Another type of proprioceptive orthotics

Robert,

Do you have a (not so) secret Zonda obsession?

If you reply and tell me that you own one as a result of an unbelievably successful and lucrative private practice, I might have to have some anti depressants prescribed!

Regards,

Robin

 

David Wedemeyer I have a Question and you are the best person to answer it I beleive. If you have the time could you try and explain the mechanism of how the STJ or foot it ment to effect the TMJ or vise versa. I understand that you don´t think it does from your great post, but as Simon stated he has not come across an article which explains it all well.

Thanks before hand.

 

1. Yes. It's a fantastic machine. Performance which in the real world kicks the bugatti veyron's backside but less than HALF the price. Means you can spend the Nearly half a million you have left over on a nice house to keep it in. And it looks beautiful. Really beautiful. If I had the choice of an hour inside one of those and an hour in, say, keira knightly, I'd take the car.

2. Ha bloody ha. I work 4 days a week for the nhs. Take home about £100 a day. I've been known to earn more doing a couple of doms on the way home than I have all day. I drive a dustbin with a wheel at each corner. Sometimes when I'm driving I close my eyes and imagine it's a zonda... Then I hit the curb, buckle my rims and have to go to the breakers yard for another new wheel.

 

To be fair there are some pretty clear differences! All the mainline treatments for vps (cryo, caustics, electro etc) work on the same principle, causing controlled trauma to the area to stimulate an immune response. All needling is is another way to cause controlled trauma in a way that causes no scarring and minimal post op pain. The mechanism is well established, it's just another way to use it. If you were going to make a comparison with orthotics a closer one would be a new flavour of pre fab. Yes it's specifically unproven, but it works on an established principle (increasing orf medial to the sta)

Then there is the question of the outcome we're measuring. Measuring internal kinetic change is piggin hard! Stating whether a damn great plantar wart is gone or not is a pretty simple binary sort of an outcome to observe.

If I thought that needling affected peoples sinuses it would be a closer analogy!

I'm not saying we should not look at the tmj link but in the absence of either a decent deductive or inductive link...

 

If I remember correctly, the last time I looked at the Cochrane review for wart treatment cryo was no better than sal acid, and sal acid was no better than a placebo- hmm, so go deduct all you like Is their an absence? Go back and look at that research again, Robert.

Lets see if we can use some of our mental talent to come up with some hypotheses and deductions. Lets start at the head end:
TMJ dysfunction alters the position of the head and cervical spine, I think that's pretty much what has been reported. Robert, as a paediatric specialist can you tell me what role does the head have in gait development?

Here's some broader questions, how heavy is the average head? What effects does head position have on gait or vice versa? What effect does head position have on CoP? If I alter the net GRF vector beneath a foot, which joints does this influence?

 

I don’t believe that I am Stanley. AK as taught by Goodheart is defined even by the International College of Applied Kinesiologists as an adjunct to standard examination procedures. This begs the question “why is it even important at all”? CRA should be appended to CRAP. They are similar enough that it raises my eyebrows.

Read their Faq page and you tell me if their explanation seems compelling or an obfuscation, they do not deny the link between muscle testing and selling supplements. A lot of it sounds defensive rather than objective:

http://www.icak.com/about/icak_faq.shtml

Stanley, while I understand your use of an analogy comparing a reflexologist to a podiatrist, we must all agree that it is a poor one. A podiatrist is a medically trained professional with a specialty in the foot and more proximal structures. I digress on comparing the two because the podiatrist’s education is simply valid, lengthy and is recognized. I personally feel that there is enough important work to be done by the podiatrist within their scope that it negates forays into musculoskeletal treatment. I also do not understand why focus licensed physicians feel compelled to delve into areas beyond their scope.

Since when was the care of the foot and related structures from a surgical or biomechanical (conservative) perspective not challenging enough for the podiatric practitioner? Just look at the verbal expanse of this web board! Likewise, the chiropractors who delve into areas of primary care have in my opinion really missed the boat during lecture or were absent on the day scope of practice was defined. I keep very busy just managing spinal and extremity complaints; I am focused and committed to this purpose. Sure, I offer nutritional therapy in conjunction with many patient's treatments but am also mindful of when the presentation requires medical intervention. The AK practitioners that I have encountered do not and they base the needs of the patient on muscle testing and other quasi objective and invalid measures. A simple lab test or referral would be in the best interest of the patient, but too often I encounter months of ineffective AK based treatment instead of objectivity.

Could you please explain this statement?

Again how does that affect the foot structure and what is the causal link between the muscles of mastication and/or TMJ and the feet? I have ADD and really need for us to stay on topic here!

A 2007 report of full members in the ICAK reveals the following: http://www.icak.com/about/chapterreports2007.shtml

J. ICAK-USA
671 full members. I hardly find that representative of my profession as there are well over 60,000 practicing DC’s in the U.S. This is a fringe practice even in chiropractic.

From the ICAK website: I had someone touch a spot on me and then test a muscle. It was weak. Then I held a bottle of pills and was told I needed them. Is that Applied Kinesiology?
This is one of the abuses of muscle testing. To tell if you need to take a supplement requires knowledge of your symptoms, examination for known physical signs of imbalances, a dietary history, possibly blood analysis and then the Applied Kinesiology examination can help to determine what is missing and should be supplemented.
There you have it. They do not deny that ultimately treatment includes supplements to resolve symptoms. While I have some sympathy for the concept of supplementation it is not required in every case. Ultimately I see this as a way to sell more products and some of these AK guys come up with rather creative and expensive items and probably wholly unnecessary.

I do use acupressure on patients, especially in sciatic neuropathy. Dr. James Cox’s father was an osteopath and a chiropractor and this set the tone for him to pursue chiropractic as a career. He picked up where McManus left off with osteopathic treatment using the flexion table and refined it into a technique taught as a core course of the chiropractic curriculum. I am a Cox practitioner as well and find Dr. Cox protocols not only useful but very well researched and validated in managing the sciatic and low back pain patient. Our profession (and our patients) have benefited greatly from his teaching and research. Dr. Cox advocates goading of certain points along the affected leg in sciatic neuropathy and I believe that acupressure is every bit as effective as needle acupuncture because it stimulates the neuroepidermal junction, obviating the need for needle penetration. That is a whole other discussion…

Interesting. I will now have to look for these findings in my own exams Stanley. Is “weakness’ defined by AK testing primarily or by standard orthopedic evaluation on a 1-5 scale?

I am not familiar with these terms. I was taught that the innominate nutates either forward or backward in response to normal gait, postural adaptation etc. An Anterior Superior (AS) ilium is nutated forward and rises to a higher point than the contralateral side and corresponds to the functionally short leg in many cases (let me repeat in MANY but add not ALL cases). A Posterior Inferior (PI) ilium would therefore be the opposite. There is a problem here though; I wonder if Podiatry as a profession has really devoted much didactic coursework to examination and assessment of the myriad complex interactions between the lumbar spine and the pelvis. While heel lifts in theory are a simple concept, in clinical reality I find a number of errors in prescribing them and this is not limited to podiatrists by any means. Again I shall have to review my lower extremity patients and get back to you on my findings.

When there is equinus or limited ankle dorsiflexion you can also find either a tight gastroc/soleus complex (contraction not flaccid as in weakness), a congenitally altered talar morphology or a shortened Achilles tendon that requires surgical intervention as well, correct? Why does it have to be a muscle weakness and how does muscle weakness correspond to equinus? I usually find it is muscle contraction or the above that contributes to equinus. Anyone else care to chime in here?

Good case in point; we know that equinus often contributes to plantar fasciitis and that through various means removing the equinus contributes to resolviong PF. Do we agree? How is muscle testing or AK going to resolve this problem? Why not simply do some PT on the patient? Too esoteric for my blood really :deadhorse:

I believe that much more needs to be investigated about acupuncture. Dr. Robert Becker’s book “The Body Electric” is a heady read into the theory I proposed above about the mechanism of stimulating the neuroepidermal junction via needle or direct manual pressure. I feel the latter obviates the need for the former and it is based on science (Dr. Becker was the physician sent to China to investigate Chinese Medicine by President Nixon. His work with electricity and magnetism spawned advances that lead to the bone growth stimulators used in surgery today). His book is worthy of a read and based in real science.

I perform extremity manipulation daily Stanley but not as much for the foot. If I find a really glaringly obvious malposition I treat it but to be quite honest I obtain better results with orthoses for many conditions. How these two approaches blend together is not a subject for which there is enough research or agreement IMO. I actually was discussing visiting and training with Dr. Rue Ticker in Napa, CA sometime this year with a colleague of yours who is also on this board. I will report back because I am certain that it will be worth the effort to seek him out. He ran Dr. Hiss’ clinics and really tried to expose manipulation to a broader podiatric audience in the past. Now I am probably the one who has written too much. I don’t chime in often enough on this board, observe and learn is my MO, so I hope everyone can forgive us for our prolix discussion.

I am not familiar with the Lovett pairs Stanley. I am possibly the most straight forward chiropractor that you will encounter and I am sure that I have much more to learn.

I’ve met numerous DC’s who practice AK over the years Stanley and a few instructors of the technique. I do not believe that I am mistaken. I would enjoy reading your lecture. We may not agree on AK or aspects of it but I won’t dismiss entirely out-of-hand something that you are this passionate about. I appreciate your contributions and this discussion.

Regards,

 

Michael.

I cannot, sorry. I could propose all manner of scintillating minutiae to achieve your request but in the end I would be betraying my cognitive beliefs. Plus I won't provide the opposing team a reasonable explanation of a subject that I dispute! Ha, ha....

 

Fair enough. I guess I´ll keep looking as I beleive the point Simon is making. That until we can say that alot of "old cobblers" we should look into the mechanism at play. If you think of anywhere there maybe a good discription of the mechanism at work PM, if you can or will

Thanks David

 

Dave, It’s a pleasure to have a discussion with you. You have an open mind and bring up some excellent points.

I think it would be a good idea for you to read this article:
http://www.chiroandosteo.com/content/15/1/4
It explains the muscle test better than I can.

I can see where you might think they are similar enough. The difference is that AK looks for a specific weak muscle, and then tries to strengthen it. The protocol consists of first looking for neurologic imbalance, specifically left to right balance of the cerebellum and frontal, temporal, and occipital cortex. This test will tell whether there is a cranial fault or whether a peripheral joint is involved. If this test is negative, then the five factors are checked, those being neurolymphatic, neurovascular, cranial sacral, the acupuncture meridian system, a specific spinal segment, and then finally nutrition. The nutrition test requires that the substance be placed under the tongue and then test the muscle to see if it strengthens. This should be the next to last thing tested. After that is proprioceptive defects (strain counter-strain, etc.) CRA starts with a strong group of muscles and touches the patient at a reflex point to weaken the muscle. Then it has the patient hold nutrients in a bottle to see if it negates the weakness.
The reasons that this is not an AK muscle test are 1. a specific muscle is not being tested. 2. The practitioner does not touch any reflex points in AK, the patient touches his own. 3. Nutrients in a bottle are not part of AK.

I thought only Rothbart orthoses could fix all of this. Seriously, Iif you look at any system, there are some outrageous claims. I won't hold it against you.

Dave, the scope of practice in my state says that I can treat the muscles of the leg and foot through mechanical means. Mechanical means using one’s hands, so if I mobilize a skull to strengthen the peroneus longus, I am within the scope of practice in my state. I don’t know if anyone else is doing this, but I think I should use the full scope of practice to help a patient. As far as the AK practitioners that you encounter, they are not AK practitioners, and as such, my analogy is valid. I agree that the practitioners you see are not doing their patient’s justice, and are giving your profession a bad name. They are using CRA which was started by Versendaal.
http://www.choosecra.com/store/evaluations/cra.html.
I looked up the Cox technique that you use. When I hurt my back, I went to a chiropractor that had a flexion distraction table. She told me that this is the best way to take the pressure off the disc. She strapped me down and pulled on my legs and rotated them around. I felt better for 20 minutes. I don’t know if it was the flexion distraction table or the electrical stimulation she applied. I can easily say that she was a Cox practitioner, and to me who is not really familiar with the ins and outs of the Cox technique, I can’t tell the difference, but I after reading what you had to say and the Cox interview, I don’t think she was a certified Cox practitioner.

Dave, We were taught that if you don’t give the patient time to contract properly, you can beat the muscle every time. We were shown that if you don’t isolate a muscle, you get a group of muscles; and if one in the group is strong, the muscle will appear to be strong. For instance, when I test the peroneus tertius, I have to make sure that the toes are flexed to eliminate the effect of the extensor digitorum longus. What I am saying is that muscle testing takes time and practice to perform properly.

Dave, Here is a link to an interview with Cox. As you can see he uses SOT from DeJarnette. Goodheart incorporated a lot of SOT into AK.

The term sacral occipital is very specific, as these two bones are Lovett pairs. Lovett pairs are two bones that move at the same time ie. Sacrum-occiput, C1-L5, Temporal bone-Ilium. So if the temporal bone moves, then the ilium moves. When a unilateral muscle of mastication is weak (more specifically the masseter), then the temporal bone on that side is allowed to float up, and hence the high ilium. Correcting the unilateral of mastication pulls down on the temporal bone, and balances the ilium.

1% of 60,000=600, so I guess you are on the fringe by your definition. We are not talking epidemiology of techniques, or all of us are considered fringe.

These numbers are from Cox himself.

I looked up the Cox technique. It seems very well thought out. I tried to find a certified Cox practitioner in my area, and I can’t access the web page. I agree with you about the needle not being necessary. I find that you can actually palpate an active acupuncture point by dragging lightly on the superficial fascia. In one direction you can feel a freer movement than the other. Treatment is just a slight tug in the direction of ease, not disease. You are done, when the fascia is equally free in both directions.

This is through AK muscle testing. Remember that AK muscle testing puts the muscle in its shortest position, and then a lengthening force is applied. You are feeling for the abiity to perform an isometric contraction, or in other words, the ability to adapt to a perturbation. These are not my terms. This is the term use by Turvey in an article that was a long discussion on this list serve. He recognized what Goodheart found with neither knowing each other.
http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=11470&highlight=turvey

Dave, I have read articles regarding the 7 axes of the subtalar joint. But we don’t have to get that complex to understand what is happening. To simplify this so that the podiatrists that haven’t studied the SI can follow along, visualize that each innominate can rotate in the sagittal plane. The back of the innominate (where the PSIS is) is where the back attaches, and the front (where the ASIS is) is where the legs attach. Forward flexion of an innominate will result in the ASIS going down, and the PSIS going up. This also has the effect of lengthening the leg. This is called an anterior innominate. Conversely, backward flexion of an innominate will result in the ASIS going up, and the PSIS going down. This also has the effect of shortening the leg. This is called a posterior innominate. So if we see a high ASIS in stance with a low PSIS on the same side, we would call that a posterior innominate. WE do not know what causes this unless we do further testing. If we then put the foot in neutral, and both spines level out, we can say that the posterior innominate is due to foot pronation. If there is no change in the innominate to the ground, then it is not caused by the foot. This is what DC’s are good at treating. If both the PSIS and ASIS is high on the same side, then there is no involvement of the Iliosacral joint. (I don’t want to confuse this discussion about Sacroiliac and iliosacral lesions; suffice it to say that osteopathic literature says it is the same, as the sacrum and iliums move as a unit. So we don’t have to discuss left on left lesions, etc.) Commonly in podiatry, the side of the high ASIS and PSIS is called the long leg. There are times that the crest of the ilium is low, and that is another type of dysfunction, but let’s not discuss that as it is rare. If putting the foot in “neutral” levels the PSIS and the ASIS, then the foot is causing the leg length. If not, then the leg length is considered primary. All of this is according to an article I had published in JAPA 25 years ago.

Excellent question. I look at the limited dorsiflexion as a quick way to assess what is going on (along with the pelvic position). Usually associated with limited dorsiflexion is weak peroneals. Correct the peroneal weakness, and the dorsiflexion normalizes. Just to give you the bigger picture, another part of this is that the mortise joint (the ankle) has an anterior talus. Some of the latest research shows muscle fibers in the connective tissue. When the peroneals get corrected, the anterior talus also gets corrected.

There is a study that shows that the optimum effect of the needle is when it is twisted twice. The reason for this is that the needle drags the fascia. If you feel the fascia over the acupuncture point, you can feel the dysfunction. The superficial fascia is easier to move in one direction. This is the direction of dragging the fascia to treat the point.

Dave, you are thoughtful and intelligent in your discussion, and therefore you can’t write too much. How long are you going to spend with Dr. Ticker?

I appreciate your input also. Send me your Email address and I will forward it to you.

Regards,
Stanley

 

hope my tmj knowledge and experience helps.
1.Occlusal appliance or tmj orthosis does relieve head, neck, shoulder. facial pain signjficantly, if done correctly
2.Occlusal appliance does improve sleep quality
3. Patients generally repond shortly after occlusal appliance delivery, most common report is relaxation of cheek, i.e., masseter muscle
4.Swallowing may be easier or no difference by occlusal appliance
5.There is no effect on faulty mechanics of respiration
6.some patients may report improvement on walking, but no observable gait change
7.No matter what kind of bite, the critical issue to achieve therapeutic effect is muscle function.
However, in a clinical setting, it's difficult to substatiate. The criteria I used isbased on patient's subjective report
8.fabrication of occlusal appliance is very technique sensitive.
Best
Scott Ma

 

Stanley, I agree that this discussion is an enjoyable one. Recent threads on this board pertaining to manipulation appear quite popular and there is a great deal of interest in manipulation within the podiatric profession apparently, but I don’t want to us to get too far off topic and bore everyone else. :bash:

Stanley I have read that literature review (it is not an RCT and only 12 of the 100 papers are RCT’s) previously actually. I wonder how many are independently funded, as you well know bias runs high in many studies and reviews. Goodheart is one of the reviewers of this review and of note is their disclaimer:

I read some of it but honestly it left me wanting. I believe that if we want to see a value in anything that we feel is beneficial and the research does not present a modicum of evidence that validates our feelings, that we should consider that we have to accept that. That is how I feel about AK at this point having been exposed to it all through my training.

Again AK is not taught as a core course in any doctoral level program in the U.S. What I find of real interest is that the ICAK admits that AK is an adjunct to routine orthopedic and neurologic diagnostic testing for which there already exist established valid protocols in examination. I cannot glean from any of the AK literature why AK is even important given that all licensed musculoskeletal practitioners are required by law to examine and treat their patients in a manner consistent with their education and the standards set in place for their license and scope of practice (btw, I fail to see how AK treatment of a assumedly weak peroneal muscle through manipulation of the cranial vault falls within the scope of practice of a DPM. Don’t be angry, it’s just the way that I see it).

Example; a patient exhibits pain on resisted abduction of the shoulder, the Supraspinatus or ‘Empty Can’ test. This test has a fair degree of specificity for a muscle or tendon tear in that region or a possible subscapular nerve neuropathy (how would AK be more specific in this scenario?). An MRI is performed and the culprit is a grade II tear of the tendinous insertion of the supraspinatus muscle and physical therapy is recommended. Had this been a subscapular nerve insult, EMG testing would have been indicated.

How does an AK practitioner manage such a scenario and what evidence exists to suggest that their techniques in any fashion augment the above diagnostic scenario? It is apparent to me that AK delves into allergies, visceral and somatic complaints frequently; with no clearly identifiable mechanism of action or evidence that such intervention is beneficial beyond the anecdotal.

This is where I diverge from the AK practitioner completely. I have already performed sufficient orthopedic testing to be fairly certain prior to sending that patients out for MRI or an orthopedic consult that there is a musculotendinous insult and I know how to treat it conservatively. A muscle is weak (or in the real world painful and dysfunctional) not due to some illusory design of the AK paradigm but because there is a structural insult to either the foundation (bone) or the soft-tissue elements that act to provide motion for the skeletal system (muscle & tendon) or the spinal nerves supplying those structures. This is scientific fact; AK does not follow this logic.

I fail to see where this is inaccurate Stanley. This has been excerpted completely out-of-context. The lumbar plexus can affect the lower sacral nerves in pronounced or prolonged neuropathic insult. You are assuming Dr. Cox was pointing specifically to women’s issues of pelvic pain such as PID where he is clearly discussing pelvic pain of a lumbar origin that was treated with flexion/distraction. I have referenced his book and the excerpt you have posted appears on page 358 under the heading “Pelvic Disease and Disc Compression of Nerve Roots”. Ask any neurologist, orthopedist or chiropractor about sacral nerve ‘root signs’, they are a valid clinical entity and up to a point Cox flexion decompression is a valid conservative treatment.

Rothbart is more of a fertility expert is he not

I hope so Stanley. I wouldm’t wager my professional reputation or livelihood on it though without consulting an attorney versed in scope of practice personally.

I still feel very strongly from what I have witnessed with my own eyes and reports from patients that AK’s ultimate goal is to sell more treatment and more supplements based on pseudo-science. I will not even approach allergy testing and AK but it is a very real and common practice. I do this for a living and know a lot of DC’s and others who claim to be AK practitioners and they all sell a boat load of supplements and treatment based on this system. There is not end point to care within this paradigm, which disturbs me. Prove me wrong, please.

Reciprocal inhibition of muscles and antagonists are a whole other subject. Isolating a lone muscle completely is nearly impossible. Suffice to say to contract any muscle in the human body without some level of reciprocal inhibition, antagonistic muscle action or cognitive involvement of the subject is quite difficult even with EMG monitoring. I have performed functional capacity evaluations before and from experience I do not see how this is performed with AK alone.

I use some podiatry related treatment (orthoses) in my practice but neither is it podiatry nor am I a podiatrist! Sorry Stanley but I couldn’t resist. There is a lot of overlap in the healing arts and especially within styles or methods in my own. This does not surprise me but I know that Dr. Cox is not a cranio-sacral practitioner pre se.

SOT has some elements that I find useful (blocking) but their evaluation methods are too esoteric for me and I am not convinced that the cranial bones have any effect on various human conditions or more peripheral structure. Just as I am not convinced that you can affect the TMJ with insoles.

The 1% you note is persons who are Cox certified. Certification is not mandatory for those who were afforded training in Cox Technic in their didactic training (it is a core course or elective in almost every chiropractic college in the U.S.), just as certification in any of the techniques that were taught in Chiropractic College is not mandatory. The NBCE and state boards license chiropractors based on basic proficiency to utilize these techniques as received during our training and clearly override any post-graduate training certification.

Cox is offered by Dr. Cox as a post-graduate specialty course for those who were not offered the course in Chiropractic College. I was taught Cox Technic by a Cox certified faculty instructor. As I recall we had two trimester length courses in the technique which means that my classmates and I completed the full 36 contact hours of instruction and passed not only practical but written examinations in the subject. I have also read his book cover to cover twice now and use it as a reference in my general practice. To pay Dr. Cox to become ‘certified’ at this point seems rather redundant; I am educated and capable in practicing his technique as I have done successfully for years.

Let me clarify though that I am not solely a Cox practitioner. I use the Cox protocol on approximately 10% of my patients. I mainly employ Gonstead, Full Spine Specific and Diversified techniques in daily practice and less frequently Activator, SOT (blocks only) and Thompson techniques.

Cox is a marriage of chiropractic and osteopathic principles that was begun by McManis and refined into an effective and clinically useful system by Dr. Cox. It is not a uniquely chiropractic technique but it is useful if you follow the protocols established by Dr. Cox. Unfortunately I am aware of colleagues who did not receive the Cox protocol training in their didactic education and who have not become certified who maintain that they are knowledgeable in practicing the technique.

I would simply ask any DC that you are considering having utilize Cox Technic on you whether they received their training in college or as a post-graduate certification. If they have had neither move on. It is not a difficult protocol to learn but does require training and specific equipment obviously.

Here are the true statistics on Cox utilization by chiropractors:

http://www.coxtechnic.com/images/fd_novice_vs_experienced.pdf
…is used by 58% chiropractors on some percentage of their
patients1-2…..

1. Cox JM. Low back pain: mechanism, diagnosis,
treatment. 6th ed. Baltimore: Lippincott Williams
and Wilkins, 1999.
2. Christensen MG, Kerkoff D, Kollasch MW. Job
analysis of chiropractic, 2000. Greeley, Colorado:
National Board of Chiropractic Examiners,
2000:129.

http://books.google.com/books?id=x7...rcentage of chiropractors who use cox&f=false

As you can plainly see it is not a fringe practice in chiropractic despite your playful assertion otherwise.

Clearly the issue of pelvic dysfunction and LLI are beyond this thread. Many disciplines have different approaches to these problems, a chiropractor will look at many things but often the lumbar spine for rotational malposition, the podiatrist will address the foot etc. I think we can find some common ground there as we all treat the LLI and LLD. I am somewhat curious why you treat the pelvis and innominates as a podiatrist but that’s another conversation as well. I truly feel that every good podiatrist needs to be familiar with a good chiropractor to aid those patients where manipulation mau be of benefit and vice-versa every chiropractor should refer and defer certain cases to podiatrists (and other medical and allied health professionals) when their scope of practice may limit what they can effectively provide. This is a gap in licensure that should be addressed by individual practitioners in an attempt to provide the very highest level of care for our patients. Unfortunately, my own profession has made an abysmal effort overall in presenting our abilities to professions such as yours on a larger scale. Boards such as the PA aid to bridge that gap I am hopeful.

As for Dr. Tikker I do not know how much time he has available and how much of my time I will be able to devote to learning from him. I will probably attend his shop on a couple of weekends coming up this year. It should be an eye opener and judging by the other threads here on FMT some of you may find my experiences of interest.

Please send me any research that you care to or papers that you have submitted for publication. I have a fairly open mind to many subjects Stanley. I will PM you my email.

Regards,

 

Hi
In my search for Dr Butterworth I came across this forum. I am not usually a forum user however took the time to register in order to post a reply.

For information I have been a client of Edward for some years ( and referred a number of people to him) and so I may appear biassed.

I am also NOT a practitioner but just a lowly patient in much pain for most of my life a result of flat feet (and the ongoing resulting problems.)

I tried many types of therapy including hard orthotics from the age of 24 and whilst achieved some relief nothing really ever changed. If I were to not wear my orthotics for any more than a day my severe pain would return and so believed after much advice that the pain would stay and I would Need to wear corrective devices for the rest of my life.

That was until I came across Edward Butterworth as a result of a referral from a chiropractor dealing with what had materialized into a full body breakdown and the resulting pain.

Regardless of the methods, from the minute (and I a not joking - I was standing in reception paying the account) I placed the orthotics the changes started. By the time I was in the car driving home I noticed I was unconsciously pushing back into the seat. At the time having no idea why.

This was when I was 37yrs.

I am now 49 and have changed the orthotics 3 times in that time.

Here's the outcome.

Other than having relatively no pain on a day to day basis ( and I do a reasonable amount of on feet work) I now have what I can only describe as a basic arch. I can in summer go for many days without shoes and don't have anything like the pain I used to have before these wonderful devices.

So for what it's worth, whilst I get the theory at a basic level I am a sufferer. After over 20 years of varied and often very expensive advice and solutions, none have even come close to these very basic orthotics that Edward offers.

As a basic customer of your industry maybe you could listen a bit more and stop professing your theories that at the end of the day don't fix anything...just keep it in check. Not good enough in my opinion. But I guess that won't mean much given some of the ridiculous and over zealous attitudes espoused here.

Kind regards

David

Ps...I am about to contact Edward again. Just lost his details. And no he did not ask me to write this.

 

Come on ED!Post a decent reply and answer those questions!
(1) How do you think your orthoses actually work?
(2) How does your product stimulate but not support selected plantar muscles to produce a postural correction?
(3) Which plantar muscles, when stimulated, improve posture?
(4) How do you believe hard supporting orthotics will weaken the arches by taking over their muscular function?

 

a team of french doctors scholars of René Bourdiol are currently marketing this kind of insoles

 

Just because someone markets an insole/orthotic/support/whatever as "proprioceptive" does not mean that it is. Its all a marketing scam. As there are NO proprioceptive sensors/nerve endings under the bottom of the foot, I still waiting for someone to explain how they think they actually work via proprioception???

 

They market it as "proprioceptive" because they can't spell "exterioceptive" - and it doesnt sound half as sexy!

 

Maybe I need to patent and trademark "exterioceptive insoles" and then go and do Roberts course. ... time I started making some $

 

Exterio-thotics - by Craig Payne

"Exterioceptional"

 

Exteriordinary devices.

Do you need some stimulation in your life?

 

Too late. I could hear the shuffling of Shavelson scurrying round to the US Patent Office as soon as your post went on. Patent No. 101 - ExterioType - PiloShyte...

 

mmm 2 years on and it comes back to life... strangely (or not) the website www.healthmarque.com.au cannot be found....... oh dear, so sad i wonder why!