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Golf biomechanics

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  #1  
Old 16th February 2008, 05:02 PM
Bruce McLaggan Bruce McLaggan is offline
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Default Golf biomechanics

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Hi

Can someone point in the right direction. A lot of my client are golfers and in order to offer them sound advice I need some good biomech info pertaining to golf. Are there any good research paper or books covering this sport.

Kind regards
Bruce
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  #2  
Old 16th February 2008, 07:43 PM
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Default Re: Golf Biomech

GOLF!
I would start with MYTPI.COM
This is a great site for golfers and they have begun certifying golf fitness instructors.
One word of caution, as an avid golfer and Podiatric Surgeon, golf biomechanics is in it's infancy (in my opinion).

Good luck

Steve
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  #3  
Old 16th February 2008, 10:29 PM
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Default Re: Golf biomechanics

Related threads:
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  #4  
Old 17th February 2008, 12:34 AM
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Default Re: Golf Biomech

Quote:
Originally Posted by drsarbes View Post
One word of caution, as an avid golfer and Podiatric Surgeon, golf biomechanics is in it's infancy (in my opinion).

Good luck

Steve
Quite the contrary, Steve, golf biomechanics has been studied by the international biomechanics community for at least the past quarter century.

1.
COMPARING GOLF PUTTING MOTIONS WHEN HANDLING DIFFERNET LENGTH SHAFT PUTTER A QUANTIFIED MESSAGE FOR DEAR TIGER WOODS
Journal of Biomechanics, Volume 40, Supplement 2, 2007, Page S274
Jiann-Jyh Wang, Yi-Chung Chen and Tzyy-Yuang Shiang

PDF (151 K)
2.
THE COMPARIISON OF CHARACTERISTIC TIME BETWEEN NORMAL AND NEW DESIGN GOLF CLUB HEAD FACE PLATE
Journal of Biomechanics, Volume 40, Supplement 2, 2007, Page S276
Jui-Chun Tseng and Chen-Kai SU

PDF (184 K)
3.
SHAFT STIFFNESS SIGNIFICANTLY INFLUENCES GOLF CLUBHEAD SPEED AT IMPACT
Journal of Biomechanics, Volume 40, Supplement 2, 2007, Page S279
JT Worobets and DJ Stefanyshyn

PDF (86 K)
4.
THREE DIMENSIONAL ANALYSES OF CLUB MOVEMENT AND CLUBHEAD ORIENTATION AT IMPACT DURING THE GOLF SWING
Journal of Biomechanics, Volume 40, Supplement 2, 2007, Page S317
K.R. Williams and B.L. Sih

PDF (132 K)
5.
A KINETIC ANALYSIS ON GOLF SWINGS TO KNOW WHAT SKILL CAN INCREASE CLUB HEAD SPEEDAND IMPACT ACCURACY
Journal of Biomechanics, Volume 40, Supplement 2, 2007, Page S765
Jiann-Jyh Wang, Pei-Feng Yan and Tzyy-Yuang Shiang

PDF (253 K)
6.
The analysis of golf swing as a kinematic chain using dual Euler angle algorithm
Journal of Biomechanics, Volume 39, Issue 7, 2006, Pages 1227-1238
Koon Kiat Teu, Wangdo Kim, Franz Konstantin Fuss and John Tan

SummaryPlus | Full Text + Links | PDF (365 K)
7.
Detailed investigation of mechanisms causing golf-specific injuries using analytical methods and computer simulation
Journal of Biomechanics, Volume 39, Supplement 1, 2006, Page S180
S. Lehner, O. Wallrapp and K. Burgardt

PDF (160 K)
8.
Comparative analysis of the body motion in golf swing
Journal of Biomechanics, Volume 27, Issue 6, 1994, Page 672
Kazuaki Kawashima

9.
The optimization of golf swing and its application to the golfclub design
Journal of Biomechanics, Volume 27, Issue 6, 1994, Page 780
Y. Kaneko and F. Sato

10.
The role of the shaft in the golf swing
Journal of Biomechanics, Volume 25, Issue 9, September 1992, Pages 975-983
Ronald D. Milne and John P. Davis

Abstract
11.
Analysis of breathing waves and EMG during the golf swing
Journal of Biomechanics, Volume 25, Issue 7, July 1992, Page 709
Kazuaki Kawashima, Masuo Muro and Akira Nagata

12.
A kinetic and kinematic analysis of the golf swing
Journal of Biomechanics, Volume 25, Issue 7, July 1992, Page 711
Bruce R. Mason, Roger L. Thinnes and Sandra L. Limon

13.
A change of fixation point in golf approach shot performance
Journal of Biomechanics, Volume 25, Issue 7, July 1992, Page 718
Hideki Takagi and Kiyoshi Tsuruhara

14.
Gripping forces and hand acceleration waves during the golf swing
Journal of Biomechanics, Volume 22, Issue 10, 1989, Page 1035
Kazuaki Kawashima and Akira Nagata

15.
The effect of groove shape on spin of a golf ball
Journal of Biomechanics, Volume 22, Issue 10, 1989, Page 1062
Robert J. Neal and Lyle M. Hubinger

16.
Ground reaction forces during the golf swing in relation to hitting performance
Journal of Biomechanics, Volume 21, Issue 10, 1988, Page 869
Keith R. Williams, Jan Jones and Becky Snow

17.
A triple pendulum model of the golf swing
Journal of Biomechanics, Volume 16, Issue 4, 1983, Page 298
K. R. Campbell

Charles J. Gatt, Jr, Michael J. Pavol, Richard D. Parker, and Mark D. Grabiner
Three-Dimensional Knee Joint Kinetics During a Golf Swing: Influences of Skill Level and Footwear
Am. J. Sports Med., Mar 1998; 26: 285 - 294.
......Three-Dimensional Knee Joint Kinetics During a Golf SwingInfluences of Skill Level and Footwear...characterized knee joint kinetics during a golf swing and determined the influence of shoe...joint loads. Thirteen golfers each hit a golf ball using a five iron under two footware......


Biomechanics of the golf swing in players with pathologic conditions of the forearm, wrist, and hand JOURNAL ARTICLE:
Thomas D. Cahalan, William P. Cooney, III, Kazuo Tamai, and Edmund Y.S. Chao
Biomechanics of the golf swing in players with pathologic conditions of the forearm, wrist, and hand
Am. J. Sports Med., Jun 1991; 19: 288 - 293.
......Journal Article Biomechanics of the golf swing in players with pathologic conditions...Mayo Foundation, Rochester, Minnesota Golf is an activity generally stressful to the...environment. A regular straight-handled golf club was compared to a new BioCurve handle......

Electromyographic Analysis of the Scapular Muscles During a Golf Swing JOURNAL ARTICLE:
John T. Kao, Marilyn Pink, Frank W. Jobe, and Jacquelin Perry
Electromyographic Analysis of the Scapular Muscles During a Golf Swing
Am. J. Sports Med., Jan 1995; 23: 19 - 23.
......Analysis of the Scapular Muscles During a Golf Swing John T. Kao MD Kerlan-Jobe Orthopaedic...the role of the scapular muscles in the golf swing, we studied 15 competitive male golfers...muscle fatigue in high demand golfers. The golf swing and uncoiling action requires that......


Rotator cuff function during a golf swing JOURNAL ARTICLE:
Frank W. Jobe, Diane R. Moynes, and Daniel J. Antonelli
Rotator cuff function during a golf swing
Am. J. Sports Med., Sep 1986; 14: 388 - 392.
......Article Rotator cuff function during a golf swing Frank W. Jobe MD Biomechanics...bilateral shoulder muscle activity during the golf swing was undertaken using electromyography...the information presented in a number of golf instruction manuals, the left shoulder......


Electromyographic analysis of the shoulder during the golf swing JOURNAL ARTICLE:
Marilyn Pink, Frank W. Jobe, and Jacquelin Perry
Electromyographic analysis of the shoulder during the golf swing
Am. J. Sports Med., Mar 1990; 18: 137 - 140.
......Electromyographic analysis of the shoulder during the golf swing Marilyn Pink MS, PT Biomechanics...Laboratory, Centinela Hospital Medical Center Golf is a popular sport throughout the world...both the right and left arms during the golf swing. The results reveal that the infraspinatus......
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  #5  
Old 17th February 2008, 04:07 PM
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Default Re: Golf biomechanics

Quote:
Originally Posted by Bruce McLaggan View Post
Hi

Can someone point in the right direction. A lot of my client are golfers and in order to offer them sound advice I need some good biomech info pertaining to golf. Are there any good research paper or books covering this sport.

Kind regards
Bruce
Hi Bruce,

I've worked with many PGA golfers, along with many social players, and their common concerns are usually based around technical adjustments in stance / swing.

An association with the local teaching Golf Pro is strongly recommended, to enable prolonged supervision and correction of postural technique for patients, in association with the obvious clinical assessment / advice of gait, footwear selection, mode of transporting golf bag (pulling buggy along causes many overuse injuries!), club selection (fit), etc.

As Kevin showed, there's a heap of research is available, however much of it is difficult to apply to day-to-day foot, lower limb and pelvic overuse syndrome prevention / treatment. Certainly worth the read however.

All the best,

Paul
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Old 17th February 2008, 09:47 PM
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Default Re: Golf biomechanics

Hi Kevin:

I had a feeling you wouldn't let me get away with that remark!!!!!! haha

With all due respect, many of the studies you list have nothing to do with swing biomechanics.

Perhaps it would be more correct to say that the theory of the golf swing has changed in the past decade and with it more "up to date" biomechanics.

For instance, it use to be quite common to have a reverse "C" on the follow through, not any more. Common ailments like chronic back problems along with the advent of Golf Fitness (the TIGER era) had certainly changed this.
Another: KEEPING the head stilll which promotes a reverse pivot at the top of the backswing has all but been replaced with a small sway to the back foot and more weight here as well; I could go on and on......

As a golfer who reads just about every magazine that comes out and many many books on golf, I can say from a golfers view point that the theory and biomechanics of the golf swing in the past 10 years has changed dramatically.

Fitness is now focused on core strength, stretching, balance; along with proper swing mechanics. Going out and hitting 2,000 balls isn't considered training anymore. And swing mechanics isn't what it use to be. Anything written more then 12 years ago is most likely wrong or outdated, or both.

The first to even try to bring swing biomechanics into the "modern" era was Bobby Jones' use of motion pictures, slow motion and stop action. Gary Player was, as far as I know, just about the ONLY player to ever stress fitness in golf (and he still does).

I think the Baby Boomers coming of "that" age along with the obvious fitness and almost perfect mechanics of Tiger Woods has changed golf forever.

my opinion as a golfer - not a doctor!

Steve
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Old 17th February 2008, 09:48 PM
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Default Re: Golf biomechanics

Hi Kevin:

I had a feeling you wouldn't let me get away with that remark!!!!!! haha

With all due respect, many of the studies you list have nothing to do with swing biomechanics.

Perhaps it would be more correct to say that the theory of the golf swing has changed in the past decade and with it more "up to date" biomechanics.

For instance, it use to be quite common to have a reverse "C" on the follow through, not any more. Common ailments like chronic back problems along with the advent of Golf Fitness (the TIGER era) had certainly changed this.
Another: KEEPING the head stilll which promotes a reverse pivot at the top of the backswing has all but been replaced with a small sway to the back foot and more weight here as well; I could go on and on......

As a golfer who reads just about every magazine that comes out and many many books on golf, I can say from a golfers view point that the theory and biomechanics of the golf swing in the past 10 years has changed dramatically.

Fitness is now focused on core strength, stretching, balance; along with proper swing mechanics. Going out and hitting 2,000 balls isn't considered training anymore. And swing mechanics isn't what it use to be. Anything written more then 12 years ago is most likely wrong or outdated, or both.

The first to even try to bring swing biomechanics into the "modern" era was Bobby Jones' use of motion pictures, slow motion and stop action. Gary Player was, as far as I know, just about the ONLY player to ever stress fitness in golf (and he still does).

I think the Baby Boomers coming of "that" age along with the obvious fitness and almost perfect mechanics of Tiger Woods has changed golf forever.

my opinion as a golfer -

Steve
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Old 18th February 2008, 12:29 AM
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Default Re: Golf biomechanics

Quote:
Originally Posted by drsarbes View Post
Hi Kevin:

I had a feeling you wouldn't let me get away with that remark!!!!!! haha

With all due respect, many of the studies you list have nothing to do with swing biomechanics.

Perhaps it would be more correct to say that the theory of the golf swing has changed in the past decade and with it more "up to date" biomechanics.

For instance, it use to be quite common to have a reverse "C" on the follow through, not any more. Common ailments like chronic back problems along with the advent of Golf Fitness (the TIGER era) had certainly changed this.
Another: KEEPING the head stilll which promotes a reverse pivot at the top of the backswing has all but been replaced with a small sway to the back foot and more weight here as well; I could go on and on......

As a golfer who reads just about every magazine that comes out and many many books on golf, I can say from a golfers view point that the theory and biomechanics of the golf swing in the past 10 years has changed dramatically.

Fitness is now focused on core strength, stretching, balance; along with proper swing mechanics. Going out and hitting 2,000 balls isn't considered training anymore. And swing mechanics isn't what it use to be. Anything written more then 12 years ago is most likely wrong or outdated, or both.

The first to even try to bring swing biomechanics into the "modern" era was Bobby Jones' use of motion pictures, slow motion and stop action. Gary Player was, as far as I know, just about the ONLY player to ever stress fitness in golf (and he still does).

I think the Baby Boomers coming of "that" age along with the obvious fitness and almost perfect mechanics of Tiger Woods has changed golf forever.

my opinion as a golfer -

Steve
Steve:

There is a difference between the scientific study of the mechanics of sports activities, which we call biomechanics, and the popular ideas of what the best techniques are for performing those sports. The theory of what the best golf swing has been or should be and what is the best type of swing mechanics for each golfer I'm sure occupies many of the pages of popular golf magazines, just as the many articles on proper running style and proper running training/racing methods occupy the pages of popular running magazines. However, these articles in popular golf and running magazines are written as opinion pieces to fill the pages of magazines that are not scientific journals, but rather are informational magazines for the reader without a good knowledge of the scientific study of biomechanics.

I'm sure that the one expert's opinion of the "almost perfect mechanics of Tiger Woods" will be replaced by the another expert's opinion of the even more perfect mechanics of the next great super-golfer in the next one or two decades. However, for the scientist or clinician interested in sports biomechanics, only scientific study of a sports activity will yield the type of information that allows us to draw solid conclusions regarding the mechanical nature of certain sports techniques and their relative merits for the recreational, amateur and professional athlete. Because, in the popular sports magazines, there are as many opinions as to what specifically constitutes the best sports techniques as there are individuals that consider themselves experts on the subject.
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Old 18th February 2008, 12:39 AM
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Default Re: Golf biomechanics

American golfing machine. Used by golf pros in Australia as an 'extra qualification' on top of golf-pro status.

Details 24 components of a golf swing and 3 essentials. Uses Kirbyesque applied physics on one hand, but on another is quite easily understood by the lay person.
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Old 18th February 2008, 01:00 AM
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Default Re: Golf biomechanics

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Originally Posted by Kevin Kirby View Post
However, for the scientist or clinician interested in sports biomechanics, only scientific study of a sports activity will yield the type of information that allows us to draw solid conclusions.....

Don't know about that Kevin. A lot of 'scientific study' in relation to medicine, allied health, and by extension sports medicine and by assumption sport, has been absolute tripe. On occasions pedantic, on occasions not-sufficiently clinically relevant, on rare occasions, adding to what we do every day.

In the physiotherapy field for instance, I would probably have more faith in the pre-scientific practitioners like Maitland and Mulligan...than I would have in many of us today; despite all the 'wonderful' plethora of research.


Back to golf, I would like to know who came up with "plane theory". Whether it was some academic or some hack golfer who plays off 30, I dips my lid.

I do agree though that magazine tips in health and sports etc are garbage...making tripe look quite good.


Ron
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Old 18th February 2008, 08:33 AM
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Default Re: Golf biomechanics

Bruce:
TRYING to get back to the original question; for the patient who just wants some sound advice......... mytpi.com is a very good site and is free to anyone. It's full of sound advice by some of the leaders in golf physiology, biomechanics, conditioning and nutrition.

As for the Golf magazines, I agree, of course, that these are just that, pop magazines and I never suggested anything different. However, like I said, golf swing theory has changed dramatically, and while most of the golf tips and lessons in these periodicals are by "regular" golf professionals, there are more and more articles by Ph.Ds in various fields which are, many times, based on research or studies they have done.

Golf is big business with lots of money available.... this always helps research! don't you think?

One more comment though / as for "popular ideas" as to the best golf swing. The recent changes in golf swing theory are based on sound research, not just some golfer changing his swing and shooting a course record. Like everything else, it's evolving, which is the point I made originally. Good sound scientific basis for golf biomechanics is a fairly new field.

Steve
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Old 18th February 2008, 08:50 AM
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Default Re: Golf biomechanics

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Originally Posted by Atlas View Post
Don't know about that Kevin. A lot of 'scientific study' in relation to medicine, allied health, and by extension sports medicine and by assumption sport, has been absolute tripe. On occasions pedantic, on occasions not-sufficiently clinically relevant, on rare occasions, adding to what we do every day.

In the physiotherapy field for instance, I would probably have more faith in the pre-scientific practitioners like Maitland and Mulligan...than I would have in many of us today; despite all the 'wonderful' plethora of research.
What I was trying to say is that, as a biomechanics educator, I would be more comfortable quoting facts about golf swing biomechanics if that information came from a peer reviewed biomechanics journal such as the Journal of Biomechanics than from a popular golf magazine. That is not to say that popular golf magazines don't have very valuable and practical information for the golfer, but for the scientist interested in the physics of golf, a scientific journal would be a much better place to search for information, in my opinion.
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E-mail: kevinakirby@comcast.net
Website: www.KirbyPodiatry.com

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Old 18th February 2008, 09:41 AM
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Default Re: Golf biomechanics

Just to add to Kevin's list, this article from Podiatry Today has some useful references.
http://www.podiatrytoday.com/article/2436
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Old 18th February 2008, 09:45 AM
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Default Re: Golf biomechanics

Hi

Thank you all for your input

Regards
Bruce
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Old 19th February 2008, 12:34 PM
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Default Re: Golf biomechanics

Bruce

I would assume that golfers ask you about golf in terms of the pain they get when playing and not for tips on how to improve their game.

This is how I approach such matters.

As a podiatrist I cannot also be a expert in every sport or activity that customers may participate in. I can be an expert (or at least have good knowledge) of the biomechanics of the human body. Therefore I apply the principles of mechanics and physics to the problem at hand. I can also apply my knowlegde of clininical biomechanics. I can then give the customer tailored interventions to suit that particular person.

EG1) A right handed golfer has left hip and ankle pain after playing golf, a symptom I have been presented with a couple of times. (I know next to nothing of golfing theory and practice) If a golfer by convention or habit adopts a certain stance when applying a certain technique, eg a long drive, and that stance demands that his feet be parrallel. This may be fine for most golfers but this one has restricted internal hip rotation. Therefore as he drives the momentum of the upper body is resisted by the external hip rotators and they become over stressed and strained during play. The torque is transmitted down the left leg and the STJ is inverted and so straining the peroneals.

One aswer to this may be to externally rotate the left leg and foot, say 30dgs, which will reduce torque and strain in the affected muscles during play. This has worked for my customers before.

Another example of using these principles to everyday activity might be.

A lady came to me complaining of achilles and plantar pain after work. I noticed she was rather short. I knew she worked in an office. I asked if she tucked her feet back over the rail of the chair she sat at. "Yes" she said "my feet don't reach the ground". I advised sitting with her feet on a block in front of the chair. She did this and was very suprised and pleased that she not longer had any pain.

The point of these examples is that as I said earlier one can't be an expert in everything but one can use principles that apply to every activity IE Biomechanics.

Sorry if I have I made the wrong assumption at the start and they do ask for tips on how to improve golfing technique. In which case you've got your work cut out.


All the best Dave
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Old 19th February 2008, 04:05 PM
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Default Re: Golf biomechanics

Quote:
Originally Posted by David Smith View Post
Sorry if I have I made the wrong assumption at the start and they do ask for tips on how to improve golfing technique. In which case you've got your work cut out.
Here's a story: once upon a time a golf shoe was developed which was called something like the "weight-right", it was banned by the Royal and Ancient as an unfair advantage; it was basically a shoe with a valgus wedged sole unit.

Many years ago a patient presented- I can't even remember what the problem was. But I determined that rearfoot valgus wedging was required (at this time valgus rearfoot wedging was NOT DONE. I had to blow out the flames from the bonfire "the biomechanics lecturer" had built beneath me and argue my corner in the staff room for "doing this in front of students". BTW this was the same biomechanics lecturer who's lecture notes told the students that ground reaction force positioned medial to the STJ axis caused pronation). Anyway, back to the patient who returned some weeks later, shook me by the hand, told me the pain had gone and that I'd taken three shots off his handicap. A short time passed and I became "the biomechaincs lecturer".
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Old 20th February 2008, 12:01 AM
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But I determined that rearfoot valgus wedging was required (at this time valgus rearfoot wedging was NOT DONE.

I know the podiatry world has been largely pronation-centric over the years, and anything other than correcting it has been the panacea....but I doubt that rearfoot valgus wedging was ever "not done".

In the event of the acute ankle sprain for example, I am sure many have implemented the rearfoot valgus wedge years before I started using it regularly as soon as I graduated in the early/mid 90s (for many lower limb pathologies that auger well with lateral GRFs and/or STJ eversion).


The thing is, who and what determines whether things are "not done"? Many think the academic library and/or the profession(s), but really, the best resource at hand is the patient in front of you, and a basic understanding of applied physical principles.
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Old 20th February 2008, 12:16 AM
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I know the podiatry world has been largely pronation-centric over the years, and anything other than correcting it has been the panacea....but I doubt that rearfoot valgus wedging was ever "not done".

In the event of the acute ankle sprain for example, I am sure many have implemented the rearfoot valgus wedge years before I started using it regularly as soon as I graduated in the early/mid 90s (for many lower limb pathologies that auger well with lateral GRFs and/or STJ eversion).


The thing is, who and what determines whether things are "not done"? Many think the academic library and/or the profession(s), but really, the best resource at hand is the patient in front of you, and a basic understanding of applied physical principles.
Ron,

The problem is that, without a proper theoretical biomechanical framework, most clinicians would be unable to synthesize the optimal solution to the many complex mechanical pathologies that occur within the human foot and lower extremity.

BTW, I have found that a forefoot valgus wedge works better than a rearfoot valgus wedge.....why?.....because the forefoot valgus wedge offers a longer STJ pronation moment arm than the rearfoot valgus wedge. By which theory did you decide to use a rearfoot valgus wedge versus a forefoot valgus wedge??
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Old 20th February 2008, 01:26 AM
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Ron,

By which theory did you decide to use a rearfoot valgus wedge versus a forefoot valgus wedge??

Kevin, I don't know how many ankle sprains (acute, chronic, recalcitrant, textbook, non-textbook, multipathology etc.) you have seriously dealt with?

I do know though, that you are on the record as stating that you rarely used the lunge as an assessment/reassessment tool and progress indicator. Whilst I am on the record as saying it is difficult to completely understand the ankle and most of its mechanical pathology without understanding and using the lunge.


I have no doubt that you can show me with diagrams and vectors that a forefoot valgus wedge can do amazing things for rearfoot pathology. Does this theory take into account midfoot mobility? Surely a mobile midfoot will lessen the influence of forefoot valgus forces on the rearfoot pathology!.


To be honest Kevin, what you think and what I think matters little when you have a hobbling patient in front of you. If I pop a rearfoot valgus wedge (or a forefoot valgus wedge or both) into the insole and the patient suddenly functions better with less symptoms...then presto.

There in lies the problem of teaching and learning today; it is all about rigid narrow biased theories, rather than doing what works for the individual patient and being prepared to throw a few things at something.
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Old 20th February 2008, 08:12 AM
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Kevin, I don't know how many ankle sprains (acute, chronic, recalcitrant, textbook, non-textbook, multipathology etc.) you have seriously dealt with?

I do know though, that you are on the record as stating that you rarely used the lunge as an assessment/reassessment tool and progress indicator. Whilst I am on the record as saying it is difficult to completely understand the ankle and most of its mechanical pathology without understanding and using the lunge.


I have no doubt that you can show me with diagrams and vectors that a forefoot valgus wedge can do amazing things for rearfoot pathology. Does this theory take into account midfoot mobility? Surely a mobile midfoot will lessen the influence of forefoot valgus forces on the rearfoot pathology!.


To be honest Kevin, what you think and what I think matters little when you have a hobbling patient in front of you. If I pop a rearfoot valgus wedge (or a forefoot valgus wedge or both) into the insole and the patient suddenly functions better with less symptoms...then presto.

There in lies the problem of teaching and learning today; it is all about rigid narrow biased theories, rather than doing what works for the individual patient and being prepared to throw a few things at something.

Treating all types of ankle injuries, including ankle fractures, osteochondral injuries of the talus-tibia, and inversion, eversion, dorsiflexion or plantarflexion sprains has been a significant part of my practice for the past 22+ years. Regardless of the "mobility" of the midfoot, a forefoot valgus wedge will always have a greater potential to increase the subtalar joint pronation moment than will a rearfoot valgus wedge. I have used forefoot valgus wedges very effectively in treating patients with chronic inversion ankle sprains for over two decades.

My point, Ron, is not to argue with you about who has more experience or who treats patients better. My point is that without a solid theoretical framework as to how the foot mechanically works, even the clinician with a good appreciation of physics will not be able to treat the foot by the best mechanical means. However, having a good knowledge of physics does allow the good clinician to be an even better clinician, especially when performing surgery and treating mechanical problems of the foot.
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Old 20th February 2008, 01:24 PM
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Default Re: Golf biomechanics

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Bruce
particular person.

EG1) A right handed golfer has left hip and ankle pain after playing golf, a symptom I have been presented with a couple of times. (I know next to nothing of golfing theory and practice) If a golfer by convention or habit adopts a certain stance when applying a certain technique, eg a long drive, and that stance demands that his feet be parrallel. This may be fine for most golfers but this one has restricted internal hip rotation. Therefore as he drives the momentum of the upper body is resisted by the external hip rotators and they become over stressed and strained during play. The torque is transmitted down the left leg and the STJ is inverted and so straining the peroneals.

One aswer to this may be to externally rotate the left leg and foot, say 30dgs, which will reduce torque and strain in the affected muscles during play. This has worked for my customers before."
Hi David:
I like your approach, and I agree with you on this particular problem seen in golf. One minor detail you may want to consider. On the downswing the hips rotate to the left and at the point of contact (point of maximum force - hopefully) you want the left foot in a neutral position, not overly pronated. If the foot is turned too far it will be in a pronated position and not able to transfer the optimal amount of force through it as the club passes the point of contact.

FORE!

Steve
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Old 20th February 2008, 03:56 PM
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...but I doubt that rearfoot valgus wedging was ever "not done".
Atlas oh so wrong, showing your youth, mark c
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Old 20th February 2008, 04:28 PM
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Atlas oh so wrong, showing your youth, mark c
I'm heading towards 40, so if that's youth in your books, I wouldn't be getting into a mail-order-spouse business.

Markjohconley, showing your podiatry-centricity, some other musculo-skeletal professionals haven't had the restrictions of podiatric convention, and have used it long ago. As I said, I am sure that I wasn't the first physiotherapist to dare place an eversion wedge in a shoe for a relatively acute ankle sprain.

There are some other musculo-skeletal heallth professionals that haven't always seen 'pronation' like dracula views a wooden stake...or clove of garlic.
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Old 20th February 2008, 04:41 PM
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Regardless of the "mobility" of the midfoot, a forefoot valgus wedge will always have a greater potential to increase the subtalar joint pronation moment than will a rearfoot valgus wedge.


Surely Kevin, as night follows day, a forefoot valgus wedge under the foot with a mobile midfoot, will have less of an impact (on rearfoot) than would the same wedge under a foot with stiff (less mobile...) midfoot. How on earth can you argue otherwise?

Similar principle as placing an inverted device under the foot of an ankle (STJ more specifically) with less coronal plane range...in that the impact on the knee will surely be greater. This was a concept that I discussed quite a lot in 3rd year biomechanics with PGCarter.
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Old 20th February 2008, 07:28 PM
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Surely Kevin, as night follows day, a forefoot valgus wedge under the foot with a mobile midfoot, will have less of an impact (on rearfoot) than would the same wedge under a foot with stiff (less mobile...) midfoot. How on earth can you argue otherwise?

Similar principle as placing an inverted device under the foot of an ankle (STJ more specifically) with less coronal plane range...in that the impact on the knee will surely be greater. This was a concept that I discussed quite a lot in 3rd year biomechanics with PGCarter.

Ron:

If you will read my posting carefully, I did not disagree with your opinion that "a forefoot valgus wedge under the foot with a mobile midfoot, will have less of an impact (on rearfoot) than would the same wedge under a foot with stiff (less mobile...) midfoot."

Here is what I did say: "Regardless of the "mobility" of the midfoot, a forefoot valgus wedge will always have a greater potential to increase the subtalar joint pronation moment than will a rearfoot valgus wedge."

In other words, Ron, if a clinician is going to place a valgus wedge under the foot to try and prevent ankle sprains, that wedge will be much more effective if placed under the forefoot than under the rearfoot. In addition, I am still waiting for your answer to my question, which forms the basis of my comments regarding clinicians needing to have proper theoretical frameworks in order to make the best clinical decisions:

"By which theory did you decide to use a rearfoot valgus wedge versus a forefoot valgus wedge??"
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Old 21st February 2008, 02:02 AM
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Markjohconley, showing your podiatry-centricity, some other musculo-skeletal professionals haven't had the restrictions of podiatric convention, and have used it long ago.
Yep Atlas, that's what I was referring to, podiatry, and that's what I assumed Simon Spooner was referring to. If I'm wrong re. Simon's comment then I withdraw the comment.
Correct me if i'm wrong fellow pod's of late 80's/early 90's eras but I never knew of any rearfoot valgus wedges prescribed (admittedly in the limited pod circles I worked in and associated with). I only knew of pod's who "saw 'pronation' like dracula views a wooden stake". In hindsight I should have perused the international podiatric journals back then and thus been enlightened by articles such as those by Kevin Kirby.
I also regret "dropping out" of physiotherapy, which I commenced post-school, and not just because I would have realised the value of valgus wedging at a much earlier stage.
mark c
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Old 21st February 2008, 04:07 AM
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Ron:

If you will read my posting carefully, I did not disagree with your opinion that "a forefoot valgus wedge under the foot with a mobile midfoot, will have less of an impact (on rearfoot) than would the same wedge under a foot with stiff (less mobile...) midfoot."

Here is what I did say: "Regardless of the "mobility" of the midfoot, a forefoot valgus wedge will always have a greater potential to increase the subtalar joint pronation moment than will a rearfoot valgus wedge."

In other words, Ron, if a clinician is going to place a valgus wedge under the foot to try and prevent ankle sprains, that wedge will be much more effective if placed under the forefoot than under the rearfoot. In addition, I am still waiting for your answer to my question, which forms the basis of my comments regarding clinicians needing to have proper theoretical frameworks in order to make the best clinical decisions:

"By which theory did you decide to use a rearfoot valgus wedge versus a forefoot valgus wedge??"

I thought I answered your question with...

"To be honest Kevin, what you think and what I think matters little when you have a hobbling patient in front of you. If I pop a rearfoot valgus wedge (or a forefoot valgus wedge or both) into the insole and the patient suddenly functions better with less symptoms...then presto.

There in lies the problem of teaching and learning today; it is all about rigid narrow biased theories, rather than doing what works for the individual patient and being prepared to throw a few things at something."




But if that isn't enough or adequate for you, I will extrapolate using the example of a typical inversion ankle sprain that has no coexisting pathology. We are all no doubt aware of the usual mechanism of injury. Most are aware that tensile stresses laterally +/- compressive stresses medially result in pathology.



So what theories, as a young physio, were available to me?

If I followed EBP, I would stay away from strapping, because, apparently, according to one often referred to study, taping only has a physical effect for 20 minutes.

If I followed convention, I would ice for 24-72 hours and then apply heat, and then 'stem-cell-like-recovery' was supposed to ensue.

If I again went back to convention and EBP and walked-with-the-herd, I would instruct my acutely injured patient to return to activity fairly quickly; implement some eversion strengthening, and if results failed blame the patient's compliance or other hidden motives like 3rd party insurance future-gains. I would also implement some proprioception exercises, resembling what the cat-in-the-hat did on a ball while carrying a cake.

If I went beyond my profession and read some podiatric literature, I would have searched for the supinatory rock during gait. Accordingly, I may have discovered a rigid forefoot valgus, and thought that I had come to the underlying cause.



But these seemingly 'proper theoretical frameworks' or theories are flawed; despite apparently solid scientific research underpinning some.


It can be proven beyond doubt that strapping can have a mechanical effect beyond 20 days, let alone 20 minutes as EBP has emphatically indicated. There are not many typical acute and/or semi-acute ankle sprains Kevin, that don't get immediate significant relief from (high-dye (podiatry term)) strapping of the rear-foot in an everted position.
Pathology heals quicker in an enviroment of minimal symptoms. Its a no-brainer, but rarely taught or emphasised at any allied health teaching scenario that I have ever been involved with. That's my theory.

So if strapping the rearfoot into eversion is a win-win for acute ankle sprains, then it becomes a no-brainer that adding a rearfoot eversion wedge will supplement (at best) and complement (at worst) this therapy.


As I said in an earlier post, I am sure you can show me, in theory, how a forefoot wedge will work better than a rearfoot eversion wedge, but in practice it doesn't work so well with a mobile midfoot. While you can use your forefoot wedge, I will continue to use my rearfoot wedge. But I bet you London-to-a-brick, that strapping the ankle (and STJ) properly will eat both of them for breakfast. To a lesser degree, so will the properly fitted suedo brace. And no Simon, I don't have shares in Suedo, Smith and Nephew, Beisdorf, or any EVA manufacturer.

Last edited by Atlas : 21st February 2008 at 04:16 AM. Reason: Typo
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Old 21st February 2008, 06:27 AM
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Default Re: Golf biomechanics

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I also regret "dropping out" of physiotherapy, which I commenced post-school, and not just because I would have realised the value of valgus wedging at a much earlier stage.
mark c
You shouldn't regret 'dropping out' at all. According to your typical physiotherapist, ankle rehab is all about evertor strengthening and proprioception. Unfortunately, that's "all tip and no iceberg" to use a Keatingism.

Modern-day physiotherapy IMO, is all about hands-off control core stability type exercises. Physiotherapy really is glorified personal training with a bit more qualification, a bit less brawn, and a bit more brain. We have become so hands off, that a visit to a massage-therapist is becoming a real alternative.

I doubt that a physiotherapy degree would have lead you the value of valgus wedging. All it would have done was give you a bit more regarding ankle and a lot more regarding knee.
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Old 21st February 2008, 06:45 AM
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Quote:
Originally Posted by Atlas View Post
I thought I answered your question with...

"To be honest Kevin, what you think and what I think matters little when you have a hobbling patient in front of you. If I pop a rearfoot valgus wedge (or a forefoot valgus wedge or both) into the insole and the patient suddenly functions better with less symptoms...then presto.

There in lies the problem of teaching and learning today; it is all about rigid narrow biased theories, rather than doing what works for the individual patient and being prepared to throw a few things at something."




But if that isn't enough or adequate for you, I will extrapolate using the example of a typical inversion ankle sprain that has no coexisting pathology. We are all no doubt aware of the usual mechanism of injury. Most are aware that tensile stresses laterally +/- compressive stresses medially result in pathology.



So what theories, as a young physio, were available to me?

If I followed EBP, I would stay away from strapping, because, apparently, according to one often referred to study, taping only has a physical effect for 20 minutes.

If I followed convention, I would ice for 24-72 hours and then apply heat, and then 'stem-cell-like-recovery' was supposed to ensue.

If I again went back to convention and EBP and walked-with-the-herd, I would instruct my acutely injured patient to return to activity fairly quickly; implement some eversion strengthening, and if results failed blame the patient's compliance or other hidden motives like 3rd party insurance future-gains. I would also implement some proprioception exercises, resembling what the cat-in-the-hat did on a ball while carrying a cake.

If I went beyond my profession and read some podiatric literature, I would have searched for the supinatory rock during gait. Accordingly, I may have discovered a rigid forefoot valgus, and thought that I had come to the underlying cause.



But these seemingly 'proper theoretical frameworks' or theories are flawed; despite apparently solid scientific research underpinning some.


It can be proven beyond doubt that strapping can have a mechanical effect beyond 20 days, let alone 20 minutes as EBP has emphatically indicated. There are not many typical acute and/or semi-acute ankle sprains Kevin, that don't get immediate significant relief from (high-dye (podiatry term)) strapping of the rear-foot in an everted position.
Pathology heals quicker in an enviroment of minimal symptoms. Its a no-brainer, but rarely taught or emphasised at any allied health teaching scenario that I have ever been involved with. That's my theory.

So if strapping the rearfoot into eversion is a win-win for acute ankle sprains, then it becomes a no-brainer that adding a rearfoot eversion wedge will supplement (at best) and complement (at worst) this therapy.


As I said in an earlier post, I am sure you can show me, in theory, how a forefoot wedge will work better than a rearfoot eversion wedge, but in practice it doesn't work so well with a mobile midfoot. While you can use your forefoot wedge, I will continue to use my rearfoot wedge. But I bet you London-to-a-brick, that strapping the ankle (and STJ) properly will eat both of them for breakfast. To a lesser degree, so will the properly fitted suedo brace. And no Simon, I don't have shares in Suedo, Smith and Nephew, Beisdorf, or any EVA manufacturer.
Ron:

Excellent reply. Your more lengthy answer was what I was looking for.
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California School of Podiatric Medicine at Samuel Merritt College

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Website: www.KirbyPodiatry.com

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Old 3rd March 2008, 05:15 AM
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Default Re: Golf biomechanics

wasnt this thread about golf biomechanics?? man, some of you fellow podiatrists need to relax and enjoy yourselves a bit.....
anyone for a round of golf?
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