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Bio-Newtonian Theory Quantitative At Best

Discussion in 'General Issues and Discussion Forum' started by drsha, May 13, 2010.

Tags:
  1. drsha

    drsha Banned

    Dr. Quinn:
    Your swarthy and condescending attitude reflects your bias.

    You are obviously a debauchee of The Arena.

    My work reverberates The Laws of Newton. Regrettably for you, it has habitually found that the pertinence of these laws to produce analytical awards when making clinical decisions over questions that arise in disengaged functioning subjects is greatly truncated when compared to the inexorable appliance of these same laws in exanimate subjects.

    The materiality of Newton's Laws is not in question in my armamentarium of medicine but I raise weighty doubts on their constancy when correlated to EBP.

    DrSha

    To respond to your ridculous statement that I bolded:
    These forces which we all know exist (and I do not deny or look to reduce in import) have reduced relevancy and applicability when applied to a human, functioning subject at the clinical level when making orthotics or decisions on the very kinetics and kinematics that they define (for me).

    FYI:
    The Thesaurus which I used to create this response (I am impressed if you did not use one) has NO THESAURUS RESULTS FOR:

    Biomechanics
    Bioengineering
    BioArchitecture or
    BioNewtonian


    The transfer of the incontrovertable scientific and mathematical homogenious nature of the principles and practice of
    Mechanics
    Engineering
    Architecture
    or
    Newtons Laws

    applicability to ZOETIC SUBJECTS
    with regards to any of their BIO equivilants is APOCRYPHAL and unwarrented and because of your skills and credentials borders on malevolent when applied to those with cross-purposes like me.

    Summarily:
    Your premise that Newton's Laws apply equally to apples and cats in motion is the basis for my heresy and will be the basis that will eventually expose you all as mercenary CHARLATANS.
     
  2. Greg Quinn

    Greg Quinn Active Member

    Goodness me. What on earth provoked that response? Unfortunately, one of the very type that has dissuaded me from posting before very recently. Malevolence coupled with debauchery are not characteristics with which I have been associated before. The implication that I would require a thesaurus to construct a coherent discussion point I shall ignore.

    It is my contention that efforts to integrate scientific knowledge in our chosen field are fairly new. Additionally, I am attempting to point out that physical laws are subject to a complex and concomitant interaction with other biological systems to deliver an ultimate biological purpose. That this might resonate with what you are trying to say and perhaps move the discussion forwards was perhaps a forlorn hope. I would like to clarify however for other readers, that it was well intentioned.
     
  3. Jeff Root

    Jeff Root Well-Known Member

    Dennis,

    The following was taken from Stanford University's Biomechanical Engineering webpage which can be found at http://biomechanical.stanford.edu/Main_Page
    And from Stanford's Soft Tissue Biomechanical Laboratory http://stbl.stanford.edu/Main_Page
    And from Stanford's Skeletal Tissue Research Lab Mechanobiology link: http://starlab.stanford.edu/research.html
    Dennis, to suggest that your work is cross purposed is fine, but you said it in a way that implies that the work of others is not. Nothing could be further from the truth. I posted the information from Stanford's website to demonstrate the pragmatic nature and application of biomechanical education and research that is being conducted at just one of many prestigious educational institutions.

    It would be impossible for man to ambulate without friction. Friction can be explained by applying the laws of physics. You seem to be dismissing or devaluing the application of the laws of physics to gait, gait related pathology and ultimately to foot orthotic therapy. You claim to have an EBM practice, but you offer no scientific evidence to support your claims and you seem to snub the scientific community because you don't believe we can apply the laws of physics to biological (“zoetic”) subjects. How else can any of it be explained? The flaw in your logic is this: Our absence of knowledge doesn't make our existing facts invalid. The fact that there are variables or factors that can’t be measured doesn't invalidate the factors we can measure. Any valid model of foot function and orthotic therapy must be consistent with the existing laws of science. The burden is on those who claim that these laws can’t be applied to living structures to prove why these laws are inapplicable or invalid and ideally, to supply some other plausible explanation. Until then, scientists will use the existing facts, including Newton’s laws to conduct their research can create models. What other option is there other than to stop looking for answers?

    Respectfully,
    Jeff
     
  4. David Smith

    David Smith Well-Known Member

    Elegant, eloquent, and right on the money.

    Got to be one for quote of the year.

    Regards Dave Smith
     
  5. I agree, as I wrote here: http://www.podiatry-arena.com/podiatry-forum/showpost.php?p=9840&postcount=7 . I look forward to reading your PhD, Greg.
     
  6. drsha

    drsha Banned

    Greg Stated:
    Malevolence coupled with debauchery are not characteristics with which I have been associated before

    DrSha replies:
    Welcome to the club. I have never been accused of or called the things that I have on The Arena either.

    The fact that bioengineering is young and is the future of where our science is going is very clear and comfortable to me.
    My complaint is the posture taken on this site as if the science is already mature, proven and totally capable of answering every clinical question that arises.
    I have stated that I understand physics, Newton's Laws and their importance but I do not understand fizzics and it has been demanded of me to learn the fizzics, do my own research and obey the dictums being taught here without question.
    It sounds like the BioEngineering Dept at Stanford is acting in a manner more fitting as it associates with the clinical areas at Stanford Med. They seem to be fostering relationships rather then demanding conversion.

    Furthermore, and correct me if I am wrong, biomedical newtonian theory has not yet produced any viable, clinically applicable level I evidence (other than medial knee OA using a wedge that would be harmful to many feet and postures).
    I argue that that leaves room to look at other theories not blow them out of the water as is routinely done here.
    Finally, if feet vary so much as a bell curve in toto, why not subgroup them for purposes of clinical exam and care and research in order to have less error and more focused care and results. What's so crazy about that?

    DrSha

    I've quoted Bob Dylan:
    I'm glad I'm not me

    DrSha
     
  7. What is fizzics? We all have to do our own research Dennis, unless we can pay someone to do it for us.
    Firstly, your foot-typing approach has produced what level 1 evidence? Secondly, show me the level 1 evidence that valgus wedging is harmful to many feet and postures...

    From an excellent paper I read today:
    "To be scientifically useful, a theory
    must be prescriptive and make predictions
    that then should be tested. If
    the theory survives a series of falsifying
    tests, it may gain credence."


    Kuo Arthur D; Donelan J Maxwell: Dynamic principles of gait and their clinical implications. Physical therapy 2010;90(2):157-74

    By presenting your theories here in the absence of experimental data to support your contentions, then the falsifying tests can only begin with the asking of questions. If you had published your theories in a peer -reviewed journal, the paper would be questioned by your peers in much the same way. If anyone had the time, money and inclination they could perform physical experiments to test you hypotheses. But to be honest, if the theory doesn't appear water-tight in the first place, why go to that time and expense?

    You can sub-group data, but you first need to demonstrate that the probability that a member of one sub-group could also belong to a another sub-group is not too great. Statistical processes, Dennis. But, that is not what you want or what you are talking about. You want us to accept your method of foot-typing as valid, so first you must demonstrate the validity... Then we need to see if it is better than another method of sub-grouping the data, for example using the foot posture index which has demonstrable validity and reliability through published research.
     
  8. Or indeed the Quadrastep system.

    There is quite the choice of foot typing systems at the moment. Is sub grouping the new black?
     
  9. No. What's the date of your gig down here, Rob?
     
  10. Is it not? 12th June.
     
  11. blinda

    blinda MVP

  12. No. Yeah, where is it?
     
  13. drsha

    drsha Banned

    Originally Posted by drsha
    Furthermore, and correct me if I am wrong, biomedical newtonian theory has not yet produced any viable, clinically applicable level I evidence (other than medial knee OA using a wedge that would be harmful to many feet and postures).

    Firstly, your foot-typing approach has produced what level 1 evidence? Secondly, show me the level 1 evidence that valgus wedging is harmful to many feet and postures...


    if we can agree that neither of us has proven our theory with level I evidence?
    I for one, have not

    DrSha
     
  14. No we can't agree on that! Since, the theory based on physics and Newtonian principles does have level 1 evidence (as you pointed out); while your theory does not (a fact which you concede above). The fact that I, personally, did not generate that evidence is neither here nor there to this discussion.
     
  15. :empathy:
     
  16. Sammo

    Sammo Active Member

    "armamentarium"

    Do you mean armoury?

    S
     
  17. drsha

    drsha Banned

    Dr. Spooner:
    As I am interested in the amount of Level I Evidence BioNewtonian Theory has produced to this date and as I wish to have a starting point from which to continue to grow my work, if you could list those Level I EBM additions to the literature so that I may examine them, I can then state that my work has none and yours has ......
    Thus creating a beginning for the state of Level I Evidence in biomechanics. Other theorists could then list their level of data and we will have "The Current State of Biomechanics Level I EBM".
    DrSha
     
  18. Try using google with key words such a valgus wedge knee etc, sooner or later Dennis you are going to have to start doing some research for yourself; research includes finding the evidence.

    This one took me less than 30 seconds to find.
    http://www.ejbjs.org/cgi/content/extract/91/2/493

    And BTW, this one is for varus wedging.
     
  19. Oh, Ok then.;)

    Embarrassingly I'm not exactly sure. I think its honiton. Possibly exeter. I'll find out for sure. What can I say, I'm an educational ho. I just go where i'm sent and do what i'm told. :eek:

    Oh and

    http://www.japmaonline.org/cgi/cont...cs&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

    LYNCH DM, GOFORTH WP, MARTIN JE, ET AL: Conservative treatment of plantar fasciitis: a prospective study. JAPMA 88: 375, 1998
     
  20. drsha

    drsha Banned

    I know you could have accomodated my request if you wanted to as I have seen you spew out articles when requested by others.

    I have learned alot from you when it comes to building walls in a relationship and how to live a biased and tunnelled visioned academic life.

    Now I finally have gotten some valuable information from you. When someone asks me for the evidence for Neoteric Biomechanics, I will simply reply:
    Simon, you a going to have to start doing some research for yourself; research includes finding the evidence.

    To continue on your suggestion:

    I googled foot orthotic level I evidence and from the first page there was:
    http://www.aetna.com/cpb/medical/data/400_499/0451.html

    which includes:
    Foot orthotics are considered medically necessary for members who meet all of the following selection criteria:

    1.

    Member has any of the following conditions:
    1.

    Adults (skeletally mature feet):
    1.
    Acute plantar fasciitis
    2.
    Calcaneal spurs (heel spurs)
    3.
    Calcaneal bursitis (acute or chronic)
    4.
    Neurologically impaired feet (including: neuroma; tarsal tunnel syndrome; ganglionic cyst; and neuropathies involving the feet, including those associated with peripheral vascular disease, diabetes, carcinoma, drugs, toxins, and chronic renal disease)
    5.
    Inflammatory conditions (i.e., sesamoiditis; submetatarsal bursitis; synovitis; tenosynovitis; synovial cyst; osteomyelitis; and plantar fascial fibromatosis)
    6.
    Acute sport-related injuries (including: diagnoses related to inflammatory problems; e.g., bursitis, tendonitis)
    7.
    Musculoskeletal/arthropathic deformities (including: deformities of the joint or skeleton that impairs walking in a normal shoe; e.g. bunions, hallux valgus, talipes deformities, pes deformities, anomalies of toes)
    8.
    Medial osteoarthritis of the knee (lateral wedge insoles)
    9.
    Vascular conditions (including: ulceration, poor circulation, peripheral vascular disease, Buerger's disease (thromboangiitis obliterans), chronic thrombophlebitis)
    10.
    Conditions related to diabetes (see section above on therapeutic shoes for diabetes for a complete list of medically necessary diagnoses).

    Foot orthotics have no proven value for back pain, knee pain (other than medial osteoarthritis), pes planus (flat feet), pronation, corns and calluses, hammertoes, hip osteoarthritis, and lower leg injuries.
    2.

    Children (skeletally immature feet):
    1.
    Torsional conditions (e.g., metatarsus adductus, tibial torsion, femoral torsion)
    2.
    Structural deformities (e.g., tarsal coalitions)
    3.
    Hallux valgus deformities
    4.
    In-toe or out-toe gait
    5.
    Musculoskeletal weakness (e.g., pronation, pes planus);

    and (for both adults and children)
    2.

    The member must have symptoms associated with the particular foot condition (foot orthotics are not considered medically necessary when the foot condition does not cause symptoms); and
    3.

    The member has failed to respond to a course of appropriate conservative treatment (e.g., physical therapy, injections, strapping, anti-inflammatory medications). (Orthotics should not be considered first line therapy.)

    Foot orthotics are considered experimental and investigational when these criteria are not met.

    Please advise if you have any Level I Evidence to refute Aetna's Policy?

    and
    Here's another, somewhat more promising but nothing that would convince me to alter my EBP protocol for treating plantar fascitis.


    Plantar Fasciitis: Evidence-Based Management: Treatment Modalities

    http://www.medscape.com/viewarticle/562437_5

    Treatment Modalities
    Achilles Tendon Stretching

    Stretching the Achilles tendon is generally included in most treatment plans for plantar fasciitis. Pfeffer and colleagues[8] looked at stretching as the only treatment: 72% of patients assigned to stretching alone noted improvement of symptoms compared with 88% of patients who utilized prefabricated splints along with stretching exercises. The study's main weakness was the lack of an observational control group to evaluate the effectiveness of the stretching program alone. DiGiovanni and colleagues[9] noted improvement of symptoms if the program utilized dorsiflexion of the forefoot and toes, as opposed to Achilles tendon stretching alone.

    Recommendation. Achilles tendon stretching may be helpful, but there are few studies to support its practice.

    Level of Evidence. Expert opinion; recommended in most treatment guidelines; no randomized controlled trials (RCTs) to confirm effectiveness over simple rest.
    Rest

    No randomized trials were identified that evaluated rest as an intervention for treatment of plantar fasciitis. There were 2 retrospective studies (514 patients) noted that asked patients to evaluate different therapies. Rest ranked third, behind casting and injection, among 11 other modalities examined in the study.[10,11]

    Recommendation. Although rest is likely to be helpful, there is minimal support for this approach in evidence-based literature. Of note, most patients usually experience a decrease in pain within the first 6 months, independent of the initial treatment selected.

    Level of Evidence. Expert opinion; no RCTs to demonstrate utility vs more active forms of therapy.
    Taping

    No studies were found evaluating the effectiveness of taping in the treatment of plantar fasciitis. Most taping methods tend to run the length of the longitudinal aspect of the plantar arch. Taping decreases the amount the arch flattens during the active stance phase. This also serves to prevent excessive pronation of the foot (ie, pes planus), which is known to be associated in patients with plantar fasciitis. Although taping is frequently used in the acute care of this ailment, no studies were located examining the effectiveness of taping in this setting.

    Recommendation. Because taping has not been adequately studied in the literature, no clear recommendations can be offered in its role for management of plantar fasciitis.

    Level of Evidence. None.
    Night Splints

    Night splints have been used to maintain the foot in dorsiflexion during sleep. The consensus of opinion is that this may allow the fascia to begin to heal with the plantar aponeurosis in full extension, thereby reducing the tension at the origin of the fascia at the calcaneus. In 1991, Wapner and Sharkey[12] described 14 patients with symptomatic plantar fasciitis for greater than 1 year who had not responded to multiple treatments. They were splinted in 5 degrees of dorsiflexion overnight. Eleven patients had no pain, with full relief of symptoms by 4 months.[13] Additional studies have demonstrated similar improvements.[14]

    Probe and colleagues[15] in 1999 compared the use of shoe modifications, nonsteroidal anti-inflammatory drugs, and stretching with a similar program utilizing these interventions with the addition of night splints. A total of 116 patients in this study were followed for 3 months with no difference in outcome between the 2 groups. The reason for the outcome of the study is likely related to significant differences in patients in the 2 treatment arms. The group that demonstrated efficacy of night splints enrolled patients who had failed to respond to many modalities for long periods of time. The arm of the study that did not demonstrate a treatment advantage used splints as one of the initial treatment measures. The study is also limited in the small number of patients studied, making it problematic to demonstrate any significant treatment advantage from any modality used in the initial treatment of plantar fasciitis.

    Recommendation. Night splints may have some utility in the treatment of persistent plantar fasciitis.

    Level of Evidence. Evidence from RCTs (small/moderate).
    Heel Pads and Orthotics

    A review of various biomechanical studies does not support the use of heel cups in the treatment of plantar fasciitis. Studies that have evaluated heel force impact demonstrate that the heel strike forces in patients with plantar fasciitis are similar in both painful and asymptomatic heels.[5] Another study that examined heel strike impact forces noted similar outcomes, with heel pads only proving useful in patients with localized pain from contusions as opposed to plantar fasciitis.[16] However, custom-made orthotics have been shown to reduce the tension in the plantar aponeurosis, whereas standard orthotics did not produce the same effect.[17] As stated earlier, because tension at the origin of the plantar aponeurosis is the likely etiology of plantar fasciitis, reducing the tension in the plantar aponeurosis would likely reduce pain and aid healing.

    Recommendation. Heel pads are not recommended for the treatment of plantar fasciitis but may provide relief for patients with pain due to a heel contusion. Orthotics are recommended in the initial treatment of plantar fasciitis. Custom molded orthotics are more effective than preformed orthotics. The cost of custom-molded orthotics, however, may limit the utility of this treatment option.

    Level of Evidence. Small RCTs showed a trend toward benefit.
    Steroids

    Corticosteroids are frequently used to treat patients with plantar fasciitis. Different prospective RCTs have shown positive effects of using both iontophoresis[18] and percutaneous infiltration[19,20] techniques to reach the plantar fascia with steroid medications. However, all studies have noted the relief to be transient. After 30 days, no significant difference in pain relief was noted between treatment and control subjects. As a limitation, the RCTs have had small numbers of patients.

    One risk of using steroid medication on the plantar fascia is the possibility of rupture of the fascia. Acevedo and Beskin[21] examined 765 patients with plantar fasciitis in their 1998 study. Steroid injections were performed in 122 patients overall. Of 51 patients experiencing a rupture of the plantar fascia, 44 of the patients received a steroid injection prior to rupture.

    The technique for injection of the plantar fascia may be ultrasound assisted. However, there is no evidence that this technique improves outcome or reduces the incidence of long-term complications. The standard method of injection is the medial approach at the point of maximal tenderness on the medial aspect of the calcaneus. One should avoid the heel pad as a site of injection because this may result in significant discomfort for the patient.

    Recommendation. The benefits of steroid injection appear to be transient, although they are commonly used in the initial treatment of plantar fasciitis. Steroids also have the potential to increase the likelihood of rupture of the plantar fascia. Corticosteroids should not be used in the initial treatment of plantar fasciitis due to the potential for harm and lack of a lasting beneficial effect.

    Level of Evidence. Evidence from small to moderate RCTs and retrospective studies.
    Extracorporeal Shock-Wave Therapy

    Extracorporeal shock-wave therapy (ESWT) has recently been advocated in recalcitrant cases of plantar fasciitis. It has often been viewed as a useful option prior to considering surgical treatment. Impulses of low-energy shock waves through ultrasound guidance are focused at the point of maximal tenderness across the base of the calcaneus in a transverse axis. These waves may help to accelerate the healing process via an unknown mechanism.[22]

    There have been 2 small RCTs and 1 medium-sized RCT published in the past decade, but all have major limitations. Two studies by Rompe and colleagues[23,24] in 1996 utilized inconsistent patient selection criteria, and a subsequent investigation by Speed and colleagues[25] in 2000 was rather small with a high drop-out rate in the placebo group (5/15). An intention-to-treat analysis of this data would not have demonstrated any treatment advantage. In fact, due to issues related to cost and minimal evidence supporting use of ESWT, the health ministries of 3 European countries in 2000 put a hold on reimbursement for this procedure until further evidence emerges to support the validity of the treatment.[26]

    Additional recent studies have not resolved the controversies over ESWT. A prospective RCT by Rompe and colleagues[27] in 2003 examined 45 runners with persistent heel pain and noted a significant decrease in pain at 6 months and 1 year in patients treated with 3 applications of 2100 impulses of low-energy shock waves.

    Theodore and colleagues[28] also reported a beneficial effect from ESWT. However, there were significant limitations from this study. The initial improvement at 3 months was not convincing, with 56% of patients who received ESWT reporting improvement at 3 months, in comparison with 46% of patients receiving a placebo. There was also no long-term follow-up available. In fact, the authors permitted patients to cross over to the active treatment group after the 3-month assessment. In contrast to these studies, many other studies have failed to show benefit from the therapy. Multiple other studies have not demonstrated an advantage of ESWT.[22,29-32]

    A Cochrane review of ESWT in 2003 noted that "there is conflicting evidence for the effectiveness of low-energy extracorporeal shock-wave therapy in reducing night pain, resting pain, and pressure pain in the short-term (6 and 12 weeks) and therefore its effectiveness remains controversial."[33]

    Recommendation. ESWT may have some utility in the treatment of chronic plantar fasciitis. There are studies that have shown no benefit, while other studies show moderate improvement in a proportion of patients. It remains controversial at this time. There is no evidence of harm from the therapy.

    Level of Evidence. RCTs (moderate sized) with systematic reviews.
    Surgery

    Surgery is generally considered in patients who have not responded to conservative measures over a period of 1 year. In fact, a study by Wolgin and colleagues[11] showed that a large proportion of patients will have a reduction in their symptoms between 6 and 12 months.[11]

    Specifically, a plantar fasciotomy is performed along with neurolysis of the nerve to the abductor digiti quinti.[34] Both endoscopic and open fasciotomy have been performed, with both techniques demonstrating similar outcomes seen only in retrospective patient survey data.[35] There are no prospective studies on whether the open or endoscopic technique is associated with better functional outcomes. In multiple studies, between 70% and 90% of patients experienced initial relief after undergoing surgery.[34-38]

    However, based on long-term follow-up, the results are not as favorable. Davies and colleagues[38] found that less than 50% of patients (48%) were satisfied with the results, although they initially noted improvement following surgery.[38] Nearly 33% of patients reported continual forefoot and midfoot pain, although they were initially satisfied postoperatively with their outcomes.[34,36]

    This may be related to the fact that undergoing a fasciotomy leads to flattening of the longitudinal arch and a redistribution of the peak forces of ambulation from the heel to the midfoot.[37] This shift of forces often leads to pain in the midfoot and forefoot during ambulation. In fact, Yu and colleagues[39] noted recurrent plantar fasciitis, arch instability, and structural failure due to overload on MRIs of patients with persistent or recurrent pain following plantar fasciotomy.

    Recommendation. Surgery should be considered for patients with persistent plantar fasciitis who fail to respond to conservative measures. Some patients will take up to 1 year to experience relief of pain using noninvasive approaches. ESWT should be considered prior to considering surgery. Surgery may provide short-term relief, but long-term results are not favorable. Prior to undergoing surgery, patients should be aware of the possibility of problems developing in the midfoot and forefoot secondary to the division of the plantar aponeurosis.

    Level of Evidence. No RCTs; cohort studies show improved outcome following surgery.

    I review the biomechanics literature above average by my pulse and to date, I have reviewed no level I evidence of Bio Newtonian Theory that convinces me to alter my practice protocols. I have begun to apply more thought as to how I am using Newton's Laws in my EBP but I have not changed it to date.

    DrSha
     
  21. Round and Round we go where it stops no one knows....................
     
  22. Dennis, you seem to have mistaken me for someone who actually cares about your opinions and your ideas about neoteric biomechanics. I took one look at it, saw it for what it was and filed it undo "r". The problem with your statement above is that when someone tries to find some good quality evidence to support "neoteric biomechanics", they won't be able to find any because there is none, and if you won't answer any questions on the topic, how will anyone know anything about it?
     
  23. Or cares.
     
  24. PMSL :D

    Thanks I needed that .LOOOONNNNG day
     
  25. No, no, no - it's wonderful! Don't be distracted Dennis; it's just a conspiracy to keep you quiet. Just explain the bit about the jellied dragons and the loop-loop gait and that'll blow 'em away.....
     
  26. Almost literally PMSL! Mark, no matter how hard the rest of us may try, I suspect the quote of the year will always be one of yours.

    Thanks!
     
  27. David Smith

    David Smith Well-Known Member


    Mark, You is a baaaad man;)

    Dave
     
  28. drsha

    drsha Banned

    Your infantile releases do not change the fact that BioNewtonian Theory currently has major reasearch flaws and poor clinical application and needs to be defended by selfproclaimed bad boys waiting in the wings for the kill.

    As I have said before, I invite DPM's (you know the American blokes) to visit The Arena for education but I warn them of the acid bath they will recieve if they don't fall into line.

    Our listserves (Dr. Barry Block's for one) allow opposing points of view and there is an editor that keeps the ring free of scum and pointless degradation. This site could accomplish so much more and have a better reputation if it were more professional.

    Do you think you have the most readership because you are The New York Times or some tabloid like the Globe?

    You force the worst out of visitors after you trap them into participation.

    Why do you continue to send me Arena updates that beckon my involvment.
    Why don't you work with a password to keep the competition outside of your walls instead of asking me to "go away"?

    In America, we have a sense of competitiveness not competition. That is why Craig must travel the globe to get a podium.

    I remain fair in applauding your gifts and valuable accomplishments but it is becoming harder and harder to wade through your mocking banter in order to participate.

    As usual, I close with one of the simplist techniques that I have learned to apply to The Arena that I was taught in the streets of Brooklyn. We called it "Your Mother Talk"
    It simply ranked ones mother when losing or weakening in a debate rather than pick up a 2 X 4 and smack your opponent in the face. It generally ended by one side saying:
    "Your Mother" and the other saying
    "No Your Mother" and the round was over.

    So my response to you (all) at this moment as to a solution for the childish part of our debate is:
    Why don't you (all) go away!!
    :boxing::boxing::boxing:
    DrSha
     
  29. Dennis

    For me, I welcome people that challenge the orthodox - that's often where real advances are made and not just in podiatry. A different perspective or way of thinking or a different approach sometime solves the most intractible problem. The problem you have however, is that you appear blinkered to rational critique and argument and refuse to address flaws in your theories - which I have to say, even to someone like me - are bordering on the ridiculous at times. Okay, so you've devised a classification system that seems to work for you. All well and good. To the vast majority of your peers, it makes no sense whatsoever and even if it did, it's use in clinical practice would be limited - if it had any use at all. To be perfectly honest, when trying to follow your rationale in some of your posts, I am left wondering whether this is a man on the verge of a breakdown - rather than a breakthrough - for much of what you write is simply incoherent ramblings. But maybe that's more of a reflection on myself rather than you.

    Entertaining - yes. Educational - no. Validity - very limited. Please don't go away, Dennis, just think about it a bit more and try and converse in a language that we can all understand.
     
  30. Greg Quinn

    Greg Quinn Active Member

    I agree Mark,

    Language, language, language!

    We do not appear to have made much progress at understanding DrSha’s position. If we can start from first principles and build from there it might help understand each other’s viewpoint. This is my understanding…

    Science is the application of applied doubt by consistent methods to illuminate the physical world (as per Jeff Roots earlier post); it is the ways in which we discover nature - not defy it. Therefore, whether it is research in podiatry, physics or witchcraft the results of any experiment must be reproduced independently in another location by another researcher. This verifies that the outcomes were not the result of bias in the original experiments. I.e. Reproducibility is integral to the scientific method.

    Whichever of us claims to have discovered a phenomenon must describe in sufficient detail how it was produced so that other investigators, following similar steps, can reproduce it themselves.

    This quotation serves to illustrate the point:

    “Although the history of science contains numerous examples of an investigator's expectations clouding his or her vision and judgment, the most serious of these abuses are overcome by the discipline's insistence on replicability and the public presentation of results. Findings that rest on a shaky foundation tend not to survive in the intellectual marketplace. [...] The biggest difference between the world of science and everyday life in protecting against erroneous beliefs is that scientists utilize a set of formal procedures to guard against [...] sources of bias and error.”
    How We Know What Isn't So: The Fallibility of Human Reason in Everyday Life" by Thomas Gilovich (1991)

    This is not a standpoint that suggests your view is not authentic. It does however provide a consistent framework around which we can start to work together. I am not aware of your particular assessment or treatment approach. But any technique that claims to be EBP must be challenged by others in order to be accepted as valid. If results consistently raised questions about the legitimate use of Newtonian Mechanics in podiatric medicine then all of us would have to review and modify our viewpoints based on the strength of the evidence.

    Respectfully,
    Greg
     
  31. My viewpoint?......why waste my valuable time debating someone who is unable to use good reason in their arguments?! :bash:Life is too short for this nonsense. As I told Robert earlier.....before he later voluntarily withdrew from trying to reason with this man....your time is much better spent trying to educate someone who is reasonable and actually wants to learn.
     
  32. drsha

    drsha Banned

    ROUND NINE
    :good:

    We are finally defined!!!
    For me, I welcome people that challenge the ORTHODOX
    The Book of Russell 4:62

    The BIONEWTONIANS ARE (from the Thesaurus)
    according to the book, acknowledged, admitted, approved, authoritative, buttoned-down, by the numbers, canonical, conformist, conservative, conventional, correct, customary, devout, die-hard, doctrinal, established, in line, legitimate, official, old-line, pious, proper, punctilious, reactionary, received, recognized, religious, right, rightful, sanctioned, sound, square, standard, straight, straight arrow, traditionalistic, true, well-established


    Who made you G-D?

    You are evanganical, self proclaimed, Root is The Book (you don't have one), your flock is tiny and most "Orthodox biomechanists" think of you as bigeted researchers and EBMers without much to add clinically with a much bigger bravado than you deserve.

    Taking the Laws of Newton that govern the inanimate world and equating them just as accurate and important biologically is your HYPOTHESIS
    and it is no more important (or less) than mine or any other unproven hypothesis (UNPROVEN Craig or Hylton or most importantly Kevin).
    You are a piss in The Arena's biomechanical toilet, just like me and you haven't convinced many others that you are Elijah.

    You are a biomechanical sect, a cult (not to say that your hypothesis might not be very valid once proven) and currently, nothing more.

    You are intelligent designed not darwinian, just like me.

    I was raised an Orthodox Jew by a biased, bigeted, angry family who devoutly believed that they were the chosen people. I am currently married to a Roman Catholic Puerto Rican (imagine my mothers reaction) and I have a different version of the Jewish G-d.

    You have examined my hypothesis as my parents would have examined Budda, or Allah or any other infidels.

    I have paid an amazing, draining price to harvest your pearls of wisdom and your additions to what you have turned into a toilet on The Arena.

    Now you are exposed for what you are:
    A CHARLATAN, Religious Zealet, just like me.

    I believe that there are two kinds of fundamentalists in religion. There are those who devoutly believe that their version of G-d is orthodox but they are willing to live and thrive with others in life and those who believe that all must be converted to their god OR DIE. Which side of the ring is yours

    You are not my Messiah and I am not yours but now I see it clearly. I AM YOUR MORTAL ENEMY.
    :drinks:drinks:drinks

    There's the Bell for ROUND NINE
    Come Out Fighting

    Dr Sha
     
    Last edited: May 22, 2010
  33. The funniest thing about the above is the subtext - Reason for Editing: Clarification! Much as I enjoy reading the notes of someone so obviously gifted as you Dennis, I'll bow out and give you an unfettered platform. Goodbye.
     
  34. drsha

    drsha Banned




    The Winner!!

    Russell et al vs. DrSha.

    IS

    DrSHA

    The Opponent Failed to Answer the Bell for the Ninth Round!!!
     
  35. Ever notice that the louder the shout, the less the response?
     
  36. Indeed. Had YOU noticed that the less the response the louder the shout? ;)
     
  37. drsha

    drsha Banned

    :good:

    Robert:

    Thank you for giving me the response to the shouting directed towards me when I am not answering your questions (Your Mother).


    But Shame on You.
    Circular logic!

    In criminal justice, a lack of response would indicate an admission of guilt forcing the need for further investigation.

    Or what about the silence of someone being cross-examined unfairly (like oursiders visiting The Arena)?


    I believe, until proven otherwise by his defense that Russell said goodbye for the same reasons that Rothbart said goodbye. Why do you think it different?


    If you are correct about the virtues of silence then your never ending shouting about me not addressing questions never asked by those taking a serious look at my work would speak volumes.

    If you are wrong about silense then we are both avoiding points in our arguments that are flawed or uncomfortable to answer.


    Which is it? Only a religious fanatic would justify having it both ways.

    On The Arena, when it comes to my work, you superficially visit it to fulfill your predetermined antithetical agenda as you do with Dananberg, Root, Glaser et al).


    Mine is the shout of proclamation, What is yours?

    DrSha
     
  38.  
  39. efuller

    efuller MVP

    I guess to be a cult you have to have more than one person agree with you.

    Dennis, you have tried to present your ideas to the arena and have failed to convince us that they are valuable. This does not make you the arena's mortal enemy. Are you trying to convince us that your ideas have merit by trying to pick a fight. Do you think that's going to work? Dennis what are you trying to do?

    Eric
     
  40. I think it is something like this.:rolleyes:

     
    Last edited by a moderator: Sep 22, 2016
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