Live Updates: 42nd Congresso Nacional de Podologica; 13-14 Oct; Valencia

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Live Updates:
42nd Congresso Nacional de Podologica; 13-14 Oct; Valencia


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Congress website

 

Ok early start! Just about made the train from Plymouth to Exeter- had to do some running in minimalist footwear (Kurt Geiger's- he wants them back later) to make it on time. Now on train, just for a change the buffet car is closed, so I can't get a coffee.

Why is the packaging of nicotine patches made to be impenetrable to anything short of a thermonuclear missile? Nearly lost my incisor.

Bus to airport next- joy.

 

Didn´t you quit a couple of weeks ago ?

 

Week six. I'm still patched up though for another three weeks.

The railway between newton Abbott and Exeter is the prettiest in the uk

 

Bus to airport now. A couple of likely lads discussing the programming of assassins who suddenly go on killing spree when hearing a code word. I think my particular code words are anything and everything coming out of their white caucasion, but think their black jive ass, youth speak, mouths right now.

 

I'm on a plane, I can't complain. Next stop Paris.

 

Argh gay Paris. So so romantic and at only ten quid a pint it's so reasonable too.

 

Another plane down to Spain now. Red berry joy town on the soundtrack.

 

Nice one - enjoy the trip youth...

 

Simon:

Don't try rolling up your nicotine patches and smoking them...this too can be dangerous to your health.

 

Late nights and early starts. Don't you just love conferences? Craig and me are lecturing in the first session this morning.

Big gig with about 800 delegates.

 

Have fun.

 

Simon is first up and he is having tech problems. ..... Note to Simon: use a PC, ditch the Mac!

 

Hopefully we can get some comments on the presentations from our colleagues as almost all the content is in Spanish. Me no speaks da language very well. If the arena'ettes were here, they would be saying 'everyone talks like Dora'. ... From Dora the Explorer ... Their Spanish is better than mine.

 

Simon is talking slow enough, so there is hope that even I can understand it:

" stiffness is the new black ...."

Jacks test and lunge test are measures of stiffness

Spring mass model of running stores energy during contact .... Returns that energy later
Rate of oscillation ie the faster the rate of oscillation, the faster we can run ..... If spring is more comPliant, get more oscillations. .... ---run faster

Leg stiffness meaSured cliniclly running on spot (need to get Simon to explain this)

Increased leg stiffness is associated with increased running efficiency.

Stiffness decreases with fatigue
Different foot strike patterns have different stiffnesses
Different foot types have different stiffnesses
Stiffness increases when running on more compliant surfaces.

Cushioned running shoes are a compliant surface. ... The led will modulate it's own stiffness to compensate.

The body wants th com displacement and trajectory to remain constant ... Modulated by the CNS depending on surface. .... Does this by increasing or decreasing joint excursions and loading rates .... This will affect injury risk

There has to be a zone of optimal leg stiffness between the two extremes for each runner
Might be able to manipulate stiffness to improve performance and decrease injury risk

Fits in with nigg's preferred motion pathway model

Stiffness at foot/ foot orthoses interface to tune for the zone of optimal stiffness

ShApe of orthotics determines where demformations occur
Heel post changes area of deformation

 

When leg is stiffer cycle time is lower not when more compliant.

 

I'm in with Thomas Chang dpm he's talking about surgical fixation and why achieving stability is key.

At the moment he's showing fixation for ipj. Lots on preparing the hole correctly for the screw.

Now on to axial guide cuts to control length changes in the metatarsal.

Really nice chap and we've been talking about you Kevin.

 

Simon:

Say hello to Tom for me. He is one of the few surgeons I have met that has a true interest in biomechanics.

 

Tom says you need to meet more people. Bob frykerg on Charcot foot now imissed the first twenty minutes but basically aggressive offloading.

 

Off the top of my head, other podiatric surgeons that also show a true interest in biomechanics: Jeff Christensen, Richard Bouche, Don Green, Tom Roukis and Steve Palladino.

Any others that I'm missing??

 

I'll ask Tom later. Up next we have Craig on clinical test which aid in the prescription of foot orthoses.

Craig is about 2 minutes away from starting and he just said to me that he still doesn't know what he is going to do, but he has all his powerpoints open... Now that's what I call rock n roll.....

 

Still not licked off yet. They'e quaint out the door to get in. It's standing room only. The tension mounts........

 

Ankle joint rom and lunge test up first. Why 10 degrees?

 

Supination resistance with Javier Pascual as a subject.

Jacks test- scoring higher on the side Javier gets plantar fascia. Craig simulating forefoot valgus wedge with fingers.

Lunge test and the iPhone angle finder.

Stj axis palladium and its correlation with supination resistance. Where do we want the orthotic to push.

 

Ok so after yesterday when they couldn't get the projector to work with my Mac I thought I'd get here with plenty of time to spare just in case. Now bearing mind the first lecture is due to start in thirty minutes time, I was surprised to find only the technicians and security guards at the venue. Literally no one else is here, not another soul.

Now that's what I call casual. I suppose it is Saturday and we are in Spain.

 

Dr frykberg on diabetic foot surgery.

Talking about post op infection rates - significant increased risk in diabetes.

Neuropathy always most important risk factor for post op infection.

 

It was a tough choice:

or Wales v France .... 9-8 to France !!!

 

Surgery session. Javier Pascual is moderating. I'm hiding up the back with the cool kids. Last speaker was obviously very nervous. Although the session was in Spanish you don't need a translator to work out when the presenter is suffering with nerves. I felt for her having been in that same zone myself on more than one occasion. As far as I could tell her study was on phenolisation times for nail surgery. As far as I could tell she compared 30 sec to 60 sec. With 30 sec resulting in reduced healing times.

 

Next up a guy talking about I don't know what but the tissues are blue!!! I just asked a Spanish colleague and thankfully it is an ink which has been injected. I thought the patient had got a dose of he alien there for a minute- your roving reporter s.k. Spooner

Up next Tom Chang on flatfoot surgery.

 

Ok Tom is up now. Flatfoot surgery: pick the right operation for right patient
Planal dominance is being discussed now.

ToOOoo many toes sign.

Site of pain/ previous trauma / sPeed of onset

Sinus tarsi syndrome

Peroneal spasm in coalition

Saving the talonavicular joint and cleaning up pt tendon.

Importance of medial column position

Orthotics / richie brace

When to operate? Fusion versus functional
Maintenance? Sacrificing compliance for stability.

Calc osteotomies- Evans versus medial displacement
Arthroerisis
Medial column tendon transfer
Arthrodesis

Achilles tendon and midfoot lowering

Pt tendon clean and repair: can't do a soft tissue repair in isolation- they fail

Fdl transfer~ find it proximally it's easier. Weave through pt tendon drill through navicular and push tendon from plantar to dorsal to give stable bone anchor.

 

He was going so well, then he started talking about Mtj locking. I'll try to tutor him on this later.

 

I think the foot type he was calling a Mtj not locking was really a very medial STj axis??? .... The surgical procedure choice would still be the same.

 

Craig is up talking anterior knee pain and the lack of predictive relationship between the foot position and knee pain. Now we have power flow and the foot driving the tibia or the tibia driving the foot.

 

My sincere thanks to all of the team who helped to make this an excellent meeting. Thank you for inviting me to speak at the conference. It was great fun and I hope to see you all again soon.

I'm now back in Paris waiting for my flight back to the uk should be home and eating my dinner by 8:30pm which is the proper time to eat your evening meal ;-) no more midnight feasts!

 

Now I understand that when Simon was looking his Iphone during the lectures he was not bored... He was updating this thread... :bash:

Good job!!

 

Javier:

I have Simon and Bruce Williams coming out to lecture with me in Orlando, Florida, in a little over a week at the annual ACFAOM seminar at the resort shown below. It will be a tough life soaking up all that sun in the swimming pool!

 

I Hope you had a good trip to home. I don´t Know if you saw any 10 walking around!!!

 

\oh yeah sounds real busy! Apart from my good wife i've never seen a 10!