A Possible Alternative to Proprioceptive Insoles – Epigenetics

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Hilary’s challenging research using Epigenetic designed interventions to attenuate postural distortions (and the associated musculoskeletal and visceral dysfunctions) is laudable.

One of the current interventions to attenuate postural distortions necessitates the use of an extrinsic aid (insoles). These require a lifelong commitment.

If an epigenetic approach can be developed, which by its’ very nature is an intrinsic intervention, the need for orthotic/insole therapies would be substantially reduced. Such a method is without doubt preferable over insole therapy.

I have asked Hilary to present her ideas (based on personal experience and theory), which will make a great discussion.

 

Hello Brian

Thank you for asking me to join this discussion. I do not know what it any knowledge people have about epigenetics and if the are not familiar there is a ice introductory documentary on YouTube called "Ghost in your genes" on Nova which provides a nice introduction. Our genetic code has not changed in the last 130 thousand years. What changes continuously across out life span is our epigenome - switches that decide whether strands of DNA are turned on or off.

https://www.prnewswire.com/news-rel...mericans-suffer-from-foot-pain-259775741.html

According to that survey - 3/4 of American adults suffer from foot problems - which are indicative of more serious health problems and only a third of them seek help of a podiatrist. What is more, providing insoles is not treating the cause of the problem - how are we using our feet wrong.

Flat Feet: What Doctors Knew 100 Years Ago - Fix Flat Feet

We have being using our feet wrong for some years - and we need to work out why because we are passing these problems on to generation after generation. Not only in our epigenetic markers but also as we learn from each pother on childhood before movement patterns habitualise.

Part of the problem is that we "specialize" foot experts do not consider hand movement, or tongue movement and yet it is all an integrated system. So my starting point was that for my children's feet to develop properly, I would have to model correct foot motion and to do so I had to figure out what I was doing wrong.( I studied psychology and understood how children learn)

If you have perfect posture, dental alignment and foot motion - we should learn from you, otherwise we are repeating bad habits. Show me the dentist with perfect teeth, the ophthalmologist who does not wear glasses, etc.

Searching for researchers who had made links between foot motion and the rest of the body lead me to your research eight years ago and I went down the rabbit hole.

That was my starting point - what does anyone else think?

 

Hi Hilary,

There is a definite interaction between foot function, dentition (occlusion) and vision in determining the upright posture. Trying to understand how these 3 systems interact is a daunting undertaking, to say the least.

As a podiatrist, I naturally started from the feet. After many, many years of investigation (clinical and research) and frustration, I was able to put together an ascending postural model. I isolated specific postural distortions that resulted from abnormal (gravity drive) pronation, which I then linked to chronic musculoskeletal pain and visceral dysfunctions.

Based on this research, I developed an intervention using (what I term) proprioceptive insoles. As effective as this intervention has proven to be, it does require a lifelong commitment. That is, if you don’t use the insoles, the symptoms return.

If we could find an intervention that fixed the gravity drive pronation without using an extrinsic aid, that certainly would be preferable.

In a private email, you stated that you have experimented using an epigenetic approach that you thought might actually correct the abnormal pronation. I would like to pursue that discussion in more detail with the understanding that this may lead to no definitive conclusion.

What do you think?

 

Can I suggest:
Normal genetic variation of the human foot: part 1: the paradox of normal anatomical alignment in an evolutionary epigenetic context

Greg Quinn. J Am Podiatr Med Assoc. Jan-Feb 2012.

Normal genetic variation of the human foot: Part 2: Population variance, epigenetic mechanisms, and developmental constraint in function

Greg Quinn. J Am Podiatr Med Assoc. Mar-Apr 2012.

And:
Mechanobiology and Adaptive Plasticity Theory as a Potential Confounding Factor in Predicting Musculoskeletal Foot Function

Greg Quinn, MRCPod, FRCPodS
J Am Podiatr Med Assoc (2021) 111 (5): Article_14.


I acted as professional reviewer on behalf of JAPMA for all three of the above papers. I am also now involved in an unrelated research study with Greg Quinn, good scientist.

 

HI Brian

The, what you term gravity drive, can only be changed if you change the corresponding eye movement. Otherwise the prediction of movement (saccade) will move the tongue before the movement ever happens.

In order to change foot motion you must change where it is starting from. Our unconscious does not predict foot movement specifically, it will predict a specific hand eye coordinated movement which will change foot motion unless feet are trained otherwise.

The way I commenced changing my foot shape and dental alignment was by controlling my eyes - making sure that each movement started from central point. If I want the inside of my right foot to touch the ground - look at the inside of my left foot as I do it. When I am sitting down, keep reminding specific points of my feet to touch the ground so that the learn the new position.

Feel free to share what I privately messaged you

Thank you

Hilary

 

Do non-sighted people exhibit this hand eye coordinated movement?

also, keen for any references you could provide to support your above conjecture

 

Hi Hilary,

What you have written makes sense if you were born with (what I term) a plantargrade foot, a foot in which the entire plantar surface of the foot rests on the ground when the subtalar joint is placed in joint congruity. In such a structure, the foot’s motion during ambulation is controlled by the transverse oscillations of the pelvis (Inman, 1976 ; Rothbart and Esterbrook, 1988). There is no disruption in the foot's motion.

However, if you were born with a PreClinical Clubfoot Deformity (Rothbart, 2002), when you walk your foot will be forced into gravity drive pronation. That is, gravity will engage the foot (which is structurally in supinatus) to roll inward and downward until the entire plantar surface of the foot rests on the ground. Is it possible for controlled eye movement to offset gravity drive pronation?

(Gravity is an unrelenting and tiring force. Try holding your arm straight out, away from you body, and observe how your arm will fatigue and drop to the side of your body)

Simon raises an interesting point. Non-sighted person will not be able to exhibit this hand-eye coordination. So they would be exempted from this discussion.

• Inman Verne. The joints of the ankle. II. Biomechanics of the subtalar joint. Baltimore: Williams & Wilkins, 1976
• Rothbart BA, Esterbrook L, 1988. Excessive Pronation: A Major Biomechanical Determinant in the Development of Chondromalacia and Pelvic Lists. Journal Manipulative Physiologic Therapeutics 11(5): 373-379.
• Rothbart BA, 2002. Medial Column Foot Systems: An Innovative Tool for Improving Posture. Journal of Bodywork and Movement Therapies (6)1:37-46

 

You miss the point- non-sighted individuals walk, run, hop and skip- they do not exhibit markedly different foot structures to their sighted counterparts, if Hilary’s contention that a hand-eye coordination was linked with foot posture and walking, surely we’d see differences between sighted and non-sighted? Can the hypothesis withstand this?

I’m not convinced that what is being discussed here is “epigenetics” either. Rather, conscious adjustment of foot placement during gait is what is generally termed “gait retraining” and has been used with varying degrees of success in the published literature for some time.

 

Simon and Brain

The premotor saccadic eye movements I am referring to are not connected to vision - we make on average 3 of these eye movements per second .
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575504/

They are predicting motor ( not necessarily hand (eye coordinated) but typically)responses to stimuli from our unconscious based on experience. This happens all the time, when we have to intervene - and take conscious control, the unconscious responses get stopped - and we replace the initiated unconscious response with a conscious conscious one. The point in space at which we take control is I believe the region of interest and is the focus of my research.

The reason why I am now doing research is because people will rightly ask - where is the research. Brian you are quoting your research, and I can't support my position as I have not yet carried it out. My starting point is demonstrating how changing unconsciously predicted responses rather than inhibiting enables movement from one movement plan to another - my current research is people who stammer.

How is this related - it is all about and connected to tongue movement and position. And not I have not carried out that research yet either. But any individual can demonstrate to them self that if they place their tongue on the roof of their mouth and rotate their hands their tongue will move - and moving eyes has the same effect.

As I have not carried out any research on blind people, I am not in a position to comment beyond that.
I have, using the process I am using with people who stammer, enabled my self to walk pain free without using any insoles. I will continue to carry out the relevant research

Kind regards

Hilary

 

Hilary,
Thank you for your response and good luck with your studies. My only advice is be a good scientist; be open-minded and try to put aside as much of your own bias as possible when collecting and analysing the data- setting out on a study in which you have preconceived expectations is not the way to go.

Hace a good Christmas

 

Hi Hilary,

Thank you for clarification.

I would like to run an experiment. Let’s test the premotor saccadic eye movements impact on gravity drive pronation. With your agreement, I will send you to the website with directions on how to the photos I require to run the CPA and KBTs, with vs without saccadic eye movements.

 

Hi Brian

Yes of course - although I have specified with my supervisor that whatever tests I carry out be done in his movement lab. Just to be clear, I can use my eyes to move my tongue instantly. For this to then change predicted postural stability takes time as the unconscious learned body position has to be reprogrammed. To achieve lasting change, that is what needs to occur and that is where neuroplasticity comes into it.

Ultimately, I will produce x-ray evidence of my old foot shape 20 years ago when I broke my ankle and that will show the real change. Hospitals are busy at the moment so that will have to wait. I will reiterate what I said to you previously in PM.

I tried many times to write/explain but as I have not carried the necessary research, the are too many holes. Let me give you an example. Building on your theoretical involvement of the proprioceptive system I considered the anatomy of the leg and arm. Specifically the plantaris and palmaris longus -these deal specifically with proprioception.
Proprioceptive cells like Golgi Tendon Organ cells were originally believed to be activated with pressure ( chiropractors) and released with muscle overload. More recent work has shown that activation and deactivation is because of angles specifically the angles formed near the joint.
One of my research steps will be to show how changing the angles of these muscles changes tongue position. This needs to be established before I can move on to how eye movement predicts movement/angles and therefore moves the tongue and facia. Predicted movement is stopped and then new movement implemented - and the problems are caused by where the movement is stopped as this becomes the starting point for subsequent movement. This is what I am currently attempting to demonstrate in my stuttering research.
The implications of this "point of Attention being" what causes problems goes far beyond stuttering, feet, dental alignment but also a range of neurological disorders. As my entire approach is novel, I will have to carry our research at every stage -

I hope that again clarifies my position and why I am happy to partake in this discussion.

Kind regards

Hilary

 

Specifically: what data are you collecting and from what sample population? Are you going for a prospective design in which you show change over-time within your experimental group versus a control group?

 

I have been asked, on more than one occasion, why I would advocate an epigenetic approach in resolving postural distortions, in lieu of using a proprioceptive insole, that I invented (see attached US Patent) and sold throughout the world.
My answer is two words - Occams Razor. The simpler the intervention, the better. (e.g., intrinsic intervention e.g., epignetics vs extrinsic intervention e.g., insoles)

Hopefully, the research into epigenetics as a means to correct posture, will prove feasible.

 

I have watched from afar, and now am in despair at the lack of science in this thread. Be quite clear, epigenesis is real. It was first described, at least in my reading, by Waddington in the 50's (ish). His view was one of an epigenetic landscape where there was an interaction of genes and environment. Epigenesis is not in doubt. Ask the alcoholic, diabetic Australian indigenous population; ask the American Indians. And more recently, ask the diabetic Italians after WW2. However, you seem to invoke some variety of "choice": you may choose it, it therapeutics. Evolution is not about choices. It is about biology. The phrase that comes to mind is bullshit, though I have stronger phrases. I have been an evolutionary biologist for nearly 45 years; don't bullshit me.

 

So, my question is: Is it your belief that it is not possible to offset gravity drive pronation by using an epigenetic intervention? By that I mean, incorporating an intentional change in behavior to offset what DNA has encoded genetically.

 

I do not even recognise the phrase "gravity drive pronation" in science class. However, epingenetic intevation (to use your phrase). implies a human intervention. I have read a lot of bull shit in my time, but this does take the biscuit. My advice? Get a science education, I mean a real one.

 

Hi Rob,

I didn't intentionally use the term epingenetic intevation. If I did, it was obviously a typo error for epigenetic intervention. But thank you for pointing that out to me. I try to catch my typo errors, but obviously not 100% successful.

Returning to the point of this discussion, when you said:

• “Epingenetic intevation (to use your phrase) implies a human intervention. I have read a lot of bull shit in my time, but this does take the biscuit”.

Does this mean you believe that it is ridiculous to suggest that behavorial (epigenetic) modification can diminish gravity drive (abnormal) pronation?

If so, what published studies are you citing, or is this simply your personal opinion?

 

Can you upload those publications and make them available to read?

 

No

 

Not a problem. I located Greg Quinn in ResearchGate and requested a copy of Mechanobiology and Adaptive Plasticity Theory as a Potential Confounding Factor in Predicting Musculoskeletal Foot Function directly from Greg.

 

Yeah we had a chat a couple of week’s ago; he’s expecting you.

 

Can you provide a study that shows gravity is driving the pronation that you are talking about?

 

Gravity Drive Pronation is based on Newton’s law of universal gravitation: F = G (m1m2/r2)

• Where F = Force of Gravity Drive Pronation (measured in newtons/kg)
• G = gravitational constant,
• m1 = mass of object 1,
• m2 = mass of object 2 and
• r = distance between centers of the masses

Understanding the geometric configuration of RFS and PCFD, where r = distance in mm of supinatus (foot deformation to ground) and m1 is the mass of the foot, one can quickly compute the Force that drives the dynamic foot into pronation.

In the RFS, F is calculated at foot flat. In the PCFD, F is calculated at heel contact.

I have published many papers on the geometric deformations present in both the RFS and PCFD and how to measure r.

Does that answer your question?

 

No it does not answer the question. Pronation is a rotation and to explain what causes a rotation you need a moment aka torque. Frankly, your answer shows that you do not understand what causes motion. You should refrain from naming what causes a motion.

 

∑iτi=Iα ∑ i τ i = I α

We can continue the discussion using Newton's Second Law of Rotation (see above) which describes the sum of the torques on a rotating system, if you like. But I don't think there are many mathematicians viewing this thread and hence very little interest.

On second thought, I think it best to go in this direction:

v=Lw=√3Lg
where L = distance from foot to ground
V = velocity at impact to ground


Your decision. Happy to continue.

 

H

Happy to discuss biomechanics and that comes with mathematics, so crack on. Only thing I’d say is if you are going to put up an equation, can you define the algebraic notation in full please so that we can be sure of the terms being included. For example what is “w” in the equation above?

 

Start a new thread with the appropriate title. I do not have a degree in mathematics (mine is in organic chemistry), but let's give it a try.

I will be surprised if this thread generates many views.

 

No need to start a new thread, let’s continue the discussion here. Please define the algebra in your equations.

 

Disagree, start the new thread.

By the way, next time you talk with Greg, can you tell him to send his paper. Have not received it.

 

No, answer the question. You posted the equations here so let’s continue here.

re: Greg’s paper, he’s a big boy, if he wants to send you his paper I’m sure he will.

 

Newton Universal Law of Gravitation allows you to compute the forces generated by gravity. Perhaps you can be more specific as to what you are asking.

 

Giving it more thought, Newton's 2nd Law may be most appropriate. Start the thread and let's see where it goes. Again, I would be surprised if we garnish many views on this subject.

 

I didn’t ask that, I asked you to define the terms in the the algebraic equations you posted above. Please define the algebra

 

Regarding Newton's Universal Law of Gravitation, done in reply #24. I am not sure that the 2nd Law of Rotation applies here.

Again, start the thread.

 

Brian, can I take it from your unwillingness to simply expand your algebraic notation that you do not understand the equations you cut and pasted above?

 

Simon and Eric:

Hope both of you realize that trying to get sensible mathematics and physics explanations out of Brian Rothbart is like trying to squeeze a rock and get water out of it. Ain't gonna happen!!

 

The problem is that you coined the term gravity drive pronation. What I am asking is why do you think gravity causes pronation at one point in time and doesn't at another point in time (hip drive pronation). What makes it clear that you do not understand physics enough to be coining these terms is your previous answers and that you are asking for more specificity now. Someone who understood the science of motion would understand the difference between torque and force. You are just making it more clear that you have no idea what you are talking about. Brian, just stop.

 

Brian Rothbart can't stop, Eric. Don't you remember, he is the self-proclaimed "Father of Chronic Pain Elimination"!! http://www.rothbartsite.com/about-professor-rothbart.html

 

I don't know where to begin with you, Brian. As Simon, Eric and Dr. Kidd have already alluded to, you spew out this BS here on Podiatry Arena that makes no sense and expect all of us to believe you. Your physics knowledge is pathetic.

1. Newton's Law of Universal Gravitation means that gravity is universal and that the force of gravitational attraction is directly dependent upon the masses of both objects and inversely proportional to the square of the distance that separates their centers. However, trying to say that "Gravity Drive Pronation is based on Newton's Law of Universal Gravitation" is meaningless in the context of trying to understand the forces and moments that cause pronation across the subtalar joint (STJ) axis of the human foot since the mass of the earth is constant and the mass of the individual will remain constant so the individual will always have a gravitational force acting on it relative to its mass. To put it another way, both individuals with low mass, and high mass can have their STJ pronated or supinated by gravitational forces. Therefore your idea that "Gravity Drive Pronation is based on Newton's Law of Universal Gravitation" can't be true since gravity can cause both STJ pronation moments and STJ supination moments, depending on the spatial location of the STJ axis.

2. F=force is not measured in Newtons/kg, it is measured in Newtons.

3. Your statement "Understanding the geometric configuration of RFS and PCFD, where r = distance in mm of supinatus (foot deformation to ground) and m1 is the mass of the foot, one can quickly compute the Force that drives the dynamic foot into pronation" seems to imply that the distance from the surface of the earth can change the gravitational acceleration acting on the foot significantly. News flash, Brian! Gravitational acceleration of the earth is not calculated from the surface of the earth but, rather, from the center of the earth. Now, since the distance from the surface of the earth to the center of the earth is about 4,000 miles, I don't think the gravitational acceleration acting on the foot is going to change going from 4,000.0000 miles to 4,000.0001 miles from the center of the earth.

In other words, Brian, quit the BS because there are intelligent individuals like Dr. Kidd, Dr. Spooner and Dr. Fuller who are watching you and challenging you. Just admit you don't understand physics, don't know what you are talking about and that you made all of this stuff up, and I will be satisfied. And by the way, you are no more the "Father of Chronic Pain Elimination" than I am the Tooth Fairy.