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Can Abnormal Pronation Change the Occlusion

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Brian A. Rothbart, Oct 24, 2012.

  1. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Members do not see these Ads. Sign Up.
    In 2008 I published a paper (JAPMA) suggesting that foot twist (abnormal pronation resulting from either the Rothbarts Foot or the PreClinical Clubfoot Deformity) will change the sagittal plane inclination of the temporal bones. I also suggested that a Class II malocclusion can occur from abnormal foot twist.

    Costa et al recently published a paper in the Journal of Anatomy in which they conducted a computerized tomographical study of the morphological interrelationship between the temporal bones and the craniofacial complex. Among their findings was that the inclincation angle of the temporal bones (anterior/posterior rotation) has a direct impact on the positioning of the mandible/maxilla (e.g., the occlusion).

    Although not conclusive, I believe the link between abnormal foot pronation and changes in the occlusion has been established.

    Costa HN, Slavicek, R and Sato S 2012. A computerized tomography study of the morphological interrelationship between the temporal bones and the craniofacial complex. Journal of Anatomy, Vol 220:6;544-554. June.
  2. On which planet, Brian?:rolleyes:
  3. So lets break this down.

    22 patients, selected out of hundred and whatever to suit the study, measurement taken from corner of lips (hope they weren't smiling) to eye, by the same person who measured their FPI (slightly oddly getting them leaning forward against a wall). Proves nothing.

    Even if it was 22,000 patients, the VFD measurement was proven repeatable, the study was double blinded and the statistics were solid, it STILL wouldn't prove the causal link you "suggest", only correlation between a more pronated foot and a funny shaped head! And even if it DID prove a causal link (which it doesn't) there's still a big stretch between that and proving that changing the "foot twist" would change the face as the infomercials on your website infer. But ok, it was, as you said, only a suggestion.

    Right, so this was a study into whether the temporal bones (which are in the head) affect the craniofacial complex (which I presume refers to the head and skull). So the shape of the head bones, affects the shape of the head.

    No problem there, seems reasonable to me that the shape of the head might be affected by the shape / position of some of the bones in it.

    Wait, what?!

    Only if you're initial "suggestion" that there is a predictable and reproduceable impact on the position of bones in the head has been established. Which it hasn't.

    This is like saying "I suggested that my choice of shoes affects the mating patterns of gibbons in Sydney zoo, and how many baby gibbons are born. Since a study has now been published indicating that how many baby gibbons are born is impacted by the mating patterns of gibbons at Sydney Zoo, I believe the link between my shoes and baby gibbons has been established. "

    Its your initial "suggestion" which needs proving Brian, not the link between head bones and face shape. A "suggestion" is worth somewhat less than a puff of warm methane.

    And please, no links to your "research" website. Thats not research, its marketing. This:

    Is about the level, and frankly... just no.
  4. Craig Payne

    Craig Payne Moderator

    ....which was totally discredited and you failed miserably to answer a single one of the questions that you were repeatedly asked. Instead you got your cheer squad to post testimonials about how great you were (and even they totally failed also to answer the same questions!). How about going back and answering the repeated questions that were put to you? Here is the thead for everyones amusement
    Last edited by a moderator: Oct 27, 2012
  5. David Wedemeyer

    David Wedemeyer Well-Known Member

    This study says no such thing Brian, in fact a link to the foot is not even a consideration of their study design.

    I'll wait for the retarded spiders to come crawling out of the cracks to defend Brian's latest meritless proclamation.
  6. fishpod

    fishpod Well-Known Member

    start the music.

    the toe bones connected to the met bone
    the met bones connected to the calc bone
    the calc bones connected to the f_____ jaw bone
  7. Brian A. Rothbart

    Brian A. Rothbart Active Member

    I can readily appreciate how disturbing my findings might be to certain Podiatrists. If my research is confirmed by other researchers, it will demand that Podiatrists increase their vision (from myopic - feet only, to global - full body) when using any type of orthotic or insole underneath their patient's feet. This will require a more total body training in Podiatry than what is currently offered in many of our schools.

    Currently I have submitted a paper that has linked both proprioceptive and dental interventions to changes in the frontal plane position of the cranial bones and atlas. Unfortunately, I am restrained from presenting this paper until it is published, but below is the abstract:


    The purpose of this study was to determine if the frontal plane position of the cranial bones and atlas could be altered using dental orthotics, prescriptive insoles, or both concurrently.

    Methods: Three patients, each diagnosed as having a TMJ dysfunction and a PreClinical Clubfoot Deformity, were selected to participate who had received both proprioceptive insoles and dental orthotics.

    Using an orthogonal protocol, each patient had 4 cranial radiographs taken, using a fixed positioning device, in which: (1) neither the dental orthotic nor proprioceptive insoles were used (baseline measurement); (2) the dental orthotic only was used; (3) the proprioceptive insoles only were used, and; (4) the dental orthotic and proprioceptive insoles were used at the same time.

    The degree of change in angle between the various specified cranial landmarks and atlas were measured directly off of these radiographs and compared to one another.

    Results: In two patients, improvement towards orthogonal was achieved when using both prescriptive dental orthotics and prescriptive insole concurrently. Improvement towards orthogonal was less apparent when using only the prescriptive dental orthotic. And no improvement or a negative frontal plane shift was noted when using only the prescriptive proprioceptive insoles.

    In one patient, the frontal plane position of the cranial bones and atlas increased (away from orthogonal) when using the generic proprioceptive insoles and/or a prescriptive dental orthotic.

    Conclusion: This study demonstrates that changes in the frontal plane position of the cranial and atlas bones occur when using podiatric and/or dental interventions.

    It serves no function to make sarcastic, invective and occasionally vituperative remarks about me personally or my research. This unproductive, unprofessional conduct leads nowhere.

    I would be very pleased to have an engaging conversation with other reseachers who (are published) and looking at the same possible interconnections between foot motion and global postural distortions.

    Having said all this, I will continue to ignore all juvenile and smart aleck remarks.

    Brian A Rothbart
  8. fishpod

    fishpod Well-Known Member

    three patients in the study wow brian havent you pushed the boat out cant wait to read this research could u please publish it on along soft roll with perforations every 8 inches ime sure ill find a use for it.
  9. Griff

    Griff Moderator

    Will you be including your intra-rater and inter-rater reliability statistics in the full paper Brian?
  10. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Dear Fishpod,

    I apologize but I could not resist thanking you. Your timing is perfect. Your remark epitomizes exactly the type of remarks I alluded to in my above post.

    Thank you for demonstrating, so quickly, a feebleminded, illiterate, screwball remark.

  11. It's a fairly germane point Brian. 3 patients, unblinded, uncontrolled, it's scarcely conclusive is it?! Honestly, who do you imagine is going to be convinced by that?

    What you are experiencing is a critique of the rather poor quality of "research" you are offering. The mockery stems from the fact that you are unable to recognise or appreciate the relevance of the criticism.
  12. Craig Payne

    Craig Payne Moderator

    Not at all. I would be happy to accept your research if it stacked up to scrutiny and critical appraisal. It fails miserably to stack up. All that is disturbing is your continual unsubstantiated and nonsensical claims from your flawed research. We are not that gullible that we fall for it. I challenged you again above to answer the question put to you about the research:
    You failed again to take up that opportunity. Another epic fail.
  13. fishpod

    fishpod Well-Known Member

    dear brian i have never done any research other than which sage fly rod ill buy for my next expedition . i am an ordinary practising podiarist not an academic like kevin simon craig and robert but
    even i know everything you promote is bogus bulls--t what is the point of all this crap you produce why do you expend so much energy getting ridiculed by your peers. tell me when will i ever see a patient with a problem in the head that i can treat as a podiatrist' ive never come across one in 30 years its like youre off with the fairys have you ever considered therapy you need help.
  14. When patients pay 30,000 Euros for a course of treatment you want to be able to "help" as many as you can right?

    And when you're selling courses, the more you can represent your ideas as mainstream and respectable, the better.
  15. David Wedemeyer

    David Wedemeyer Well-Known Member

    I nominate this gem for quote of the year please.

    Brian please do some adequate research for the good of mankind and perhaps your peers will take you seriously. I'm not a pod and I can see right through your motives, anecdote and shoddy work. I only hope the unsuspecting public can do the same as you have accomplished nothing other than to provide them false hope, subvert adequate and rational treatment and relieve them of their hard earned money. It's really not funny at all, in fact it is reprobate and you should be ashamed of yourself. :hammer:
  16. Brian:

    You calling fishpod "screwball" is like the pot calling the kettle black.

    You want to talk about screwball, let's look at some of the many things you claim on your websites.

    Your insoles can cure anything from headaches to fibromyalgia.


    You claim that you were the first to discover, demonstrate and document how the foot is linked to the knee, pelvis and low back, along with six other ridiculous claims.


    You invented a "Rothbart's Foot Awareness Week".


    And, to top them all, you claim that Anna Nicole Smith died of complications from a severe case of Rothbart's Foot.


    And you are calling someone else a screwball, Brian?! Why don't you just go crawl back under a rock somewhere, Brian.....where you belong.
  17. That paper never would have been published if I had been the reviewer....
  18. Rob Kidd

    Rob Kidd Well-Known Member

    Nor me!
  19. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Hi Rob,

    This paper suggests that a connection does exist between how the foot moves and the position of the cranial bones and atlas. I am surprised that you made a judgment based solely on the abstract.

    The cranial radiographs were taken and read by as board certified orthogonist. The protocol for taking the radiographs followed the format delineated on my website. The dental orthotics were fitted and facial photos were taken by a well respected research dentist.

    The cranial bones moved, clearly seen on the radiographs.

    However, I started this thread in an attempt (that has failed again) to discuss current research on the connection between the feet, innominates and temporal bones (I authored two papers in JAPMA on these links). And the connection between the temporal bones and the occlusion.

    If there are any Posturologists reading this thread, I would be very interested in hearing your opinions.
  20. Rob Kidd

    Rob Kidd Well-Known Member

    I think the best plan ........ is to leave me out of this, altogether
  21. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Hi Rob,

    Now that you have entered this discussion, I would like to hear more about why you feel foot motion can not possibly change the position of the cranial bones and atlas.

    Is it from an anthropological point of view? Do you hold that postpartum, the cranial bones become fused and therefore are unable to move after a certain age. If so, you might find a paper published in Cranio by Smith et. al. that demonstrated that cranial therapy (massage) does change the frontal plane position of the temporal, malar, mastoid and sphenoid bones. Or research done by Sutherland, Retzlaff et al (at the University of Michigan, school of Osteopathy) who publish their research on what they referred to as cranial rhythm which suggests that cranial bone movement does indeed occur (which is the basic tenant of cranial sacral therapy)

    Or is it that you believe that the motion in the foot, being so distant from the cranial vault, can not possible have any impact on the position of the cranial bones. That would be a difficult position to defend if you were an engineer holding the belief that the position of the foundation has no impact on the position of the roof. And in fact, once my paper is published, it would be difficult to maintain that absolute position.

    In Europe, specifically in France, Italy and Germany, a great deal has been published on the global shifts coming from foot motion. Unfortunately these papers are not written in English. A fact eluded to by Dr Gagey in a previous discussion where he was remiss for the fact that they have not yet published in English journals.

    From your previous publications, I know that you are not a stranger to controversy, especially when you adamantly stated that forefoot varum and valgum are myths, only held onto by Podiatrists. I sure that stance did not endear you among your fellow Podiatrists.

    Podiatrists can, if they choose, to keep their heads buried in the sand ignoring the phlethora of papers being published in Europe on the link between foot motion and postural distortions. But in time, I believe this also will become an untenable position, just like those Podiatrists who still hold onto the belief that structural forefoot varum and forefoot valgum exist and dispense orthotics to treat those conditions.


    Upledger, JE (1995). "Craniosacral therapy". Physical therapy 75 (4): 328–30. PMID 7899490.
    Upledger, JE (1978). "The relationship of craniosacral examination findings in grade school children with developmental problems". The Journal of the American Osteopathic Association 77 (10): 760–76. PMID 659282.
    Upledger, JE; Karni, Z (1979). "Mechano-electric patterns during craniosacral osteopathic diagnosis and treatment". The Journal of the American Osteopathic Association 78 (11): 782–91. PMID 582820
  22. Griff

    Griff Moderator

    Just to repeat my previous unanswered question Brian; could you furnish us with the intra-rater and inter-rater reliability statistics for these measurements please?

    Many thanks
  23. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Until the paper is published, nothing can be released
  24. Griff

    Griff Moderator

    So the reliability statistics will be included in the paper, yes?
  25. Craig Payne

    Craig Payne Moderator

    That has never stopped you in the past!!!!!

    How about responding to this:
    You have failed again to take up the opportunity to defend your research by answering the questions you have been repeatedly asked. Anyone can you back and read the your failure.
  26. Brian A. Rothbart

    Brian A. Rothbart Active Member


    It is not my role to defend my research. It is my role to present my research and let the readers decide for themselves.

    However, if you have published any studies that refute my basic tenant that the body is connected, foot to jaw, please present it.

    Ian, when the paper is published, read it for yourself. I believe the radiographs are compelling in themselves.


    PS Are there any double blind studies proving the existence of forefoot supinatus.
  27. Griff

    Griff Moderator

    I'm sure you do. But let's remain scientific about this shall we.

    So just to clarify - the reliability statistics for your measurements will be in the paper? (I am not asking you to tell me what they are at this stage, merely to confirm I will be able to see them in your paper when it is published)
  28. Craig Payne

    Craig Payne Moderator

    Which now has been totally discredited as you can not answer the questions about the research and defend the quality of it! Thanks for confirming that.
    As I said in the thread where I repeatedly asked you the questions that you failed to answer, I have no doubt that there is a link between foot function and more proximal problems. There is plenty of research that shows that. I have not seen anyone here disagree with that. The problem is that your research is so flawed that it does not show that!
    Are there any double blind studies proving the existence of "Rothbarts Foot"? You are the one with the credibility problem here. You are the one that made a choice to name a foot type after yourself! In the history of medicine I can't recall anyone else who has named a condition after themselves.
  29. Brian, do you really believe all this BS you say in this video?! I am amazed that you can sleep at night by continually giving people with chronic pain the false hope that your insoles will cure their chronic pain. Don't you have a conscience or is it just all about the money?

    Last edited by a moderator: Sep 22, 2016
  30. Rob Kidd

    Rob Kidd Well-Known Member

    Brian, I start with an apology. I have always said that my posts are never personal, and my comment re: referee JAPMA was too close to that; you caught me at an off moment, having just driven 1700km back to NSW with only my dog as the co-pilot. However, that is not the point. This is the point. With respect, and I do mean with respect to JAPMA, on an international scale it is a fairly low level journal. When I see your work in eg The American Journal of Physical Anthropology - which you have to walk on water to get published in (I know, I have been there perhaps 5 times), I will regard this rather odd line of suggested correlation with more attention. Until then, I would respectfully suggest that there is essentially NO correlation between any pedal dimensions and cranial morphology, structural or functional. Rob
  31. fishpod

    fishpod Well-Known Member

    thanks for the info robert so hes the david ike of the podiatry world .

    getting back to brian i had dinner on saturday night with a doctor who is a medical researcher at keele university medical school and told him about brians study with 3 patients. as you guys probably already know his comments were unprintable he laughed alot. it provided a light note to the evening and broke up all the jokes regarding jimmy saville.
  32. Rob Kidd

    Rob Kidd Well-Known Member

    Oddly, the head of anatomy at Keele and I used to work together in Manchester. Give my regards to Mike.
  33. Two things strike me.

    It would be a genuine tragedy if, as Brian appears to feel, a real and potential oppertunity to help people was lost out of cynicism.

    It would be a similar tragedy if our enthusiasm to help people caused us to believe what we WANT to believe we can do, rather than we can ACTUALLY do.

    I think that skepticism is the right approach. A skeptic demands evidence. A cynic will not believe even with evidence. There is, as yet, no evidence because the "research" which has been carried out is of such poor quality. It would be wrong to believe that the link has been established as Brian says. However the existence of poor quality evidence does not preclude that later there might be GOOD quality evidence.

    I think further discussion on the existing evidence would be fruitless. Brian, you know what would be required to constitute good evidence for your hypothesis. Rather than curse the darkness of your colleagues refusal to accept your theory, light a candle and go get some QUALITY research done rather than these unblinded case series.

    Two or three of your consultations would pay for a decent researcher for a year, full time! Find someone the community respects and / or a respected university to do it at. Get a proper, well designed, double blinded RCT done and published by someone / somewhere which would reassure the podiatric community that there are no shenanigans. Guarenteed (if of course you were proved correct) you'd get more than 3 referrals off the back of such a study, so it would be good business, AND you'd have made a great contribution to the sum of human knowledge.

    That would seem the obvious move. I can only think of one reason not to make it. How about it Brian? Shall we do this, or just spend the next 10 years arguing over crumbs of data?
  34. drsha

    drsha Banned

    Not that I don't disagree at this point that Dr Rothbart's claims are not being supported by strong evidence, the reaction by most of the participants on this thread including you, Robert, echo the comments I made on the study related to Subtalar Joint Axis measurement that you, the same parties, defended as if it had any more power and substance than this one.

    You did not join in my honest revelations of Dr Kirby's work in that the research was low level, small subject group, cadaver, etc. Why didn't you reach the same conclusions here?
    I think we know the answer.


    PS: I am trademarking a pair of flip flops with the podiatry arena emblem for your use. I'm calling them FlexEBM's ;)
  35. I think the difference is In what is claimed. Brian claims to cure impotence and "make Down's syndrome children look normal". For claims like that you need some pretty special evidence. You Dennis claim to know what the optimal way for feet to function is, a smaller claim but still pretty large. Kevin makes almost no claims, save perhaps that if you have a foot with a medially deviated axis, a medial heel skive might be a more effective way to exert a supination moment than a wedge.

    Hope you stay safe in the weather Dennis. My unfashionable and outmoded but nonetheless sincere prayers are with you.
  36. Brian A. Rothbart

    Brian A. Rothbart Active Member


    I make no claims. I only present what I have seen in my practice or what I have observed in my research. You will note that I almost always use the word 'suggests' not 'proves', e.g., the results of this research suggests that etc etc etc.

    Regarding the Down's child, I presented photos pre and post stimulation. The changes in the countenance was remarkable. However, I never claimed that my work cured Down's Syndrome. Why you would suggest otherwise, mystifies me.

    Regarding infertility, if you go on my research site, you will find an email from an MD who presents a case of a young women who tried to become pregnant for many years without success. He noted she had a tipped pelvis (anterior rotated innominates). He fitted her with the appropriate proprioceptive insoles and within several weeks she became pregnant. Does this prove anything, no. Does it suggest that more research needs to be done regarding the possible link between posture and becoming pregnant, I believe so.

    For your information, if you do a Google search on postural distortions and pregnancy, you will find many papers written before 1950's that discuss a possible link between the two. All that was discarded when surgical realignments of the pelvis came into vogue to facilitate conception. But enough of this.

  37. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Hi Rob,

    I must again respectfully, and I do mean respectfully, disagree with you. Where the paper is published, to me, is not as important as to what is published. I have seen some of cr-- published in Lancet. And I have seen some fantastic papers published in the Journal of Bodyworks and Movement Therapy (geared towards massage and cranial therapists).

    Personally, I strongly believe that foot motion changes the position of the cranial bones. The cranial radiographs that were taken (by an independent observer not connected to the study) demonstrates measureable changes in the frontal plane position of the cranial bones (pre vs post Tx). In my opinion, it is very difficult to dismiss this type of data.

    However, be that as it may, my position regarding this is: I publish my findings; let the reader decide if they find the results compelling or not. Punto, end of story.

  38. drsha

    drsha Banned

    Thank you for your well wishes.

    My family and I are fine until now.

    Are you actually stating that you judge EBM differently depending on "What is Claimed" ?

    EBM around Kevin's work doesn't need to be judged according to the same standards as Rothbart's because he makes "almost no claims"?

    I'll stop here because I don't want to divert the thread but C'mon.


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