Competing Theories in Podiatric Biomechanics Seminar

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I have accepted an invitation to lecture at a conference in Chicago on November 13, 2010 on competing theories in podiatric biomechanics where I will present a discussion of Tissue Stress Theory and Subtalar Joint and Midtarsal Joint Rotational Equilibrium theory. Other lecturers include James Clough, Guido LaPorta, James Wrobel, Bijan Najafi, Neil Horsley, and Edward Glaser.

I have made up a new lecture especially for this seminar to point out the old technology of high arched orthoses and that foam box casting in a supinated position is simply another way of producing this older high-arched foot orthosis technology that has existed for over a century. I will be having a lot of fun at this seminar!

Here is the course schedule for all of you who are interested.

 

Why isn't vaulting being discussed? It's an outrage, surely Dennis has a competing theory? In all seriousness, is this it? MASS versus tissue stress, is this what it has come to? Is MASS a theory or a casting position? How does MASS theory attempt to explain pathology?

 

One of the first things I will be stating in my lectures is that MASS is not a theory, but it is rather only a new orthosis casting position that is being used by a non-engineer orthosis marketing specialist with no faculty appointments and with no peer-reviewed papers published in order to make high-arched orthoses without rearfoot posts and hoping that he can sell as many orthoses to the chiropractic, physical therapy and podiatry profession as possible....nothing more...nothing less. Actually, Simon, the only reason I decided to take time away from my busy practice to do this seminar is that I will be given adequate time to give the audience some idea of how ridiculous some of the claims of "MASS Theory" are and how common sense the concepts of Tissue Stress Theory are. Can't wait...can't wait....can't wait....

 

For the benefit of those of us for whom chicago is a long way, is there ANY chance that this event could be recorded?

 

Just checking flights, Rob. As it seems we probably won't be going to Portugal, why not?

 

Tempting. Veeeeery tempting.

 

Because Ed and Kevin have conspired to keep "the man" down.

 

It's not on. I think we need to start a protest group: freedom of speech for the children of Muppet eagles.

 

The presentation appears very weighted with material on MASS. Should be a very interesting seminar with a counterpoint to Ed's presentation. Very tempting, can non DPM's attend Kevin?

 

I'm sure you are welcome to attend, David. In fact, it would be a pleasure to meet you and speak with you for the first time. Regarding the lean toward MASS stuff in this seminar, I can't comment publicly on this, but it is an interesting story how this seminar has developed into its current title and content. I think it will be a very good seminar and I would love to see some of my Podiatry Arena friends there so they can ask some questions of the lecturers during the seminar and enjoy the show.

 

I would love to be there, if i can fit it into my schedule and budget I'm in. If not a flight up North may also be in the cards one day since you offered. I missed the moment to shake your hand at the PFOLA in San Diego in 2007 (?), it'll be great to finally talk with you in person Kevin. I have a LOT of questions!

 

I also would like to attend this conference (and mavbe catch a Bears game at the same time - if they're at home on the Sunday), but unfortunately I live a fair distance away. As Robert Isaacs asked, is there any likelihood of someone recording this?

 

Flying out to Chicago this afternoon for the "Competing Theories" seminar and anxiously awaiting getting to lecture extensively, for the first time, in this area of the country on tissue stress and rotational equilibrium theory. Special thanks to Eric Lee for providing me with valuable information on the history of foot orthoses which I have included in my new lecture titled "High Arched Foot Orthoses: New Innovation or Old Technology?" Should be a very interesting seminar. BTW, there is discussion that the seminar may be videotaped, for those of you who are interested.

 

Have fun and safe home.

 

Good luck Kevin,
You know, we migh want to "hook" you again for 2012 are you ready for waffles and beer? :drinks

 

Definitely!

 

Thanks, Simon. Looking forward to seeing our paper published soon.:drinks

 

I am enjoying getting some email updates as this conference unfolds from the conference floor ... problem is the tone and content of the emails are not exactly publically publishable!

 

Surprise, surprise most of those emails are from me!

I just got home after the conference and it was quite good. Some of the things that Dr. Bijan Najafi and Dr. Wrobel are working on are very exciting. I would very much like to work with them both since they are only about 1.5 hours from me and at my alma Mater, Scholl College.

Kevin and Jim Clough did an excellent job as well. Kevin's lecture on orthotic history which used a lot or most of the material from Eric Lee was really great to see. I have to stop calling it a "morton's" neuroma from now on apparently, and instead call it a "Durlacher" Neuroma! ;-)

Dr. Glasser's stuff was - interesting? He unfortunately seemed more interested in taking down most of the literature used to prove orthotic function to allow himself no need to use literature to back his claims. Well, nothing but the one study that showed his orthotics worked best anyway. He is a compelling salesman with some excellent slides. It did not seem that he swayed much of the crowd of 90 physicians and 30 students in attendance, but I could be wrong. He was cordial to everyone.

All in all it was a good day to see some friends, Jim and Kevin, some students who I"ve worked with before, and to make some new friends like Drs. Wrobel and Najafi!

Cheers and I hope my emails weren't too bad between the too of us Craig!

Bruce

 

I think the "highlight" of the seminar was when, at the very end of this seminar on competing theories in podiatric biomechanics, Ed Glaser made his dwindling audience sit through 15 minutes of testimonial videos of Guido LaPorta, DPM and then Gary Dockery, DPM, claiming the miraculous benefits of SoleSupport orthoses. Amazing! :craig::bang::butcher:

 

Kevin,

To me Guido LaPorta and Doc Dockery are two of the most respected experts in all of Podiatry.

Since, Dr. Laporta was scheduled to speak and had to cancel due to illness, I felt that his expert opinion was more than appropriate. Since Dr. LaPorta was going to give case studies, (although it is obviously not a complete case study) I presented Dockery's case, personal experience and expert opinion as well for a good reason. They totaled about 8 minutes together, but I am sure it seemed like 15 to you especially after I completely disproved SALRE and showed how tissue stress model was being misapplied.
I put these two videos at the end of my lecture so that I could decide whether or not to use them. After you presented your anecdotal story of one patient who was in the break-in period and just probably needed some stretching exercises or maybe a slight adjustment to their orthosis, I felt that it was appropriate to counteract that mis-information with Doc’s experience where 40 different attempts at single axis orthoses failed and Mass Posture orthoses succeeded. It was especially relevant because he not only got relief of symptoms, but reversal of hammer digit deformity, reversal of Hallux Limitus, reversal of Sub 2nd IPK, etc. etc., as he said, 12-14 injections and over 35 years of suffering alleviated with one attempt at Mass Posture. Very typical of our results.
I knew that no one especially you would mind since the vast majority of all of your writings, including you peer reviewed articles are nothing but expert opinion.
I looked over the evals afterward and I did far better than you. Our booth was inundated with docs standing several deep trying to learn MASS Posture. Six were cast on the spot and numerous others gave us their cards and said they will call Monday to begin the certification process. Enormously successful.
The lecture was video taped……we video taped only my lecture which we will post fully in a few days. I do not know what the school will do with the others. Anyone who watches it will see how I showed clearly how the SALRE theory is …….well, each will decide for themselves…... As for Bruce Williams’ observations…..well he would declare your victory even if you ran out of the room crying with a large lump in your pants….in the back, that is.
As for your history lesson. Great. I am proud to follow such distinguished colleagues who also see the value of changing foot posture. It seemed that you were concerned mostly about who would get credit for Mass Posture Theory. Although none of those brilliant doctors mentioned a posture like MASS Posture, compressed the soft tissues, calibrated the shells or attained full contact in MASS Posture, I found it very validating that they knew that Posture Controls Function. If I were wrong, then wasting half of your afternoon lecture time on ‘who gets credit’ would not matter. Indeed, I don’t care who gets credit. You can give Bozo credit for all I care……Unlike yourself, I am not in this for self aggrandizement or credit…….. I am in this only to Make People Better. Not for money……I already have my toys and give most of the profits to researchers like Najafi and Wrobel……who have agreed to study my theories at the CLEAR center. As Dr. Leslie Trotter clearly stated….my research grants come with no strings at all. I do not pick the research questions, methods, and have no control of the results. She told me that other labs have offered funding but always back out when they see the ‘right to publish clause’ in the contract. Often the first I see of the data is in the article when it comes out. So all of your personal attacks aside, your theory fails on its scientific lack of merit only…..and anyone who watches the video of my second lecture (who is not guzzling the Kirby Kool aid) will come to the same conclusion.

I want to thank you for participating. You came a long way to take a sound thrashing.

Sincerely,
Ed Glaser, DPM
CEO Sole Supports, Inc.
www.solesupports.com

 

Sounds like a barrel of fun!! Good time had by all. Ed, you've obviously been working on your felicity of style! Thats the nastiest post I've read in a while!:drinks

To be honest though I'm more interested in Theta orthotics now. They're higher in the arch (and therefore better) than sole supports by a clear 13 degrees! Can't argue with that. Pity the patients struggling with the (relatively) flat and unsupportive sole supports.

Assuming the L Trotter study came up, did anyone point out that all the data shows is that casted insoles worked better than 3mm open cell flat foam insoles? Hope so!

Shame I missed it. If you fancy a UK version of the same debate ed, let me know. I'll try not to poop myself.

 

For those of you who are interested in what I did lecture on for my 15 minute lecture :"High Arched Foot Orthoses: New Innovation or Old Technology?" yesterday in Chicago, I have attached a pdf of my lecture here. Special thanks, again, to Eric Lee, whose excellent research on the subject of foot orthoses allowed me to provide a more accurate history of the high arched foot orthoses.

 

Wow Dr. Glaser,you obviously don't know me or the history of my discussions with Kevin and others regarding SALRE theory.

I would say there was no victory for anyone yesterday short of the decorum that the other scientists and physicians showed in holding their tongues through most of your presentations.

You did nothing to disprove any theories yesterday though you did your best, in your mind, to even the playing field by attempting to focus on actual research that, despite your claims, does show positive outcomes regarding custom foot orthotics.

Your cherry picking of findings and quotes out of context is quite obvious since you provided nothing in the literature to back any of your claims about MASS theory.

If you want to prove your theories then do so by building a case in support of your ideas and concepts, not from attempting to discredit all others ideas and theories of foot function.

Your actions do nothing to benefit what podiatrists do with orthotics. Instead you attempt to discredit our actions so that your theory, and yours alone, will stand aloft.

I am sure that Dr. Dockery is pleased with your devices or he would not have filmed the testimonial that he did for you. Until he shows me a before and after picture of his feet I will never believe you or any other practitioner can eliminate a true overlapping second toe deformity with the use of a custom foot orthosis. That statement alone discredits his sincere testimonial completely in my eyes.

If you want to help our profession then give money for research as you say you are and will. But do it in a way that gives credit to what has and is being done in a way that is positive for our profession and not solely to benefit your claims.

sincerely;
Bruce Williams, D.P.M.

 

It was especially relevant because he not only got relief of symptoms, but reversal of hammer digit deformity, reversal of Hallux Limitus, reversal of Sub 2nd IPK, etc. etc., as he said, 12-14 injections and over 35 years of suffering alleviated with one attempt at Mass Posture. Very typical of our results

good evening all,
i am not as experienced as anyone who has already contributed to this discussion and so i hope i am not out of my depth here but i have trouble with the notion that you could reverse hallux limitus. Could you enlighten me? am i missing something here?
cheers
JB

 

Bruce,
Lets just wait for the video to get posted and each can decide for themselves.
Good Night,
Ed Glaser, DPM

 

Bruce, if that's the case, he is not shining a good light on the profession. Coming from the stance of one searching for the best of podiatirsts - - I find it both disheartening and abysmal that one would promote a product without empirical evidence and review from peers.

 

"For when the One Great Scorer comes
To write against your name,
He marks - not that you won or lost -
But how you played the Game." Grantland Rice

Education is a method whereby one acquires a higher grade of prejudices.
Laurence J. Peter

etc. etc.

 

Yeah, this is fun!!

The Greatest enemy of knowledge is not ignorance, it is the illusion of knowledge.
Stephen Hawking

To be ignorant of one’s ignorance is the malady of the ignorant.
Bronson Alcott

There is nothing more frightening than active ignorance.
Goethe

 

It's what you learn after you know it all that counts.
Earl Weaver

Desperation is like stealing from the Mafia: you stand a good chance of attracting the wrong attention.
Doug Horton

 

Win or lose you're a class act Ed. Bravo!

 

A bird in the bush is better than rolling stones, any day of the week!

 

The dog who rides the tractor can laugh at the snake.
Ed

 

There's no 12 point plan for STUPID! Ed!

 

Dr. Graham:

I was just adding to the philosophy and poetry on ignorance.

Dr. Bill Orien autographed my Vol. 2 after seeing my lecture 11 yrs ago, “To a fellow soldier in the fight against ignorance.”

Lets face it there were certainly several that came into that room with their own prejudices. There were doctors who have never tried MASS Posture, who have read the “expert opinion” of this paradigm from Kevin Kirby on this site.

Some obviously thought that it would be a deathblow to MASS Theory. Instead it was quite the opposite.

One female podiatrist came up to Leslie after the conference and said that she had been in practice for many years using the standard podiatric foot orthotics with mixed results. I took her a few exposures to my course before she agreed to try MASS because she was skeptical about how patients would tolerate the arch in the MASS posture. She switched and said that the comfort for her patients was far improved (BTW Dr. Najafi referenced an article showing more comfort in higher arched devices…. Not related to MASS). She said that her results were far better than anything she had previously experienced. I only bring her up to illustrate that there were others who entered the hall with a prejudice in favor of MASS as well. Her positive experience was a hard obstacle for Kirby to overcome.

Kevin tried very hard to frame the argument from the very beginning around the height of the MLA. Early in my lecture I show a very low arched MASS orthotic. I made it clear that this was not a fight between Neutral and MASS either, in fact, you will be surprised to hear in the video, that I acknowledge Neutral as being the correct rotational position around the STJ axis. Maybe Root biomechanics is not dying….as Kevin writes in Podiatry Today.

Instead this is a major and important paradigm decision for every Podiatrist

Single Axis theories and MASS Postural Theory (all axis theory).
I go over fundamental assumptions one must make to accept a single axis theory…. Quoting Kevin…..and then the data measured by Nester, Kogler etc. that contradicts those assumptions.

And fundamental application differences in:
1. Casting
2. Palpation
3. Method of application of corrective forces
4. Geometry
5. Soft Tissue Compression
6. Level of Supination of Posture.
7. Calibration and Measurement
8. Materials
9. Repeatability
10. ….and more.


I introduce new research that we recently conducted at the Smithsonian Institute.
Research currently going on at various Universities.

I reference from 43 sources within the podiatric literature (books, peer reviewed RCT’s and Literature review articles)…… although I could certainly understand Bruce not noticing any of them (powerful stuff….. that Kool Aid). I picked a few and looked closely at the data….. my conclusions were drawn carefully and in agreement with several notable researchers like McPoil, Nester, Nowczecki, Root and Kirby himself amongst others. I could easily have one of my staff prepare a complete bibliography of references……no, on second thought, watch the video and find out for yourself.

Then I go over the Physics, funtion, and relative importance of STJ motion and moments…..

You will also see some funny videos ….. at least we had a lot of fun planning and shooting them in our TV studio and 3D virtual studio….. a lot of credit to our videographer, Greg Welsch and our 3D animator Santana Marcum, and our President, Head of Graphic Design Don Bursch, PT …..especially for their meticulous attention to accuracy….. of course like everything we are always improving our graphics. Their help was enormously appreciated in the preparation of this lecture.....and also Dr. Stu Currie, our director of research for his assistance with references, Smithsonian research and coordination of university research grants as well as conducting our own in house research projects.

I will check with Greg tomorrow and find out when the video will be posted…..if it hasn’t already.

One thing that bothered me:

Bruce said, “If you want to help our profession then give money for research as you say you are and will. But do it in a way that gives credit to what has and is being done in a way that is positive for our profession and not solely to benefit your claims.”

I would think it unscientific to slant research with a bias toward supporting the status quo just as it would be unscientific to bias research in favor of any particular result. Real Scientific research, like Dr. Trotter, Dr. Wrobel and Dr. Najafi performs, should not be performed to shed a positive light on a product. Ours is not….as Dr. Isaacs so readily points out. But when it does favor a particular paradigm that alone does not invalidate it. Research that brings truth is the most positive for our profession…. Even when, no especially when it does ‘benefit my claims’ because I am claiming to Make People Better….. and that is what we all should be after.

Sincerely,
Ed Glaser, DPM
CEO Sole Supports, Inc.
www.solesupports.com

 

igs::drinks

 

Ed:

When will you stop your straw-man arguments that are only designed to make your ideas look better by calling my 25 years of publications on foot and lower extremity biomechanics as being "single axis theories"?

Maybe once you stop giving infomercials at seminars about your orthotic lab's product and stop claiming that you created a "theory" because you use a "new" supinated casting postion in a foam box, then maybe someone will start taking you seriously. Or better yet, why not try something totally foreign and novel for you.....getting a paper you have authored into a peer-reviewed scientific publication?

I know, you want the quick way to fame in the podiatric profession....pay your way into seminars around the country.....lecture every weekend on how great your "theories" are.... show ridiculous non-sensical demonstrations of how everyone's theories are wrong but your own. Sadly, Ed, even though earlier you had an opportunity to do something positive for the podiatric profession and create a postive image for yourself.....you now will always be considered to be nothing more than a salesman for the orthotic lab he owns.......and no amount of money you throw at it otherwise will change people's opinions of you.

 

Kevin,

You’re so cute when you’re angry.

Hey, you don’t have to worry about my feelings, OK, because I don’t HAVE any. LOL

Let’s address your STRAWMAN contention, because it is a fantasy.

You ARE all about "single axis theories". The only people who don’t know that are the people who cannot find a cup of coffee in Seattle or Micky Mouse T shirts in Orlando, FL.

Let’s LOOK at the DATA.

Firstly your “theory” is called the: SUBTALAR AXIS Location and Rotational Equilibrium Theory. This axis may translate considerably but it is still a singular axis at any moment in time.

Let’s examine the titles of your articles in no particular order:

Subtalar Joint Axis Location and Rotational Equilibrium Theory of Foot Function.
Rotational Equilibrium Theory Across the Sutalar Joint Axis.
The Subtalar Joint Axis Locator
A Motion-Based Method for Location of the Subtalar Joint Axis in Cadaver Specimins
Methods of Determination of Positional Variations in the Subtalar Joint Axis
In Vivo Tests of an improved method for functional location of the Subtalar Joint Axis

In Kevin Kirby’s article in Podiatry Today entitled: Emerging Concepts in Podiatric Biomechanics Kirby writes that …….…. “Kirby proposed that the spatial location of the STJ axis had a significant mechanical effect on the function of the foot since its abnormal spatial location relative to the plantar foot significantly alters the magnitudes and direction of rotational forces (i.e. moments) acting across the STJ axis.”. What a surprise SALRE is the emerging concept here. You call me a salesman? Look in the mirror.

For fun, I did a ‘find’ on STJ and Subtalar in the first article. I think you deserve a world record: 433 mentions in one article…… WOW. Who would think you are married to the STJ axis? Why, You hardly mention it……you little strawman, you.



As for the rest of your babble. It is unprofessional, untrue, irrelevant, and it makes you look bad.

Everyone can see that you are trying to divert attention away from the valid criticisms of SALRE and your entire paradigm because it is a very ugly paradigm, flawed, based on invalid assumptions with massive errors, inaccurate and unrepeatable measurements and ends up in just an unscientific wild ass guess. To think doctors have the time these days to spend twenty years studying at the feet of the “God of Podiatry” to become the master of lumpy-bump placement is ludicrous.

http://www.facebook.com/group.php?gid=1116574388887423

You need to hand out Kool Aid with that fantasy.

Doctors want an easy to understand, accurate, easy to perform, repeatable technology that gives their patients a truly custom (shaped to match the foot) device that is cast in the correct posture and applies a full contact, more evenly distributed corrective force pattern through the gait cycle with a calibrated plastic leaf spring like orthoses.

Prefabs can accomplish the lumpy bump, Mr. Potato-thotic approach. Look at Foot Levelers, The Good Feet Store and Dr. Scholls in Walmart.

Strawman my foot…. LOL

Ed

 

The difference Ed, is Kevin isn't "selling" any thing except reasonable ideas and some well written books. :deadhorse:

It's a shame if podiatrists want a "quick' technical out from truly understanding what they are doing. They are not what makes a profession recognized and respected.

 

Graham,
We all sell. Kirby did not give away 13000 orthotics in his career and neither do you. You have to sell the patient on your ability to help them. He sells his books......and he is trying to sell the podiatry profession a model of understanding Podiatric Biomechanics. Root sold us on the last model. Selling is helping people make better choices. I believe in what I teach. I use it. It works. If you want to learn more about it...fine....if not .....fine also.
Sales is a noble profession. At IBM there has always been a sign: Nothing Happens Until a Sale is Made. In manufacturing custom devices that is even more true. We have no finished inventory. Everything we make is ordered before we begin making it.
Am I a Salesman. YES!!!!!!!! and proud of it. I am selling the Podiatric Profession a new paradigm that corrects the omission, in single axis theories, of Postural correction and solves many of the application errors that Single Axis Theories like "Neutral" and SALRE have. I am selling them on a fast accurate method of casting the foot. I am selling them on the idea that you can and should take accurate measurements of biomechanical parameters of posture that are relevant not only to our understanding of pathology but also used directly in the manufacturing process. And mostly I am selling them a way to Make People Better than traditional orthotics even attempt to. Most practitioners want to Make People Better........and that is all we are about. WE MAKE PEOPLE BETTER. Our core value is in alignment with that of our customers.

That is what I am most proud of.

Ed