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Biomechanics podiatrist needed for cavus foot orthoses

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Simon Spooner, May 20, 2009.

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    All, I had a call from a guy from Denmark yesterday who needs some help with foot orthoses. Does anyone know of a good biomechanics podiatrist in Denmark, Sweden or Germany to save this guy flying to the UK and then spending 4 hours on a train, just to reach me down in Plymouth?

    He sent me an e-mail today which I've copied below along with some photo's of his feet, as you will see the devices he has are a little "primitive".

    Any help you can offer will be much appreciated.

    I am 38 years old from Copenhagen, Denmark.

    As I told you I think I have a cavus foot. Please see attached pictures. I am 186 cm tall and my weight is 84 kg

    Through my life I never really experienced problems with my feet. 18 years ago I had knee surgery in my right leg and I developed a bit of drop foot and numbness on the lateral side from the knee down. It improved over time and never bothered me much. Over the last 10 years or so I have been doing quite a bit of running (20km /pr. week) in neutral running shoes with no foot problems.

    In 2007/2008 I lived in Bangkok and had an intense flirt with salsa dancing there. Unfortunately a dance teacher persuaded me to get a pair of thin leather jazz dance shoes. Super contact with the floor but zero cushioning. I practiced for hours on hard surfaces and after a while I was limping out of bed in the morning. I told myself it would pass and continued dancing the nights away. One morning in april 2008 after an intense night of dancing I woke up with the ball of my right foot severely inflamated. Especially the joint behind the big toe was seriously swallen. This happened after 4-5 months of intense dancing.

    I stayed a lot in bed the first week expecting this to heal quickly but I would soon learn otherwise. It took a couple of months before the inflamation was reasonably under control. The joint behind the big toe continued to be dropped in a much more prominent way than before.
    Salsa crazy as I was (without even being able to walk normally) I tried to get get back in to dancing using shoes with more cushioning, but it never worked. I had a pair of orthotics made in Thailand. They had massive support of the arch and gave much needed relief to the joint behind the big toe, but also made me supinate even more.

    In december 2008 I moved back to Denmark and here I have seen various types of doctors and therapists. All together I have had 3 orthotics made.

    Based on design advice from a doctor I tentatively had a pair of orthotics made, that I think are on the right track (se attached fotos of the right one). They are made of rubber foam designed with a vedge along the lateral side of the foot including a lift under the 2-5th metatasal. There is also a bit of arch support.

    I purchased a pair of MBT shoes as well. They do take some of the pressure of the forefoot and help me to some degree.

    I am not sure how much to write about my symptoms:

    Right foot:

    Heal pointing inward. I think my current orthotics correct this to a certain degree and do feel some tenderness on the arch and medial side of the heel…. like it is being stretched.
    General discomfort and tenderness under the metatarsals. The first is the worst.
    A bit of af strain on the lateral side of my ankle (probably from supination)
    An osteopath I just started seing has measured that I put 10 kg less weigth on my right leg and also that my right seems slightly shorter. He is trying to adjust this a bit through working on my bag and pelvis

    Left foot
    On my left foot I have a tendency for hammertoes to form on my second and third toe.

    When I read through websites like "Podiatry Arena" I very clearly sense there are some more capable and dedicated profesionals out there than what I have seen in Denmark. I need to consult with 1 or 2 of those and feel sure that I give my foot the best possible treatment.

    Would be really great if you could refer me to some specialists in your network from a place reasonably close to me. Otherwise I am willing to travel to Plymouth if I feel that is necessary.

    Being uninformed I hunger for knowledge on this issue and browse the web for hours looking for information. Recently found a pretty good article with some real information I could understand here:
    http://www.performancezone1.com/subtle_cavus_foot.pdf

    If you have a link to a couple of good articles or can recommend a really good book to a layman like me I would be very interested.

    This became a long text. Hope its not too bad :).....Really looking forward to hearing from you and thank you for listening!
     

    Attached Files:

  2. David Wedemeyer

    David Wedemeyer Well-Known Member

    This same gentleman contacted me last week Simon, friendly and inquisitive fellow. I meant to post a similar thread so I am glad that you did since I am slow on the uptake.

    Just looking at his feet I can say he has a really good grasp of the problem and (those inserts are tragically wrong for him I bet being OTC with additions) and is clearly trying to add full-length valgus wedging to his OTC inserts. Not bad at all for an untrained person!

    . I wonder if anyone has ever considered a Coleman Block test, he appears to have some rearfoot compensation. I read a good article not long ago in Biomechanics on what one author called the 'subtle cavus foot'. No mention of the STJ axis but it seems to follow much of what I have read here about correction of the heel and forefoot for this type of foot.

    Hope someone can help him.
     
  3. Boots n all

    Boots n all Well-Known Member

    Lothar Jarling, Germany, you cant go wrong, he did travel quite a bit with Pro sports men..............l am sure there are others that the local society could put him in touch with even closer
     
  4. Do you have any contact details for him?
     
  5. Boots n all

    Boots n all Well-Known Member

  6. carolethecatlover

    carolethecatlover Active Member

    Danes speak German as well as they speak English. I speak German if you need help. But I wouldn't have a clue as the technical words that our Danish co-respondent has a fluent grasp of in English! I am impressed!. Carole, 2nd year student.
     
  7. carolethecatlover

    carolethecatlover Active Member

    Just read thru the link given by Boots and all. this is a application to attend a conference organized by Swiss Tennis. The only email is the admin.
     
  8. Simon Wheeler

    Simon Wheeler Welcome New Poster

    You could also try Mike Weber in Sweden. He is a NZ trained Australian Podiatrist. His details should be on this forum with admin?
    cheers
    Simon
     
  9. Boots n all

    Boots n all Well-Known Member

    Sorry for the delay, just received the info. as follows

    http://www.footpower.de


    Lothar Jarling
    footpower Pilot-Filiale
    footpower Gießen
    Schiffenberger Weg 115
    35394 Gießen
    Fon 0641 74155
    Fax 0641 74145
    E-Mail: giessen@footpower.d
     
  10. Carole,

    Can you read the site and give us the sp please. I see a word "sensomotorischen" and can't help but think of Rothbart. Indeed, I heard on the grape vine that his theories might be a little at odds with current biomechanical theory here in the UK, Australia ( parts of the US :rolleyes:), And that his orthoses are allegedly flat EVA sheets with a large bump under the sustentaculum tali and cuboid. I've not seen them myself, so I can't really comment.
     
  11. Boots n all

    Boots n all Well-Known Member

    Nothing like Rothbart.

    He has been here in Australia quite a few times now, traveling with "a" pro-tennis player out here for the Oz open.

    There is a bit more than a lump or two involved, l am sure if you contact him direct, now that you have his contact details, he would be happy to hear from you and explain some of it to you........he does also speaker English
     
  12. Since you obviously have knowledge of this David, it might be quicker and easier if you explain... I translated the web-page, it sounds a little like David Pratt's dynamic orthoses, or Duncan's tone-inhibiting insoles. The kind of thing used in patients with cerebral palsy. Would be interesting to get him onto this forum to discuss some of this.


    "What is special about the deposit of footpower?

    The classic supply deposits found in the past mostly with "static resource" instead. Static stabilization and erection of the foot was the objective. The deposits were often uncomfortable to wear, limited the movement and also took over (similar to a corset) is a function of body.
    Deposits of footpower working under a completely different, the sensorimotor system. The fundamentally different approach in which the muscle controlling the running apparatus is focused pressure on specific nerves and tendons in the affected foot. The body regulates itself and carries out a new, correct movement pattern. That footpower-deposits, of course, for athletes of a very high wearing comfort is guaranteed.

    What are Sensomotorische deposits after Jahrling?

    Already since 1991 the emphasis in the work of footpower in the development and advancement of deposit issued by a special relief the highly complex rules of our body, the "sensorimotor system" and influence. One of the main principles of these utilities is to deposit with the relief will not put pressure on a muscle belly of the sole exercise. Muscle bellies are, in addition to the joints, the active part of the freedom of movement and must have room for expansion. Only tendon trains may be contacted. footpower Inserts work with a sophisticated form, it specifically allows positive influence on the joint position to exercise and muscular work.

    The developers of footpower did this, an ability of the human brain to use: namely, that even in old age to new situations, and learning. New movements are from the brain after a variety of conscious perception and repetition of the "unconscious" saved. The man trained. Drawback: even erroneous movement is executed after frequent repetition of the brain as "automatic movement patterns stored. The result of the" wrong "posture and movement are abnormal joints, increasing wear and pain.

    "Sensomotorische deposits after Jahrling" stimulate the body through the neuromuscular system to "correct" movement repetitions. They improve the coordination of the running and they are optimizing the motion sequences."
     
    Last edited: May 25, 2009
  13. He is more than welcome to come and see me in Stockholm

    Michael Weber
    Functional Foot Podiatry
    Skeppargatan 30
    Östermalm
    Stockholm

    info@functionalfoot.com
    +46 8 663 2400

    Michael Weber
     
    Last edited: May 25, 2009
  14. Boots n all

    Boots n all Well-Known Member

    Michael it has already been pointed out that he does not come here, his contact details have been listed if you want to speak to him l suggest you contact him directly yourself, really nice guy.

    Simon, as you have already translated the basic process it's based on trigger points on tendons , never on muscle bulk.

    l am working with a college of Lothars based here in Sydney Australia, Karl Schott www.footpower.com.au
    It is best explained by those that practice the method, l have seen the results with CP children and Habitual toe walkers......heel down in 4 - 6 months has been the outcomes so far, with the few that l have been able to track through.

    l have told Karl about the discussion here but whether he gets here is another story, as l know he has just got back from Germany, feel free to contact either as you now have contact details for both.
     
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