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Challenging the foundations of the clinical model of foot function

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Jan 31, 2017.

  1. Stanley

    Stanley Well-Known Member

    I guess you also disagree with ascending vs. descending pathology. So what is the mechanism for an anterior ilium and what is the mechanism for a posterior ilium according to your theory?
     
  2. Dennis Kiper

    Dennis Kiper Well-Known Member

    For alignment issues, balance starts at the ground. That's my opinion. I've met DC who think func ll starts at the hip.
    There certainly may be some anomoly that I'm not aware of are you? Otherwise I believe the majority of every foot on the planet fits the profile of ascending bio-mechanical pathology.
    My theory to as/pi is that it's a neuromotor response to asymmetrical pronation. As I said earlier, I see this imbalance in postural alignment with children as early as 2 yo. For me, this was confirmed, that in every single case I also see contralateral shoulder positioning. I didn't keep records, this is anecdotal of thousands of exams given at major running events.
    In addition to my last post I have found that the mechanical function of pronation, remains the same, regardless of ll (variables-aside) I believe, that tissue efficiency and performance results from the alignment of mechanical function, starting at the MTJ. I've observed that mechanical eff starts and ends with the tri-plane motion of the POM. I knew Orien , I spoke with him months before he died. He said that Root was adament about the rearfoot. Weed saw it that way too. He says he did think about the MTJ and wanted to pursue it but went along to keep peace and move on. From that, you understand bio-mechanics as you do.
    I have found that for the supinator population of our society and some anomolies that exist, hydro-dynamic technology enhances the mechanical efficiency of functional bio-mechanics. I admit I haven't written all I've seen like you did, so when you talk about lifts and compensation, those have different definitions to me then what you and I have learned in the same classes.
    It is the principles of physics involved which are confirmed by scan tech, that tells me, the science tells me this! Why doesn't it tell you the same thing?--are you influenced by those that think this is snake oil? or are you afraid to learn something new? Is it just because you don't like me? If so, mankind will owe you a great debt.
    The only thing I'm expert in is what I've learned about bio-mechanics and bio-mechanical medicine from this technology. It's given me the opportunity to take out the guesswork of pt response, results and dx. I've been accused of doing this for $$. It's you that are losing $$$$. Because if podiatry started to teach the public the importance of bio-mechanical health (like dental health) prevention over a lifetime starting as yearly as 10 yo and the tool to accomplish this is scientifically established, bio-mechanics would become the largest part of your business. And you won't be discussing how many degrees you post to effect bio-mechanics, instead you can discuss how many grams or mg you need to pronate or supinate the TNJ to effect the POM. your business would be more about bio-mechanics than anything else, that information would spread. I think podiatry and foot specialists should take the lead instead of getting mired down in theory and conjecture.
     
  3. Stanley

    Stanley Well-Known Member

    What is POM? It appears that you don't believe in descending pathology nor a primary posterior ilium. Also you can't explain an anterior innominate. Can you distinguish between an anterior innominate vs an opposite side posterior innominate?
    You have no idea what I believe in as far as how the body functions.
    I really don't care if you make money. I just care about the truth of how the body really functions.
    Finally, yes there is a neuromotor response that causes a posterior innominate, but the cause is not what you think.
     
  4. Dennis Kiper

    Dennis Kiper Well-Known Member

     
  5. Stanley

    Stanley Well-Known Member

    No, you have no idea of how I think the body functions. The reason is that I haven't told you.
    I do know that you have no idea that there are primary ilio sacral dysfunctions, and you can't tell me the difference between a posterior or anterior innominate or how to distinguish it.
    You claim to have been involved in sports medicine. But that is suspect in my mind because if you have, then you would have seen the high school runner that during his first speed workout of the year felt a pop in his back and then developed a lateral knee problem (IT band syndrome) which is a primary iliosacral joint pathology. which requires the iliosacral joint to be mobilized/manipulated via one of many techniques.
    All I know is that you think that if you put a fluid filled sac under the foot, it will find its neutral position automatically and the pelvis will level. You have no explanation of the mechanism of how this occurs except some vague neuromotor response and you call it scientific technology.
     
  6. Gardener

    Gardener Welcome New Poster

     
  7. Gardener

    Gardener Welcome New Poster

    What is the significance of the First Ray in establishing a tripod effect in feet?
     
  8. Dennis Kiper

    Dennis Kiper Well-Known Member

    Stan,
    I've explained this before, when you're dealing with a scientifically calibrated orthosis, then your bio-mechanical results are predictable. This experience has taught me what I know. I know everything you know and think you know. I know what you don't know because you don't know what I know. Because I haven't told you.
     
  9. Dennis Kiper

    Dennis Kiper Well-Known Member

    the biomechanics of foot orthoses and the concepts of Tissue Stress Theory does not need to measure subtalar joint neutral, forefoot to rearfoot relationship, subtalar joint range of motion or neutral calcaneal stance position to prescribe excellent custom foot orthoses for their patients.
    This concept is the level of mechanical insuffieciency that makes the profession's orthotics only equally as effective as generic and orthotics for a fraction of the cost. One of the difficulties the podiatry profession has always faced in working out financial reconciliation for orthotic therapy with health insurance companies or Medi-Care is based on this evidence pointing to the efficacy of cheaper generic and pre-fab orthoses being equally effective to customized orthoses, for both short and long term results.
    In other words, nearly all of those measurements, which the people that dogmatically preached Subtalar Joint Neutral Theory to us for decades as the only way to make "correct" custom foot orthoses, don't really need to be done in order to make great custom foot orthoses.
    While your statement is fine for a generic orthotic, it does not meet the criteria or standards of what our profession should be able to do. and when you can calibrate mechanical efficiency for a stance phase you can do more than make a great custom orthotic, you can consistently make a bio-mechanical health support system that can be changed as tissue stress resolves and bio-mechanical health is restored and maintained over a lifetime. The ability to grow the accuracy and health benefit of a pt's lower extremity. This includes the use of lifts when appropriate. then you know what to expect. it's the measurements based on past and present theory that has resulted in the inability for precise bio-mechanical measurements and mechanical function, which matters like 20/20 vision. You just don't realize it. Present day orthotic technology does not do this.
    The Subtalar Joint Neutral dogma, full of errors and inconsistencies, which has been passed on from generation to generation of podiatrists, blinds many podiatrists to the truth of how the foot and lower extremity actually works.
    I don't agree, we know how it works, you don't know how accurately it should and could work.
    Better theory needs to be actively taught

    Better technology for the mechanics that fit needs to be learned. That's what would change the course of the entire profession and health benefit world wide. Any theory that is not scientifically supported is not a good theory.
    Those that continually want to refer to the past contributions of our ancestors of podiatric biomechanics, keep things as they were 35 years ago, and not keep an open mind to change and move on to better theory,

    Hydro-dynamics is a simple technology, there's no theory, it just works just like a bio-mechanical tool should for the right foot. You may in some cases even make something better than a generic o., especially for anomolous conditions--otherwise clinical results are still around 50%.
     
  10. efuller

    efuller MVP

    I'm not sure what you mean by tripod effect.
     
  11. Stanley

    Stanley Well-Known Member

    I am glad you do, so tell me how you would use a one point acupuncture technique vs. a two point acupuncture technique to affect the foot? How does the cervical righting reflex affect symmetry and how would you treat it? Tell me how the vagus nerve effects the foot and what techniques would use use that would mimic that of a vagus nerve stimulator?
    How does a first degree forefoot sprain affect the biomechanics of a foot?
    I remember my first experience with a silicone insole. It was in the fall of 1976. I was amazed at how it felt and for a few hours, I thought I was going to use this instead of real orthoses. Then my heels started to hurt. I immediately went back to my self made orthoses and my heel pain left.
    So please explain to me how a bag of slime constitutes a scientifically calibrated orthosis?
     
  12. Dennis Kiper

    Dennis Kiper Well-Known Member

    Here's an example of what you don't know that, because of the difference in wt and pronatory distribution, you're initial heel pain was perfectly normal and just temporary. If you were really medically and biomechanically informed you would have realized that and that it's not necessarily the orthotic that was at fault. You must give up easily on a lot of stuff?
     
  13. Dennis Kiper

    Dennis Kiper Well-Known Member

    This is the structure of an elephant foot.
     
  14. Stanley

    Stanley Well-Known Member

    What are your patient responses when you tell him that the new pain he developed which he never had before by wearing his new "scientifically calibrated orthosis" is because of the difference in wt and pronatory distribution and is perfectly normal and just temporary? How is this better than when I dispense a pair of orthoses and the patient is now able to go out and run without any pain?
     
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