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Book - Recent Advances in Orthotic Therapy

Discussion in 'Podiatry and Related Books' started by markleigh, Feb 3, 2011.

  1. markleigh

    markleigh Active Member

    Members do not see these Ads. Sign Up.
    Has anyone read the book Recent Advances in Orthotic Therapy by Dr. Paul Sherer? Was it any good/worth purchasing?
  2. Craig Payne

    Craig Payne Moderator

    I have tried several times to get a copy, but no one at LER is responding to the online form that you contact them via for the book.
  3. It is my understanding that the book hasn't been published yet. Since I wrote a chapter for the book, I would expect I would receive a copy once it is published. I was expecting it to be published a few months ago, but don't know exactly when it will be available for us to all look at.
  4. I just received my copy of the book, "Recent Advances in Orthotic Therapy: Improving Clinical Outcomes with a Pathology-Specific Approach" by Paul Scherer, DPM, for those who want to purchase it. I would assume it is availabe for purchase now through Lower Extremity Review.
  5. Kevin, could you give us a run down on chapter titles and authors please?
  6. admin

    admin Administrator Staff Member

    I got the attached Index from LER

    Attached Files:

  7. admin

    admin Administrator Staff Member

    Picked up this from the authors intro:
  8. markleigh

    markleigh Active Member

    I know this book has only just been released but what level of knowledge is the book aimed at?
  9. Thats a bit rich when we have a title : Metatarsalgia: Decision Making for Orthotic

    but maybe it´s just me............. ho hum
  10. Do we have a list of authors?
  11. LLH2O

    LLH2O Welcome New Poster

    Author: Paul R. Scherer, DPM
    Introduction by Kevin Kirby, DPM
    Other contributors: Larry Huppin, DPM and Cherri Choate, DPM
  12. The book doesn't seem to make a distinction of who wrote the different parts of the book, other than in my introductory chapter on foot orthosis therapy. The book has many nice color photos and has a clean and sharp look to it. Paul Scherer and the other authors [both Larry Huppin and Cherri Choate are former students of mine and are excellent teachers in foot orthosis therapy] have made a concerted effort to provide as many references from within the scientific research literature to support the use of custom foot orthoses.

    This is not a book with cutting-edge biomechanics theory, but it does offer good basic advice for improving foot orthosis therapy for the average podiatrist. In addition, it does a very nice job of pulling together the available scientific research to support the use of custom foot orthoses for different pathologies. I would think that most of the people here on Podiatry Arena who teach biomechanics and orthosis therapy and those who are interested in or use foot orthosis therapy for their patients would enjoy reading this book.
  13. Two Shoes

    Two Shoes Member

    I have inquired about this book and it costs $161.35. It is too expensive for what it is, in my opinion.

    While I was influenced to buy Werd's Athletic footwear and orthoses in sports medicine on your posts Kevin, I don't think I'll follow this one.

    Werd's book turned out to be a great disappointment.
  14. Have you purchased any books on foot orthoses in the last decade that haven't been a great disappointment?
  15. drsha

    drsha Banned

    Hope this posting finds you all well and that you and your families have survived the winter.
    So sorry about my colleagues who suffered natural disasters in Australia.

    Wellness Biomechanics has been making great strides and monitoring The Arena has been somewhat less stormy in my abcense but I can't remain silent on this one as it plants the seeds for Kevin's next "Kirby Evangelical Personal Fame Tour".

    Sight Unseen, I predict that the title of this book should be:

    Recent Advances in Orthotic Therapy Reported Through The Biased Tunnel Vision of ProLab and Incestuous West Coast Podiatry Biomechanics for Profit of The Authors But We Hope We Can (Continue To) Trick Some of You Into Thinking It's Evidence Based Science and Philanthropy.

    How many blinders and filters do the authors have on?
    Whom do they think they are that they deserve to be the judges of what the recent advances in orthotic therapy are?
    How much of this text's tenets and conclusions have been Peer Reviewed and Double Blinded?

    Paul Scherer and Larry Huppin own Prolab and teach/ or have taught at the California College for decades (as has Kevin).

    Kevin verifies his former students, Huppin and Choate, as excellent teachers of orthtoic therapy?
    I for one, don't agree. I think I am.
    I bet Craig thinks he is.

    And Kevin..........................................You all know Kevin

    For me, "pathology based biomechanics and orthotics"is just one of a bunch of self promoted, self validated, non Level I Evidence Based, unproven biomechanics paradigms, no better than any of the others in the pool that purport to have advances for orthotic therapy waiting to be tested by the biomechanics community until a new concensus surfaces.

    Why doesn't Kevin give the same close scrutiny that he gives to other unproven , self proclaimed advances in biomechanics, using anecdotal evidence as proof and bring out Darth on them?
    We know why!

    Bi ASS?
    Self Rightiousness?
    Self Verification?
    Personal Gain?
    Profit Motive?
    Snake Oil Sales?
    Mutants For Parents?

    Wait, that's me not Kevin or Scherer, or Huppin.

    If MASS, Sagittal Plane, Foot Centering, etc. should be blown out of Kevin's waters of biomechanics and its developers never utter one word that makes biomechanical sense for Kevin......
    Why does this this one deserve readership and a fair review and the others do not?
    We know why!

    Kevin seems to feel that this one is good enough for the DPM (American Podiatrist) that he so often calls impotent and incompetent and hopelessly lost when it comes to FLEB but not mine or Ed's or Howard's.
    We know why!

    Why didn't Kevin wait for Craig (or others) to get a copy and give his (their) opinion (s) first before he critiques his own book and its value on the biomechanical horizon on this Arena?
    We know why!

    I continue to plod along and as I have predicted would happen, recent evidence seems to reflect that possibly functional foot typing, foot centering and TIP may deserve the fair inspection to serve as a starting platform for FLEB EBP that they were not given on The Arena in the first go round.

    1. The recent stride-rite funded HSS study of children.
    2. The recent article on callus presentation verifying the rigid and flexible forefoot FFT's to have predictable callus presentation.
    3. The Recent article showing that both snannig and Root Plaster casting do cannot recreate rearfoot to forefoot relationship adequately.
    4. The Canadian article showing that all subjects had heel pain on the long side.

    I turned down an offer to be the white coat for a leading minimalistic shoe manufacturing company.
    I have been invited to write a chapter in another medical text entitled The Diabet Foot on 'The Biomechanics of The Diabetic Foot".
    I have applied for another patent.

    Wishing you all a pleasant Spring.

    Dr Sha
  16. Please go on Dennis.......

    Attached Files:

  17. I wish I was special, just like you, Dennis.

    Or is it just a feeling of emptiness when you're not here?
  18. footfan

    footfan Active Member

    lol i know you guys are bored of this, but im loving the banter on PA recently like Ed Glazer et al . Its like the cripts v the bloods of the pod world =D

    BLUE or RED pods .........your choice lol
  19. NewsBot

    NewsBot The Admin that posts the news.

    Last edited by a moderator: Sep 22, 2016
  20. drsha

    drsha Banned

    Possibly the lines are being drawn in the sand as to the two platforms rising from Rootian Biomechanics Quicksand from which to base a functional lower extremity biomechanics practice based on the evidence. (EBP).

    1. "Get Sick and Come to Me" Biomechanics

    Pathology Specific Biomechanics
    The Scherer School

    EBM Shows That Orthotics Help
    We Have No Idea Why

    Free to be bastardized by any profession, lab or corporation like Rootian Biomechanics over time


    2. "Wellness Biomechanics"
    Prevention, Performance Enhancement, Quality of Life Improvement and "Get Sick and Come To Me" Biomechanics

    Functional Foot Type Biomechanics
    The Shavelson School

    EBM Shows That Orthotics Help
    We Have No Idea Why

    Protected by Patents for 17 years allowing controlled growth.

    Here's to the future

    Dr Sha
    Last edited by a moderator: Sep 22, 2016
  21. So far, Dennis, it seems like you are still the only one using "Functional Foot Type Biomechanics"......so I guess you are right.....this certainly could be considered "controlled growth"...:rolleyes:
  22. markleigh

    markleigh Active Member

    This book is now available for digital download (PDF) for $99.
  23. markleigh

    markleigh Active Member

  24. LLH2O

    LLH2O Welcome New Poster

    Great! Don't have to worry about it being in my other office like so many of my other reference books
  25. David Wedemeyer

    David Wedemeyer Well-Known Member

    Dr. Shavelson interesting comments but I have to ask why? Do you believe that the bulk of custom foot orthoses should be provided as a preventive measure and why? What about medical necessity, should we routinely bill a patient's insurance for a CFO when there is no diagnosis to warrant payment or is this pay at the time of service?

    Do you feel that we should instead offer patients CFO's based on a presumptive paradigm of possible future pathology? We know that CFO's help patients by mediating forces that cause dysfunction, I hope we all agree on this. What do we know about prevention or what is proven beyond "I've seen a patient with this presentation end up with this problem so we're going to prescribe this"? I'm curious to understand.

  26. markleigh

    markleigh Active Member

    It's funny. I'm keen to get this book but I'd almost prefer to pay the full amount to get the hard copy rather than the cheaper digital copy. Silly thinking. I perceive more value in a physical book than a digital copy even though they contaithe same information.
  27. Craig Payne

    Craig Payne Moderator

    Trust me, you eventually grow out of that mindset!
  28. markleigh

    markleigh Active Member

    I know, I know
  29. drsha

    drsha Banned

    I will respond to your questions one by one.

    Do you believe that the bulk of custom foot orthoses should be provided as a preventive measure and why?

    Dr Sha replies:
    No. The bulk of my orthotics, even though they have broader treatment goals, focus on a chief complaint.

    What about medical necessity?

    Dr. Sha replies:
    Wikopedia defines medical necessity as:
    Medical necessity is a United States legal doctrine, related to activities which may be justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care.

    In EBP, I hope we agree that by existing EBM we know that CFO's (and other orthotics) work but we don't know why, this means that using EBM, we have no proven platform for treatment.
    We wait for deformity, suffering or pain to initialte our starting biomechanical paradigm and then adjust it when it fails (pathology based biomechanics as in Dr. Scherers Book).

    In reality, biomechanics uses a plan B of EBM which states that when there is no proven platform for care, one must use one's own personal training, practical experience and the low level evidence of others to determine a platform for care for a given patient (Dr. Scherer and his publisher state that their book contains anecdotal information in addition to EBM....that orthotics work...like his casting, prescribing and correcting procedures when his treatment fails).

    In summary, in biomechanics, the evidence based clinical care must be supplemented by anecdotal, experimental and unproven platforms by all of its practitioners.
    In this debate, there are two.
    1. get sick and come to me (you...pathology specific).
    2. preventive, performance enhancement and quality of life imporving in addition to get sick and come to me (I...wellness biomechanics).
    Both unproven.

    Should we routinely bill a patient's insurance for a CFO when there is no diagnosis to warrant payment or is this pay at the time of service?

    Dr Sha replies:

    I do not participate with insurance companies but for those of you who do:

    You are criminalizing medical practice for the benefit of insurance companies and their profits not our patients.
    Do you work for Aetna, Cigna, GHI, The Blues, Oxford/United Healthcare or the patient in front of you at a given moment?

    Your mentality is keeping CEO's in helicopters and and doctors afraid to make a call without thinking of what the insurance company will do or say about our care, reducing our ability to practice medicine.

    We need to reform profit oriented insurance companies into patient oriented companies interested in paying for prevention, perfomrance enhancement and quality of life issues inordere to reduce health care costs eventually.
    I will not lower my standards of care to what they control and legislate. I am a doctor, not an EBM or insurance company robot.

    Do you feel that we should instead offer patients CFO's based on a presumptive paradigm of possible future pathology?

    Dr Sha replies:
    Yes, when indicated.

    We know that CFO's help patients by mediating forces that cause dysfunction, I hope we all agree on this.

    I agree but there are other clinical uses for orthotics than mediating forces unto themselves that the foot typing platform exposes and opens to care such as muscle engine training and reduced pathological compensations.

    What do we know about prevention or what is proven beyond "I've seen a patient with this presentation end up with this problem so we're going to prescribe this"?

    Dr Sha replies:
    I am treating preclinical, precursor signs, symptoms and weaknesses that exist in repetitive biomechanical complaints early on. Heel pain, bunions, hammertoes, neuromata, runner knee, low back pains, etc, do not happen ballistically or overnight. These warnings that I treat pro-actively as a skilled professional finds you treating as an ostrich.

    If you tried to treat prevention, performance enhancement and quality of life issues preclinically, you would be making truly random decisions because your platform begins with a chief complaint (does Achilles Heel resinate?). That sends you on a possible red herring trail looking for high level evidence that you have not found and conform you to insurance or governmental restraints that are acceptable for payment under contract or budget reducing (in the short term only).

    My medical, Hippocratic Oath was to make society, healthier, more fit and disease and symptom free.

    When I see a patient for the first time complaining of a bunion, they often say to me that their previous doctors did not offer them my platfoirm of care and they wish they had met me sooner or been foot typed in the past.
    Furthermore, when I tell them that their children, if they have inherited their pathological foot type and are going through life without developing motor control and efficient muscle engine performance and are showing the same preclinical signs and symp[toms that they had when they were younger, are destined to walk their way into bunions, they bring me their children fopr care.
    They question me as to why their previous doctors waited for them to need foot surgery, shoe style elimination, activity reducing, injection therapy, pain pills, straps and other pathology specific care and I tell them that that's what they sincerely believe was best for their patients.

    Dr Sha
  30. David Wedemeyer

    David Wedemeyer Well-Known Member

    Do you believe that the bulk of custom foot orthoses should be provided as a preventive measure and why?

    Dennis not to be argumentative and this thread really isn't about this discussion but does this not mean that you are in fact guilty of the same pathology based dispensing as what you are pointing out in Dr. Scherer's book? How do you differ if not, I'm missing something here?

    What about medical necessity?

    I disagree with this because there are standards and accepted orthotic practices in podiatry and the orthotic professions that are taught, board tested and practiced everyday in offices all over the U.S. (and the world). Through clinical experience and advanced training we may learn greater acumen in biomechanics, evaluation, dispensing etc but we only add upon what we have learned. Theory and knowledge change but the foundation remains intact in my opinion. When were we taught to provide "wellness" though I wonder?

    trust me Dennis, as a chiropractor I am one of the more sympathetic ears to prevention and I agree that intervention prior to pathology would be more favorable than waiting for pain and dysfunction to drive patients into our offices. But at the same time what is wellness to you specifically may I ask? What evidence is there that foot orthoses prevent anything beyond our own beliefs from our knowledge of how dysfunction occurs? The underlined sentence above proves you don't contend with Tissue Stress biomechanical theory correct?

    Should we routinely bill a patient's insurance for a CFO when there is no diagnosis to warrant payment or is this pay at the time of service?

    I'm with you somewhat on this one. I only contract with a few insurers, Medicare (because I believe that we should open our doors to patients of a certain age despite the hassle, Blue Shield of CA and one network that includes a few plans and workers's comp payors). You're absolutely correct; I work for the patient not the insurer. At the same time though you've hung EBM out like a sword of Damocles above the head of those providing orthotic therapy but dismissed it entirely when it comes to insurance and wellness. Isn't that disingenuous?

    Do you feel that we should instead offer patients CFO's based on a presumptive paradigm of possible future pathology?

    Well there you go Dennis, that is how they work is it not? I haven't read Dr. Scherer's book but I have read some of his work. He is obviously a pivotal person in the advance of podiatric biomechanics and has contributed a lot to your profession. I wonder why then you're so eager to discount his book, have you read it by chance?

    Again, by what EBM criteria do you make that decision to intervene with a custom orthoosis when a patient has no complaint? Not arguing, merely curious? Also earlier you stated that "we know that CFO's (and other orthotics) work but we don't know why, this means that using EBM, we have no proven platform for treatment". Again I'm noting a contradiction Dennis but let's consider something. EBM has its own inherent flaws and if you look for proof of the exact mechanism by which many medications for example work they do not know why with any substantive level of proof, yet we use them because we know that they work. It's much the same for foot orthoses; we have a good base of solid clincial evidence that they do, people like Dr. Scherer, Dr. Kirby, Dr. Fuller and Dr. Spooner etc continue working to understand the science behind it better. As do you. Maybe it will one day give us a better understanding of how to prevent that which we treat?

    Are you merely disagreeing with Dr. Scherer's work because he is not a proponent of your FFT? You just agreed that we know how they work, doesn't that also answer the why?

    What do we know about prevention or what is proven beyond "I've seen a patient with this presentation end up with this problem so we're going to prescribe this"?

    Again Dennis this is merely a discussion, I'm fairly open to wellness when it is beneficial. I asked those questions because I am truly curious about your interpretation and delivery of wellness via custom foot orthoses. At the same time I see your denouncement of Dr. Scherer's work in your answers as just another plug for your system. Tell me I'm wrong Dennis? I'm really not trying to evoke another round of verbal MMA with you but your answers never diverge from your product. I'd really like to see you perform some studies, submit papers etc., seek wider recognition than just disagreement about standard practices that already possess that body of evidence.

    Best Regards,
  31. drsha

    drsha Banned


    The existing evidence serves as a foundation from which biomechanics is practiced. It grows and changes constantly because it is tested with new theories and applications and it is incomplete and flawed.

    The evidence reveals positive results for Custom Foot Orthotics (the general class) in many applications for foot and postural care.
    That is our consensus and proof.

    What the best CFO is (or is not) as to diagnosis, casting, prescribing, dispensing and its place in patient care has no consensus and no high level evidence to back it up.

    I use the same evidence as you and Dr. Scherer. We all do at this level.

    Please show me counter evidence that I am overlooking when declaring Pathology Specific Biomechanics unproven but worth visiting as one of The Modern Biomechanics Paradigms and no more.

    My problem with Dr, Scherer is not the value of his work which is clearly an advance in biomechanics for all to consider but that he is intimating that Pathology Based Biomechanics has an Evidence Base for the anecdotal part of his platform when it is no more Evidence Based than mine or Dananberg's or Glasers.

    We cannot discern between the proven and his personal unproven preferences in his book as he educates and his evidence seems "cherry picked", biased and skewed to "prove" his points.

    It is interesting that you ask if I have read Dr. Scherer's book or know his work (have you and do you?) when, in fact, Functional Foot Typing upgrades and gives purpose to the foundational chapter that he wrote in Valmassey's text on Foot Typing.

    I find that my greatest critics share things in common.
    1. They have never read my work.
    2. They have never Functionally Foot Typed a living soul.
    3. They have little proof for their EBP and so repeatedly ask me to prove mine, defensively, when I have admitted that I can't years ago, on this very Arena.

    As a proponent of prevention and seeming authority of The Foot Centering Theory of Biomechanics, have you ever read my work or foot typed a patient?

    If so, how can you explain the dirth of knowledge and the blatant misinformation you deliver when referencing it?

    Remember, Functional Foot Typing has a U.S. Patent from The U.S. Patent Office that took five years to gain approval for. It authenticates that my foot typing method, my preorthotic padding system and my foot type-specific orthotics are an upgrade of U.S. Patent Law based on the existing art and evidence.

    Dr Sha
  32. David Wedemeyer

    David Wedemeyer Well-Known Member

    How flawed can it be when it has given us a framework to understand how CFO's work? You yourself appear to agree that:

    We also know that a medial heel skive for example has a strong body of evidence to support it's use in early PTTD and AAFFD. How are the number of patients that have been helped by a CFO for these conditions not strong evidence of the efficacy of CFO's for pathology? I could go on and on Dennis but you get the point. I'm also sure that by using SALRE to describe the pathological changes we can predict which tissues will become a complaint and explain the pathogenesis of these disorders (Tissue Stress Theory) so how is that outdated if it reliably explains the cause of the pathology and provides us a framework from which to mediate those complaints?

    Postural care is an interesting topic. The SS team recently applied this paradigm to a thread discussing SALRE. When we place a CFO in a shoe do we know or have ANY level of proof that it improves posture and what structures are we discussing? Also is the foot held in a specific and predictable position in your view (or is the CFO altering kinetics through our understanding of kinematics?

    This is not a good argument in my opinion. Kevin for one has posted a tome of quality studies that show a much higher level of proof that CFO's mediate numerous pathologies than those which refute them. We also have the outcomes of clincial practice to draw from. If it were as you say then why are we even using CFO's or trying to understand and explain them better Dennis? I can find and repost that list if necessary.

    Dennis if my straightforward manner of addressing others has insulted you, please do not be offended. My point was to understand why you have such an issue with Dr. Scherer's book, again have you read it? I have read Valmassey, I have not read the book in the subject of this thread.

    I am merely pointing out that there is in fact a large evidence base to support what we do. Instead of addressing the issues that you have with "the existing evidence that serves as a foundation from which biomechanics is practiced", you again held your work out as refutation. I'm sorry but that does appear self-serving Dennis.

    I have never used FFT on a patient but I have reviewed your website. I didn't at the time see FFT as an epiphany in biomechanics that would change the way that I dispense CFO's. This is not a condemnation of your work, merely my opinion. I have looked at just about every method out there and foundationally, what I learned as a pedorthist is closely aligned with the prevalent podiatric methods. The pedorthic program was after all created to aid the foot professions in manufacturing and dispensing these devices.

    I have evolved over that past few years in my thinking and methods but I still maintain that the basic orthotic foundation remains for you to try to disprove and improve upon. I cannot see you achieving either without scholarly presentation and peer review of your methods. You could be Dr. Scherer's best friend and I would be none the wiser but his pedigree speaks volumes about his devotion to your profession and his level of understanding of the subject. He is not to my knowledge here to defend himself and I found your condemnation of his work in an academic forum surprising and I'm not a podiatrist!

    I do feel your frustration that you believe that you have a better method but Dennis but the way you go about it may not make you many friends. I am highly dissatisfied with my colleagues orthosis dispensing habits and those who I feel have exploited their lack of knowledge and training for profit. I have chosen to do something about it, more on that later.

    Last edited: Apr 4, 2011
  33. DanShort

    DanShort Welcome New Poster


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