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I recall chatting with Jim Ganley (c.1990) about the 'Columnar Theory' of foot function where anatomically and functionally the foot is divided into the medial (tal,nav, cun's, 1-3 rays) and lateral (calc, cub, 4-5 rays) columns.
Ted -- While I have heard of the concept, I do not recall any reference on it that would be citable.
Having said that, I do not think they concept of two independant functional columns stacks up, especially in the context of Chris Nesters works on the relative movement of the osseous segments in the foot to each other (not all of which has yet been published). See the threads on Midfoot position, ROM and stiffness and The "Midtarsal Joint"... for some discussion of some of Chris's work.
__________________ Craig Payne
__________________________________________________ ___________________________________ Follow me on Twitter | Run Junkie God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
I recall chatting with Jim Ganley (c.1990) about the 'Columnar Theory' of foot function where anatomically and functionally the foot is divided into the medial (tal,nav, cun's, 1-3 rays) and lateral (calc, cub, 4-5 rays) columns.
Does anyone know who's theory this is?
Is there a reference for this theory?
Much obliged,
Ted.
I was taught about the medial and lateral columns in podiatry school 25 years ago but don't know who originated the concept. Probably Jim Ganley wasn't the first since I believe that Dudley Morton also mentioned the concept in his book.
Chris Nester's work does not really invalidate the concept that the foot can be effectively modelled as having medial and lateral columns, as long as one understands the limitations of any model. For example, we often model the metatarsal as being a rigid segment when, in fact, it undergoes significant bending deformations with each step. I, for one, think that when teaching these complex biomechanical topics of the foot and lower extremity, sometimes it is helpful, and very instructive, to divide the foot into both medial and lateral columns.
Here is how I separated out the medial and lateral columns in a recent reply to Howard Dananberg in our thread on stance leg push and swing leg pull:
Quote:
Originally Posted by Kevin Kirby
Howard:
I believe that a better explanation of late midstance pronation is that this movement of the foot results when the dorsiflexion stiffness of the medial forefoot is much less than the lateral forefoot in late midstance. Then, as the center of pressure (CoP) moves more distally onto the forefoot during late midstance, there is a greater increase in medial forefoot dorsiflexion than in the lateral forefoot so that increased medial arch flattening and increased subtalar joint pronation occurs.
Because the medial forefoot dorsiflexes excessively, the magnitude of tensile force within the medial band of the plantar fascia increases which, in turn, increases the hallux plantarflexion moment. As a result of this increased resistance to hallux dorsiflexion (i.e. increased hallux dorsiflexion stiffness), functional hallux limitus occurs due to this medial longitudinal arch flattening and subtalar joint pronation. In other words, I believe that the primary cause of the medial longitudinal arch flattening that is often associated with functional hallux limitus is due to increased medial longitudinal arch compliance, not due to some "force dissipation mechanism", as your theory proposes.
Here, I have partitioned the forefoot into medial and lateral sections so that I could simplify the discussion for instructional purposes. It is not exact reality, but it is a very useful model for clinical teaching purposes.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Cunningham (1937), Hiss (1937) Lewin (1943) and Morton (1935) believed that weightbearing motion was transmitted through the ankle joint in two direction, described as "medial" and "lateral" segments of the foot. Duchene (1959), Horwitz (?), Polokoff (1959), Shreiber and Weinermann (1948) "showed" that as the foot is plantarflexed against the resistance of the weight-bearing surface, weightbearing motion is transmitted through the ankle joint in two direction: Lateral: through the anterior half of the calcaneus, cuboid, and the 4th and 5th metatarsals; Medial from the talus through navicular, the cuneiforms and the 1st, 2nd and 3rd metatarsals.
History lesson over.
Dr Erin Ward presented a paper at this years PFOLA meeting titled: "segmenting the foot: what may be gained- what may be lost?'
Unfortunatley, I was already flying home by the time he presented, so I cannot add any more. He does list a number of references to more recent attempts to segment the foot in his abstract.
I'm sure if you are really interested in this he would be happy to help you. His e-mail is ftbiomech@aol.com
Cunningham, DJ: Textbook of Anatomy, 7th Ed. pp. 307-521, Oxford University Press, New York 1937
Duchene, GB: Physiology of motion, pp.311-508, W.B. Saunders Co., Philadelphia, 1959
Hiss JM: Functional foot disorders, pp. 27-49, University publishing company, Los Angeles, 1937
Horwitz, JM: Variometer. Philadelphia, PA
Lewin, P: The foot and ankle, p.47, Lea and Fabiger, Philadelphia, 1943
Morton, DJ: The human foot, pp.107-184, Columbia University press, New York 1935
Polokoff, MMJ: J. Nat Assoc. Chiropodists, 49: 315, 1959
Schreiber and Weinerman: Research in podophysiology and their application to podomechanics. J. Nat Association chiropodists 38. No. 6, 1948
See also:
Lewis, LL (1966): Podal propulsive hinge as a key to normal foot function. JAPA 56: 3, 103-109 (which talks about importance of normal movement of the metatarsals about the phalanges during propulsion and the foot as a self locking wedge. Lots of sagittal plane facilitation theory in here- check the date! Nothing new under the sun ;-))
Also a great quote at the end of this paper:
"My father taught me how to work, but not how to love it."- Abraham Lincoln
Its one thing to divide the foot ino medial and lateral columns to simplfy discussion and explanations, its another thing to base a theory of foot function on it.
The work of Nester etc and what Erin Ward presented at PFOLA is leading the way to which bones can be lumped together as a 'segment' due to the relative movements between the bones.
__________________ Craig Payne
__________________________________________________ ___________________________________ Follow me on Twitter | Run Junkie God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
Its one thing to divide the foot ino medial and lateral columns to simplfy discussion and explanations, its another thing to base a theory of foot function on it.
The work of Nester etc and what Erin Ward presented at PFOLA is leading the way to which bones can be lumped together as a 'segment' due to the relative movements between the bones.
You right about BM concepts, but thats just another theoretical model.
__________________ Craig Payne
__________________________________________________ ___________________________________ Follow me on Twitter | Run Junkie God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
Last edited by Admin2 : 12th December 2007 at 02:23 PM.
Reason: added link to arena'ettes
You right about BM concepts, but thats just another theoretical model.
Quote:
Originally Posted by Craig Payne
Its one thing to divide the foot ino medial and lateral columns to simplfy discussion and explanations, its another thing to base a theory of foot function on it.
Y'all following: I was using the force- that's how I knew Craig was going to tell me why he was up in the middle of the night.
Craig, so where does that leave theories of foot function, for example: sagittal plane facilitation theory, which employ such segmented foot models, i.e. BM's concepts & self-locking wedge as a building block to justification?
Ted,
Personally, I think we have moved on somewhat from the "columnar theory of foot function"- as you can see from the references that I provided, this was state of the art circa 1940. I also believe that often some good ideas get lost in time. For example, a UK chiropodist called Swallow published a series of articles in the 60's which were a gnats tail away from tissue stress theory. Root vol 1 and 2 were published and it took us nearly 30 years to go back down the track Swallow was leading us down; as I said, there is nothing new under the sun. Therefore, I should be very interested to hear your angle on columnar theory- perhaps you can offer a new insight on this that has been lost in the myst of time?
Its one thing to divide the foot ino medial and lateral columns to simplfy discussion and explanations, its another thing to base a theory of foot function on it.
As the Professor of Life, the Universe and Everything, and the Nursemaid to Sick Twin Girls All Night, we will allow you this one, Craig.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
As the Professor of Life, the Universe and Everything,
In case anyone is wondering what this is about...its all to do with Admin and Admin2's avatar and this. If you are not familar with the triology and who Marvin is, then don't worry about it.
So long and thanks for the all fish (...No I am not loosing it due to sleep deprivation ... those who know what that means, know what it means )
__________________ Craig Payne
__________________________________________________ ___________________________________ Follow me on Twitter | Run Junkie God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
Last edited by Craig Payne : 12th December 2007 at 02:16 PM.
Reason: added links
In case anyone is wondering what this is about...its all to do with Admin and Admin2's avatar and this. If you are not familar with the triology and who Marvin is, then don't worry about it.
Thanks for the all fish (...No I am not loosing it due to sleep deprivation ... those who know what that means, know what it means )
All I know is that both my brother and I own houses numbered 42- gotta mean something?
All I know is that both my brother and I own houses numbered 42- gotta mean something?
For those who have gone this far with us and have no idea what Simon is talking about, 42 is the answer to Life, The Universe and Everything. ... now if we can only work out what the damn question was
This thread has gone seriously off-topic
__________________ Craig Payne
__________________________________________________ ___________________________________ Follow me on Twitter | Run Junkie God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
Cunningham (1937), Hiss (1937) Lewin (1943) and Morton (1935) believed that weightbearing motion was transmitted through the ankle joint in two direction, described as "medial" and "lateral" segments of the foot. Duchene (1959), Horwitz (?), Polokoff (1959), Shreiber and Weinermann (1948) "showed" that as the foot is plantarflexed against the resistance of the weight-bearing surface, weightbearing motion is transmitted through the ankle joint in two direction: Lateral: through the anterior half of the calcaneus, cuboid, and the 4th and 5th metatarsals; Medial from the talus through navicular, the cuneiforms and the 1st, 2nd and 3rd metatarsals.
History lesson over.
Dr Erin Ward presented a paper at this years PFOLA meeting titled: "segmenting the foot: what may be gained- what may be lost?'
Unfortunatley, I was already flying home by the time he presented, so I cannot add any more. He does list a number of references to more recent attempts to segment the foot in his abstract.
I'm sure if you are really interested in this he would be happy to help you. His e-mail is ftbiomech@aol.com
Cunningham, DJ: Textbook of Anatomy, 7th Ed. pp. 307-521, Oxford University Press, New York 1937
Duchene, GB: Physiology of motion, pp.311-508, W.B. Saunders Co., Philadelphia, 1959
Hiss JM: Functional foot disorders, pp. 27-49, University publishing company, Los Angeles, 1937
Horwitz, JM: Variometer. Philadelphia, PA
Lewin, P: The foot and ankle, p.47, Lea and Fabiger, Philadelphia, 1943
Morton, DJ: The human foot, pp.107-184, Columbia University press, New York 1935
Polokoff, MMJ: J. Nat Assoc. Chiropodists, 49: 315, 1959
Schreiber and Weinerman: Research in podophysiology and their application to podomechanics. J. Nat Association chiropodists 38. No. 6, 1948
See also:
Lewis, LL (1966): Podal propulsive hinge as a key to normal foot function. JAPA 56: 3, 103-109 (which talks about importance of normal movement of the metatarsals about the phalanges during propulsion and the foot as a self locking wedge. Lots of sagittal plane facilitation theory in here- check the date! Nothing new under the sun ;-))
Also a great quote at the end of this paper:
"My father taught me how to work, but not how to love it."- Abraham Lincoln
Excellent literature review, Simon. This could be the subject of a nice review of the literature on the subject for publication regarding midfoot/midtarsal joint biomechanics, don't you think??
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Holy-Moly,
And I thought I just asked a simple question...
I lie here weaning myself off morphine based pain relief (fractured L2,4 & 5) and just when I thought I was becoming coherent again, I traverse the universe, get taken on a history lesson, commiserate the sick twins (and their dad), then get Polokof'd for just Lewin around Weinermanning about the Columnar Theory - I'm going back to the morphine, especially the 42mg dose.
However, the genesis of my thoughts (thanks for reminding me Simon) was this in the most simplest of terms...
The premise -:
The function of the lateral column is primarily the base of support for the body.
The medial column is the mobile adaptor to the earth's surface and essentially 'rests' on the lateral column.
For the hallux to dorsiflex efficiently at propulsion, the biomechanical relationship between the medial and lateral columns (as well as other biomechanical factors) must be harmonious.
Clinically, a common observation I see with 1st MtPJ pathologies such as HAV and Hallux Limitus, is an anterior 'shift' of the medial column relative to the lateral column. This can be seen clinically on occasion by the distal parabola of the toes - 1,2,3 follow a smooth arc but there is a notable difference between 3 and 4 while the arc continues between 4,5.
So, my approach to treatment (as a manipulative podiatrist) for 1st MtPJ conditions is to assess the position of the talus and determine if there are anterior driven forces originating from an anteriorly subluxated talus. An anterior talus will drive an anterior force into the navicular > cuneiforms > 1st,2nd & 3rd rays > 1,2,3 MtPJs. This 'domino' type of event is an important influence on treatment success (in my anecdotal observations).
Hence, my enquiry into any science or research into the 'columnar theory'.
This has been a fascinating journey... but I reckon I might be due for another morphine dose...
Excellent literature review, Simon. This could be the subject of a nice review of the literature on the subject for publication regarding midfoot/midtarsal joint biomechanics, don't you think??
Yes, but who on earth could undertake such a project?
Clinically, a common observation I see with 1st MtPJ pathologies such as HAV and Hallux Limitus, is an anterior 'shift' of the medial column relative to the lateral column. This can be seen clinically on occasion by the distal parabola of the toes - 1,2,3 follow a smooth arc but there is a notable difference between 3 and 4 while the arc continues between 4,5.
Are you familiar with Demp's work on metatarsal patterning?
Quote:
Originally Posted by TedJed
So, my approach to treatment (as a manipulative podiatrist) for 1st MtPJ conditions is to assess the position of the talus and determine if there are anterior driven forces originating from an anteriorly subluxated talus. An anterior talus will drive an anterior force into the navicular > cuneiforms > 1st,2nd & 3rd rays > 1,2,3 MtPJs. This 'domino' type of event is an important influence on treatment success (in my anecdotal observations).
Manipulative podiatrist- that sounds quite frightening. Anterior subluxed talus- how is this diagnosed? Do you have any pre-post manipulation radiographs?
Quote:
Originally Posted by TedJed
I reckon I might be due for another morphine dose...
I recall chatting with Jim Ganley (c.1990) about the 'Columnar Theory' of foot function where anatomically and functionally the foot is divided into the medial (tal,nav, cun's, 1-3 rays) and lateral (calc, cub, 4-5 rays) columns.
Does anyone know who's theory this is?
Is there a reference for this theory?
Much obliged,
Ted.
Ted,
Dr. Ganley talked about the length of the medial column vs. the length of the lateral column and its relation to the transverse plane of flatfoot.
He felt that when the lateral column was shorter than it should be, the foot would be in an abducted position around the midtarsal joint.
He then popularized the Evans procedure to lengthen the lateral column to surgically treat flat foot. The surgical criteria for flatfoot was expanded to include the Evans procedure for transverse plane flatfoot.
Ganley also popularized serial casting for talipes calcaneal valgus, and felt that most flatfeet were a result of the dorsiflexed and abducted talonavicular joint.
Interestingly, he did not use frontal plane corrections in his serial castings (makes you think of the oblique axis of the midtarsal joint).
It was my impression that this was his own theory (the columns in relation to flatfoot). Since no one was able to find this theory in the literature, it would seem that this is the case.
It was my impression that this was his own theory (the columns in relation to flatfoot). Since no one was able to find this theory in the literature, it would seem that this is the case.
Stanley:
How do you know that "no one was able to find this theory in the literature"? Have you ever looked in the literature or have you ever instructed anyone to do a thorough literature search to be certain that this indeed was an original theory of Ganley's? Or are you just guessing?
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Holy-Moly,
And I thought I just asked a simple question...
There are no simple questions or simple answers regarding the biomechanics of the foot and lower extremity. If it was simple, then I would have lost interest in the subject many years ago.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
I saw a magazine article by Ganley on the two unit tarsus concept. The two units are the talus and rest of the foot. He described how the foot deforms around the talus with motion. At the time I heard it (I was a fourth year student) it really helped me conceptualize rearfoot motion. I don't quite think my brief description did it justice, but it really did tweak my thinking at the time.
Stanley: It was my impression that this was his own theory (the columns in relation to flatfoot). Since no one was able to find this theory in the literature, it would seem that this is the case.
Kevin: Stanley: How do you know that "no one was able to find this theory in the literature"? Have you ever looked in the literature or have you ever instructed anyone to do a thorough literature search to be certain that this indeed was an original theory of Ganley's? Or are you just guessing?
Kevin, thank you for your interest in keeping my writings accurate.
If you noticed there are words I used such as impression and seem, which does not indicate assuredness. After reading the posts of such eminently qualified people such as Dr. Craig Payne, Dr. Simon Spooner, and Dr. Eric Fuller added to my original impression of Dr. Ganley’s lecture, it seems that no one was able to remember Dr. Ganley’s theory (which means that no one is as old as I am). I met Dr. Ganley in 1976 when I was visiting his residency program at Norristown PA where I had the privilege of picking his brain for an afternoon. Several years later, I had him lecture at a podopediatrics seminar at OCPM, where he also conducted a workshop on Calcaneovalgus casting technique. I attended several of his surgical lectures at places such as Hershey, PA where he also taught in the surgical workshops I attended.
No one can be 100% sure that something is not previously in the literature, but Dr. Ganley did not mention prior authors in his lectures.
I am however certain that if this theory in the literature exists, you will be the first to find it.
Sincerely,
I am however certain that if this theory in the literature exists, you will be the first to find it.
Sincerely,
Stanley
No, that honor goes to Dr. Spooner:
Quote:
Cunningham (1937), Hiss (1937) Lewin (1943) and Morton (1935) believed that weightbearing motion was transmitted through the ankle joint in two direction, described as "medial" and "lateral" segments of the foot. Duchene (1959), Horwitz (?), Polokoff (1959), Shreiber and Weinermann (1948) "showed" that as the foot is plantarflexed against the resistance of the weight-bearing surface, weightbearing motion is transmitted through the ankle joint in two direction: Lateral: through the anterior half of the calcaneus, cuboid, and the 4th and 5th metatarsals; Medial from the talus through navicular, the cuneiforms and the 1st, 2nd and 3rd metatarsals.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
No offense intened to Dr. Spooner, but his articles did not talk about the relative lengths of the medial and lateral column and their effect on transverse flatfoot.
No offense intened to Dr. Spooner, but his articles did not talk about the relative lengths of the medial and lateral column and their effect on transverse flatfoot.
No offense taken. I think Morton may have discussed the importance of segment length and it's relation to flat-foot.
Are you familiar with Demp's work on metatarsal patterning?
No I'm not, can you direct me to a site?
Quote:
Manipulative podiatrist- that sounds quite frightening. Anterior subluxed talus- how is this diagnosed?
As a 'manipulative podiatrist', I mean a manual therapist who uses 'hands on' therapeutic techniques of joint mobilisation and manipulation. Not the 'frightening' definition of manipulative that is:
ma·nip·u·la·tive adj
1. using clever, devious ways to control or influence somebody or something
The anterior talus is readily palpated by mildly distracting the ankle (in the frontal plane of the leg) and then rocking the talus within the mortice. An anterior sublluxated talus clunks and grinds (because the articlar surfaces have lost their correct relationship) whereas a normally positioned talus has no perceivable/detectable movement felt.
You can confirm the anterior talus on a weightbearing x-ray and check the cyma line. Both the DP and Lateral views will show the talar distal articular surface displaced anteriorly relative to the calc:cub joint space, hence a 'break' in the cyma line will be evident.
This comes from Gamble & Yale's Foot Roentgenology and Christman's Foot & Ankle Radiology.
Demp PH: The metatarsal hyperbola and the pathomechanical forefoot. Currrent Podiatry 20:3 1971 p15-17
Demp PH: A numerical taxonomy for evaluating the angular biomechanics of the human metatarsus. Current Podiatry 24:5 1975 p.9-11
Demp PH: Biomechanical optimality and the mathematical measurement of diagnostic patterns in the human foot. Arch Pod Med Foot Surg 3:1 1976 p.11-21
Demp PH: Biomechanical foot roentgenometry. Yearbook of podiatry 1978-1979. Ed: TH Clarke. Futura Publ. Co. New York 1978 p. 64-70
Demp PH: An anthropometric index for screening foot dysfunction. Current Podiatry. 28:6 1979a p.11-13
Demp PH: A mathematical taxonomy to evaluate the biomechanical quality of the human foot. M.S. Thesis (unpublished) Polytechnic Institute of New York, USA June 1979b
Demp PH: A correlation of length, width, height and pathomechanical quality in the human foot. Current Podiatry 31:8 1982 p23
Demp PH: Biomechanical profile analysis of the foot radiograph based on mathematical modelling. Current Podiatry 32:10 1983a p15-17
Demp PH:Mathematical modelling in podiatric surgery. A new approach to biomechanical evaluation. J Acad Amb Foot Surg 1:1 1983b p72-73
Demp PH: A mathematical taxonomy to evaluate the biomechanical quality of the human foot. Mathl Comput Modelling 11 1988 p341-345
Demp PH: A mathematical taxonomy to evaluate the biomechanical quality of the human foot. Mathl Comput Modelling 12 1989 p777-790
Demp PH: Using conic curves to classify pathomechanical biostructure of the metatarsus. Mathl Comput Modelling 14 1990a p668-673
Demp PH: Pathomechanical metatarsal arc: radiographic evaluation of its geometric configuration. Clin Pod Med Surg 7:4 1990b p765-776
Demp PH: Numerical diagnosis of pathoanatomy in the human forefoot: A pilot study. The Lower Extremity 1:2 1994 p133-138
Demp PH: Geometric models that classify structural variation of the foot. JAPMA 88:9 1998 437-441
I'll come back to your radiographic interpretation of subluxation when I have more time.
From a slightly different perspective, the antropologist, OJ Lewis, published a thesis some time ago about the evolution of the human foot. He noted that it was previously believed that when primates evolved to upright humans, the hallux moved "in-line" to the lesser digits. He theory, however, filled with anthropologic references, was that the hallux (ie, medial column) was already "in-line", and that what needed to take place was a medial rotation of the LATERAL COLUMN. In other words, the lateral column rotated in a supinatory direction, creating the medial arch shape we have come to now accept. Considering that these two "halves" of the foot developed into a our modern day foot, maybe there is validity to the medial and lateral column theory.
Columnar Theory of Foot Function
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Linear Mode
