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A company in Tacoma Washington is selling insoles, based on my patented 25 year old design, which they now label as ProKinetic Insoles. If you go to Amazon, based on 82 reviews, 31 were 1 or 2 star.

This is consistent with what I have been googling the past 20 years:

• The Prokinetic (medial column) Insoles work well for Rothbarts foot.
• They are ineffective and can actually make symptoms worse if used in patients with the PreClinical Clubfoot Deformity.

Here is a disappointing 1-star post by Tracy, May 2016:

"I hoped they would help, but my feet seemed to get worse. They were very thin, without any cushion. There was arch support, but don't think the whole pronation part did much. Really wish I could have given a good review."

Yet, when used for Rothbarts foot, the results are remarkable. Here is a glowing 5 star post by Ann P. in March 2017:

"It changed my posture and foot placement drastically. My IT band has improved. My corn resolved within a week to 10 days. I'm 43. Female. Hospital worker (anesthesia). I am actually looking forward to building up to running again. I can actually feel my quads working in a different way which has to be why my IT band has calmed down."

The company in Tacoma Washington should inform their customers and healthcare professionals that the insoles they sell were designed (by me) to treat Rothbarts foot, not the PreClinical Clubfoot Deformity.

 

Anyone who has used these insoles, I would be interested in hearing their experience(s).

The generic insoles sold by the company in Tacoma, are very effective in treating Rothbarts foot (RFS)

And, these same insoles can be modified to effectively treat the PreClinical Clubfoot Deformity. However, if you use them without the necessary modifications, your outcomes will be disappointing.

Most likely many of the 31 negative comments on the Amazon site have the PreClinical Clubfoot Deformity, not RFS.

 

Anything on your site about foot strengthening yet, Brian?

 

Which site are you referring to?

 

Any

 

Again, you question specifically "on my site". Kindly clarify which site you are referring to.

 

An esteemed member on this forum is a strong advocate of foot strengthening exercises to control or reverse gravity drive (abnormal) pronation. He is not alone, there is a significant number of healthcare providers who would agree with this intervention.

However, I am not in that camp when it comes to treating either RFS or the PCFD. I have found that when the appropriate proprioceptive insoles are dispensed, foot strengthening exercises are not required to ameliorate the gravity drive pronation.

Other foot deformations may require physical therapy and on that subject I offer no opinion.

 

I don't know if you mean me Brian, but regardless I do not see foot strength as being entirely about controlling pronation, some degree of which is a normal part of the gait cycle, but instead I see the intrinsics having a much wider role in foot function.

These additional roles include;

1 Proper functioning of the plantar venous plexus
2 Reduction in shearing forces between the bones of the midfoot
3 Reduction in stress in the transverse ligament of the forefoot
4 Proprioception ( I suspect the intrinsic have a very important role to play here and a healthy muscle gives better feedback than an out of condition muscle)
5 Adequate recoil of the arch during toe off which keeps the tibia at an acceptable angle thus preventing a gait that begins to resemble that of a chimpanzee. See Welte et al , image below
6 Rapid development of toe flexor force the maintain balance
7 Proper force distribution in forefoot during toe off helping prevent, for example, metatarsaglia.
8 Muscle balance to prevent foot deformity

And on and on.

IMO, given that the vast majority of people have feet greatly weakened by everyday shoes, almost any contact a patient has with a foot healthcare professional should include instruction on foot strengthening if it is at all possible for that individual to safely care out such exercises.

 

Your points (1-8) are well taken.

But specifically, when treating RFS or PCFD (with the appropriate insole), IMO the above points are automatically handled by the insole. However, it would do no harm to instruct the patient on foot strengthening exercises, if the healthcare provider is so inclined.

Regarding the role shoes play in weakening the function or anatomy of the foot, IMO there still is no consensus. I believe the impact shoes have on plantar grade feet is minimal. However, my research demonstrates that the impact shoes have on the RFS or PCFD is substantial.

Regarding other foot deformations, again, I have no comment.

 

Really?

 

Topographical changes in the foot is NOT an indication of changes in the kinetics.

The widening of the foot and separation of the hallux from the 2nd met and associated phalanges has been well documented in the unshod population. But there has been NO double blind studies demonstrating a difference in the pronation/supination patterns between shoe wearing and unshod populations.

In fact, I spent 3 years in rural areas of Mexico evaluating unshod populations. I found no differences between the two populations (shoe wearing vs unshod). I published a paper on my findings (the Cuernavaca study). Specifically, the functioning of RFS and PCFD in the rural Mexican population.

 

I would argue changes in form are indicative of changes in performance capacity, but not proof.

Brian, as far as I am aware you have never been involved in a controlled, randomized, double blind, trial in your life. You can't reasonably go about demanding levels of evidence you have never provided.

Was it a controlled, randomized, trial?

Any proof of this very sweeping claim?

 

You are correct. None of my publications have been double blind studies. However, I have published single blind studies. You can go through my publications on Research gate and download those studies, if that interests you. I do not remember if the Cuernavaca project was a controlled study or not. However, the pressure plate studies that resulted from this study are compelling.

If you think function follows form, I am sure you will find healthcare providers who will agree with you. My Cuernavaca study refutes this viewpoint. Specifically when dealing with RFS or PCFD, form follows function (gravity drive pronation shapes the contour of the foot).

Posterity will determine who is right on this subject.

Again, for the 3rd time, regarding other foot deformations, I have no comment.

 

Splinting affects development.

 

I think we have beat this one to death. Let´s provide it with a respectful funeral.

 

Sure, I'll have the final words then, ok ?

Pointy high heels > bunions> pain> potentially disastrous changes in function.