Technic Forum.

I looked this thread over at Brian's invitation and am amazed that this topic has been opposed. The interelation of all body structures is so inherent in what I do, that I do could not practice without it.

First let me say I am a clinician first and foremost. I am not bound by published peer reviewed "research". I use what I can make work for the benefit of the patient. If chiropractic had waited for peer reviewed research, it would have been out of existence from the start!

I am a graduate of Logan Chiro College in ST. Louis, Mo. USA and a certified Craniopath by the Sacro Occipital Research Society, Int. Leawood, Kansas. I have been in practice since 1973. My dedication during those years has been to find what works and use it. Of course, what works consistently will have been delienated by a scientific method of investigation. And SOT was developed by just such a method. But I digress.

The basic concept of SOT (Sacro Occipital Technic) is an interconnection or reciprocation between the sacrum and the occiput. That basic connection or reciprocation is a fundamental premise of osteopathy and SOT chiropractors. From that general relationship, a plethora of more specific relationships have been discovered, including a neurological hook up between Golgi Tendon apparatus in the muscles inserting into the occiput and all of the organs of the body. Further relationships between the temporals and the innominates and facial points and all of the joints and limbs of the body have also been determined. Additional monitoring and treatment points for visceral function have been found around the tempero sphenoidal ring by M. L. Rees.

These are all basic SOT findings. Add to this the recent writings on the matrix of the body and one can see that the body is a hologram.

The thing that was missing was the connection down from the pelvis into the feet. And then Brian found the SOT Forum.

I have used the Posture Control Insoles and have studied his work. It is accurate. And if it is accurate, then female fertility could very easily be affected by changing the neurological input from the feet. And three out of four cases is a good percentage of success.

To reject the possibility of fertility being changed by using proprioceptor input from the feet is to reject the latest findings in the world of the human body. The interconnecteness of the entire body is depicted in the term holistic or wholistic medicine, which is also termed alternative medicine and which is a hot term in the US, at least in the Missouri part of it!

In my area there are at least three medical doctors that are practicing wholistic medicine, some dentists and a lot of chiropractors.

The days of seeing any one part of the body as seperate from the rest of the body are long gone. It is all connected and any one part affects the whole.

David R.
chiron@rozeboom.com