The optimal foot postion (again)

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Thanks to Miguel for forwarding this one to me.

http://www.lowerextremityreview.com...vance-of-the-arch/comment-page-1#comment-1914

Sort of blurs the line between literature review and Infomercial.

I've posted the following comment, which is awaiting moderation (don't know the journal so we'll see if they pass it).

 

Sounds similar Zones of ....

After last years agruements and discussion Ed did finially say that SALRE theory fit within Tissue stress theory but still they seperates them.....

1st half was well written...........

 

They nicked that from where and whom? Thanks, Ed. good to see you were listening, not so good to see that you are now rhyming and stealing ... http://www.youtube.com/watch?v=EIikcGo_dgU

 

Quote:
There are several flawed assumptions with MASS position. One is the concept that there is a single “optimal foot posture” for everybody. Examine elite runners like Haille Gebrselassie . http://www.youtube.com/watch?v=EAW87NsiGuI

This functional range is about as far from the MASS position as it is possible to get, yet is equally obviously functioning extremely well. If MASS is optimal, why is this apex athlete functioning so well, so far from it. Would he function better with a MASS orthotic?

Secondly, and more profoundly, the MASS model takes NO consideration of the actual nature of the pathology. Would anyone seriously suggest that the maximally supinated postion is optimal for a foot with a strain in one of the lateral structures? An inversion sprain for example, is an inverted postion (MASS) the optimal postion for treatment of an inversion sprain?

It is worth noting that the two studies quoted for outcomes compared these insoles not to shaped pre fabricated orthoses, but to flat 3mm pieces of poron. Scarcly robust evidence that this position is superior to any other!

One of the comments which caught my eye was this

“So what is the ideal foot posture if it is unrelated to subtalar neutral?”

The answer, for me, is simple. There is NO single ideal foot posture for every individual with any pathology, in every circumstance. Sadly, life is rarely that simple. The concept of an ideal position for the foot is as illogical as the concept of an ideal position of the knee, or the hip. The most favourable position for an orthotic is subject specific, injury dependant and will depend on activity and footwear. The foot defies such attempts to simplify its function, as much as it may be profitable and marketable to do so!. Quote

Here's my biased, patented, profiteering, mutant, poorly evidenced personal opinion on optimal foot position (OFP) and its importance to capture in order to generate a great orthotic shell.

There are those that believe that "the foot defies attempts to simplify its function".

I opine:
Not until patients are profiled and Functionally Foot Typed to gain a platform from which to base their OFP on.

This starting platform is being used by increasing numbers of skilled practitioners of biomechanics to develop orthotic shells that approach OFP custom for each patient.

It blows STJ Neutral Shells out of existence, no matter what system of ORF's you currently use (let's say tissue stress or SALRE theory).

These shells under Wellness Biomechanics are then refined using ORF's and Muscle Engine Training to further customize the orthotic and the treatment plan for optimizing clinical results.

When held in OFP by an orthotic shell, prescriptions then allow prevention, performance enhancement and quality of life upgrading to become considered viable complements to pathology specific biomechanics.

i.e.:

Rigid/Rigid = more Vaulted OFP (The Ankle Sprain Example)
Stable/Stable = close to STJ Neutral OFP
Rig/Flex = Forefoot Vaulted OFP
Flex/Flex = RF and FF Vaulted OFP (Haille)
Flat/Flat = less Vaulted OFP

To use the language of the above quote:

A Subtalar Joint Neutral Orthotic Shell takes NO consideration of the actual nature of the pathology.

To quote Bob Dylan when he went electric at Newport:
"I'll let you be in my world if I can be in yours"

Dr Sha

 

You scamp.

 

http://www.youtube.com/watch?v=vrQ4saKGI5k