The Most Common Foot Type

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Theoretical Question # 6:

What is the most common Foot Type?
Dennis

 

Hi Dennis,

One left, one right, 10 toes.........

Cheers,:drinks

Brad Randazzo

 

Brad Posted:
One left, one right, 10 toes.........

I think in order to satisfy his purpose of degenerating and personalizing this thread away from the actual thread, Brad truly hit the podiatry nail on the head.

In actuality, most of us treat all feet alike (even the left and right of the same patient)

STJ neutreal casting, 3 degree RF Varus post (add a medial skive if you wish or invert the heel), intrinsic post the forefoot and set your treatment goals very low (stop pain, the patient doesn;t want to return the orthotic).

We actually treat Brad's One Common Foot Type (which from herein I will refer to as The Dyfoot Type in his honor) with poor outcomes, low goal set and the inability to offer custom care because something that helps one Dyfoot will be harmful to others and cannot be utilized because Hippocritically, "thou shalt not harm".

Profiling all feet into more than one type and then developing a treatment protocol foot type specific that maximizes all that can be done for that foot type without regard for what it might do for others expands the strategies that practitioners debate and use to diagnose and treat feet and the posture whether you discuss them in engineering, physics ar architectural terms.

The fact that Neurotic Biomechanics and "how dare you patent" "not researched, not clinically relevant"and all the other quips and incestuous comments that live on my threads (I have buried my hahahaha personna as I do not wish to dignify them any longer with reaction) are anecdotal fuel for me to stay my path because if you could debate my theories into snake oil, you would have done so long ago.

What are you all afraid of?
What is the most common foot type.
Dennis

 

Dennis,

This was not my purpose!


I was making a joke (with my twisted Australian sense of humour), but also the point that I actually don't believe that you can successfully classify feet into "types" which can be applied to each and every patient in a clinically significant way.


I don't want to get into a debate with you over your "Functional Foot Typing (registered treademark)" patent! This was debated on Podiatry Arena long ago!


I actually believe that NO TWO FEET ARE THE SAME and I treat each and every one in a (maybe sometimes only slightly) different manner!


In fact I use three different custom orthotic labs and four different brands of preforms in my practice- I would hardly call that treating all feet alike! There is no Dyfoot type!


I was also not making this personal- I don't know you from a bar of soap! But I do think that your reply WAS personal and inflammatory!


Sincerely,


Brad Randazzo

P.S. I don't know how to put mulitple quotes into my reply to your post.

P.P.S. I think that you meant HIPPOCRATICALLY, not Hippocritically "though shalt not harm".

 

What is the most common foot type?

If human feet follow a normal Guassian distribution, as they should being in a natural system, then (depending on your choice of classification), it should look like the attached graph.

Whilst we know what the normal range for an INR, ESR, Na, K, or other biomechemistry test should be, we still argue over the distribution of varying functional foot types, because they can take on a range of anatomical planar deviations from normal (or rectus).

Excluding iatrogenic causes, and deformity at the level of the MTP joints distal - then most feet should be able to be classified according to some pertinent static osseous orthopaedic aligment characteristics. The problem arises where the deformity is in more than one plane, eg a sagittal plane dominant flatfoot, vs. a typical PTTD flatfoot which is a triplanar deformity. Don't get me started on more complex patterns such as skewfoot...

The question to me is; how do we fit all of the different classifications of foot type on a normal distribution curve?

 

Brad Stated:
I was making a joke (with my twisted Australian sense of humour), but also the point that I actually don't believe that you can successfully classify feet into "types" which can be applied to each and every patient in a clinically significant way.
I don't want to get into a debate with you over your "Functional Foot Typing (registered treademark)" patent! This was debated on Podiatry Arena long ago!
I was also not making this personal- I don't know you from a bar of soap! But I do think that your reply WAS personal and inflammatory!
P.P.S. I think that you meant HIPPOCRATICALLY, not Hippocritically "though shalt not harm".

Dennis Replies:
Thank you for correcting me as I was wrong to say that you were personalizing my thread away from its content. Actually you admit that were making fun of my work in a twisted way.
The Arena has professed to an open mind which I have questioned. How does “I don’t believe that you can successfully classify feet into “types” clinically significant relate to that open mind?
Finally, please correct me if I am wrong, but I believe that you have never once looked at, tested or considered utilizing functional foot typing and have not read even one article on the subject. I think that is the reason for not debating me.

Since joining The Arena, I have been able to associate with its brilliant members once I wade through the slime that seems to follow my posts.
I have added to my scientific knowledge and my terminology when it comes to how and why the foot actually functions. I have read many articles that have been suggested and my ability to debate biomechanics foundationally has been magnified many fold.
Dr. Kirby has been kind enough to provide me with an autographed copy of his third book and I have given it an initial reading (many more to follow). It has expanded and upgraded my thinking.
In order to become a more believable and capable practitioner with an organized and scientific acumen one needs to build foundational knowledge.
My coursework and preparation for podiatry included calculus, physics, organic chemistry and embryology. I never totally understood their language and cannot "speak them" but I certainly understood their importance in relating principles and protocols to my life work as a clinician and I work with and apply them every day.
Kevin will go down in the history of biomechanics as did Einstein, Newton and Cury (in their fields) and his legacy will remain scientificaaly over the world as The Father of Lower Extremity BioEngineering.
My only debates with Kevin revolve around his clinical applications and not his body of work!
In spite of the fact that I will never be fluent in its language I am a stronger, better and more capable practitioner and debater and owe a debt of gratitude in his direction.
Finally, those of you who understand the word ignoranus will understand hippocritical.

Lucky Lisfranc Stated:
The question to me is; how do we fit all of the different classifications of foot type on a normal distribution curve?
Dennis replies:
Admittedly, as with Dr. Kirby, I do not understand the language that you used to get there but now that he has provoked the thought, plotting foot types on a Bell Curve will remain an open question to me until I can answer it properly.
Currently, my anecdotal perspective, based on a population that is seeking the care of my practice (no norms) is the following:
Rearfoot Types:
Rigid: 70%
Stable: 10%
Flexible: 19%
Flat 1%

Forefoot Types:
Rigid: 19%
Stable: 5%
Flexible: 75%
Flat: 1%

In addition, these typings reveal familial, performance, complaint and presenting characteristics that organize and focus ones attention directly to each patient once typed that allows me to form a better strategy for care than previous.

The question you saise answers this thread because it selects the Most Common Functional Foot Type as the Rigid Rearfoot, Flexible Forefoot Foot Type and the others can be extrapolated from my figures.
You have given me the incentive to do a retrospective study of my patients as to foot type when I field my next fellow in June.

I have never given thanks on The Arena but collectively “Thanks to Dr. Kirby and The Arena”
Dennis

 

Dennis:

Thanks for that. Good luck in your quest to add to our knowledge regarding the biomechanical characteristics of the foot and lower extremity.:drinks

 

Dennis,

I wasn't making fun of your work specifically. I think that the more podiatrists around the world conduct research into how the foot and lower limb fucntion and how pathologies can be treated, the better!

As I stated I was making a joke which was not personal or even relating to your work.

As Kevin stated:

"Thanks for that. Good luck in your quest to add to our knowledge regarding the biomechanical characteristics of the foot and lower extremity."


I agree with him whole heartedly.

I think that this line:

"Finally, those of you who understand the word ignoranus will understand hippocritical."

was a bit harsh!


Brad Randazzo

 

Dyfoot:
I appreciate your posting very much and state that if you had not made a joke, I would not have replied as I did (not that made my reply appropriate either).
I have learned by the critisism I have recieved from The Arena to my work not from the jokes and ill wishes and I opine that they reduce the power of your arguments since they have to do with me and my convictions personally and not the academic points at hand.

Although the articles illustrations have been removed in this url, this is a good foundational article for you to review and possibly use to foot type a few of your patients.

http://www.podiatrytoday.com/article/7628

Please take no prisoners from there.
Dennis

 

Hey Dennis.

Gosh you're busy on the arena this week!

You have come in for a bit of "hot tongue" on the arena before. Kudos for returning for more. But be honest, do you really think you can make such frankly insulting generalisations as this and not create ripples!?

I still think "stop pain" belongs pretty damn high on the treatment goal list BTW!

I rarely snigger at typos given that I am more than a touch dysclinkyoxiac myself. But I loved "neurotic biomechanics":drinks. Come on, see the funny side with me. You know you want to.

Aha! I see you have constructed a function arena poster typing system as well! Brilliant members / Slime.

But are your measures accurate? What is the inter rater repeatability? You see i have been rated as both slime and valuable poster by different people and at different times. Could I objectively classified as either if the rater group cannot agree?

As David Holland will attest there is also a strong diurnal variation in this measure. I'm pretty sure I nudge the "slime" end of the scale the later it is.

Regards
Robert
Probably slime.
PS. Lest there be confusion, my first point was serious, my second a joke, and my third a metaphor with a bit of joke included. None were personal.

 

I learned in Europe there is the greek foot type the most one who does exist. It is slim and the 2cnd toe is the longest. The second type is aegyptian style, who is likely quadratic (5th toe nearly as long as the first toe)

 

Hi Gerhard

There are lots of foot "typing" systems. DrSha had developed one (or modified it) with 16 different types based on ranges of motion in the rear / fore foot. You are speaking of another based mainly on the digital formula, certainly significant especially if considering risk factors for HAV. Some people type feet as high, normal or low arch. Still others use a feiss line and classify them that way. Some use planal dominance.

I suppose the typing system one uses, if use one we must, depends on what factors we consider most important.

There is no universally accepted convention that i am aware of. Even a classification as simple as "pathological / non pathological" could, and often is debated!

Kudos on posting from another language by the way! a lot of people struggle with this forum in their native tongue :drinks

Regards
Robert

 

Classification is a waste of time all its good for is Institutions, Asylums, Market Research and Half Wits. (Bit of irony there)

Which classification fits you the best Dr Sha (Le Tan)?