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Columnar Theory of Foot Function

Discussion in 'Biomechanics, Sports and Foot orthoses' started by TedJed, Dec 12, 2007.

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  1. TedJed

    TedJed Active Member

    Members do not see these Ads. Sign Up.
    I recall chatting with Jim Ganley (c.1990) about the 'Columnar Theory' of foot function where anatomically and functionally the foot is divided into the medial (tal,nav, cun's, 1-3 rays) and lateral (calc, cub, 4-5 rays) columns.

    Does anyone know who's theory this is?

    Is there a reference for this theory?

    Much obliged,

  2. Craig Payne

    Craig Payne Moderator

    Ted -- While I have heard of the concept, I do not recall any reference on it that would be citable.

    Having said that, I do not think they concept of two independant functional columns stacks up, especially in the context of Chris Nesters works on the relative movement of the osseous segments in the foot to each other (not all of which has yet been published). See the threads on Midfoot position, ROM and stiffness and The "Midtarsal Joint"... for some discussion of some of Chris's work.
  3. I was taught about the medial and lateral columns in podiatry school 25 years ago but don't know who originated the concept. Probably Jim Ganley wasn't the first since I believe that Dudley Morton also mentioned the concept in his book.

    Chris Nester's work does not really invalidate the concept that the foot can be effectively modelled as having medial and lateral columns, as long as one understands the limitations of any model. For example, we often model the metatarsal as being a rigid segment when, in fact, it undergoes significant bending deformations with each step. I, for one, think that when teaching these complex biomechanical topics of the foot and lower extremity, sometimes it is helpful, and very instructive, to divide the foot into both medial and lateral columns.

    Here is how I separated out the medial and lateral columns in a recent reply to Howard Dananberg in our thread on stance leg push and swing leg pull:
    Here, I have partitioned the forefoot into medial and lateral sections so that I could simplify the discussion for instructional purposes. It is not exact reality, but it is a very useful model for clinical teaching purposes.
    Last edited: Dec 12, 2007
  4. Cunningham (1937), Hiss (1937) Lewin (1943) and Morton (1935) believed that weightbearing motion was transmitted through the ankle joint in two direction, described as "medial" and "lateral" segments of the foot. Duchene (1959), Horwitz (?), Polokoff (1959), Shreiber and Weinermann (1948) "showed" that as the foot is plantarflexed against the resistance of the weight-bearing surface, weightbearing motion is transmitted through the ankle joint in two direction: Lateral: through the anterior half of the calcaneus, cuboid, and the 4th and 5th metatarsals; Medial from the talus through navicular, the cuneiforms and the 1st, 2nd and 3rd metatarsals.

    History lesson over.

    Dr Erin Ward presented a paper at this years PFOLA meeting titled: "segmenting the foot: what may be gained- what may be lost?'

    Unfortunatley, I was already flying home by the time he presented, so I cannot add any more. He does list a number of references to more recent attempts to segment the foot in his abstract.

    I'm sure if you are really interested in this he would be happy to help you. His e-mail is [email protected]

    Cunningham, DJ: Textbook of Anatomy, 7th Ed. pp. 307-521, Oxford University Press, New York 1937
    Duchene, GB: Physiology of motion, pp.311-508, W.B. Saunders Co., Philadelphia, 1959
    Hiss JM: Functional foot disorders, pp. 27-49, University publishing company, Los Angeles, 1937
    Horwitz, JM: Variometer. Philadelphia, PA
    Lewin, P: The foot and ankle, p.47, Lea and Fabiger, Philadelphia, 1943
    Morton, DJ: The human foot, pp.107-184, Columbia University press, New York 1935
    Polokoff, MMJ: J. Nat Assoc. Chiropodists, 49: 315, 1959
    Schreiber and Weinerman: Research in podophysiology and their application to podomechanics. J. Nat Association chiropodists 38. No. 6, 1948

    See also:
    Lewis, LL (1966): Podal propulsive hinge as a key to normal foot function. JAPA 56: 3, 103-109 (which talks about importance of normal movement of the metatarsals about the phalanges during propulsion and the foot as a self locking wedge. Lots of sagittal plane facilitation theory in here- check the date! Nothing new under the sun ;-))

    Also a great quote at the end of this paper:
    "My father taught me how to work, but not how to love it."- Abraham Lincoln
    Last edited: Dec 12, 2007
  5. Craig Payne

    Craig Payne Moderator

    Its one thing to divide the foot ino medial and lateral columns to simplfy discussion and explanations, its another thing to base a theory of foot function on it.

    The work of Nester etc and what Erin Ward presented at PFOLA is leading the way to which bones can be lumped together as a 'segment' due to the relative movements between the bones.
  6. I tend to agree Craig. Playing Devil's advocate: doesn't Bojsen-Moller segment the foot somewhat in his theory of high and low gear propulsion:

    P.S. What time is it in The Land of Oz????????
  7. Craig Payne

    Craig Payne Moderator

    Arena'ettes are sick so been up almost all night.

    You right about BM concepts, but thats just another theoretical model.
    Last edited by a moderator: Dec 12, 2007
  8. Y'all following: I was using the force- that's how I knew Craig was going to tell me why he was up in the middle of the night.

    Craig, so where does that leave theories of foot function, for example: sagittal plane facilitation theory, which employ such segmented foot models, i.e. BM's concepts & self-locking wedge as a building block to justification?

    Personally, I think we have moved on somewhat from the "columnar theory of foot function"- as you can see from the references that I provided, this was state of the art circa 1940. I also believe that often some good ideas get lost in time. For example, a UK chiropodist called Swallow published a series of articles in the 60's which were a gnats tail away from tissue stress theory. Root vol 1 and 2 were published and it took us nearly 30 years to go back down the track Swallow was leading us down; as I said, there is nothing new under the sun. Therefore, I should be very interested to hear your angle on columnar theory- perhaps you can offer a new insight on this that has been lost in the myst of time?
  9. As the Professor of Life, the Universe and Everything, and the Nursemaid to Sick Twin Girls All Night, we will allow you this one, Craig.;):drinks
  10. Craig Payne

    Craig Payne Moderator

    In case anyone is wondering what this is about...its all to do with Admin and Admin2's avatar and this. If you are not familar with the triology and who Marvin is, then don't worry about it.

    So long and thanks for the all fish (...No I am not loosing it due to sleep deprivation ... those who know what that means, know what it means :dizzy: )
    Last edited: Dec 12, 2007
  11. All I know is that both my brother and I own houses numbered 42- gotta mean something?:cool:
  12. Craig Payne

    Craig Payne Moderator

    For those who have gone this far with us and have no idea what Simon is talking about, 42 is the answer to Life, The Universe and Everything. ... now if we can only work out what the damn question was :bang:

    This thread has gone seriously off-topic :hammer:
  13. Excellent literature review, Simon. This could be the subject of a nice review of the literature on the subject for publication regarding midfoot/midtarsal joint biomechanics, don't you think??
  14. TedJed

    TedJed Active Member

    And I thought I just asked a simple question...

    I lie here weaning myself off morphine based pain relief (fractured L2,4 & 5) and just when I thought I was becoming coherent again, I traverse the universe, get taken on a history lesson, commiserate the sick twins (and their dad), then get Polokof'd for just Lewin around Weinermanning about the Columnar Theory - I'm going back to the morphine, especially the 42mg dose.

    However, the genesis of my thoughts (thanks for reminding me Simon) was this in the most simplest of terms...

    The premise -:
    The function of the lateral column is primarily the base of support for the body.
    The medial column is the mobile adaptor to the earth's surface and essentially 'rests' on the lateral column.
    For the hallux to dorsiflex efficiently at propulsion, the biomechanical relationship between the medial and lateral columns (as well as other biomechanical factors) must be harmonious.

    Clinically, a common observation I see with 1st MtPJ pathologies such as HAV and Hallux Limitus, is an anterior 'shift' of the medial column relative to the lateral column. This can be seen clinically on occasion by the distal parabola of the toes - 1,2,3 follow a smooth arc but there is a notable difference between 3 and 4 while the arc continues between 4,5.

    So, my approach to treatment (as a manipulative podiatrist) for 1st MtPJ conditions is to assess the position of the talus and determine if there are anterior driven forces originating from an anteriorly subluxated talus. An anterior talus will drive an anterior force into the navicular > cuneiforms > 1st,2nd & 3rd rays > 1,2,3 MtPJs. This 'domino' type of event is an important influence on treatment success (in my anecdotal observations).

    Hence, my enquiry into any science or research into the 'columnar theory'.

    This has been a fascinating journey... but I reckon I might be due for another morphine dose...

  15. Yes, but who on earth could undertake such a project?;)
  16. Are you familiar with Demp's work on metatarsal patterning?

    Manipulative podiatrist- that sounds quite frightening. Anterior subluxed talus- how is this diagnosed? Do you have any pre-post manipulation radiographs?

    Me too. But who knows...
  17. Stanley

    Stanley Well-Known Member


    Dr. Ganley talked about the length of the medial column vs. the length of the lateral column and its relation to the transverse plane of flatfoot.
    He felt that when the lateral column was shorter than it should be, the foot would be in an abducted position around the midtarsal joint.
    He then popularized the Evans procedure to lengthen the lateral column to surgically treat flat foot. The surgical criteria for flatfoot was expanded to include the Evans procedure for transverse plane flatfoot.
    Ganley also popularized serial casting for talipes calcaneal valgus, and felt that most flatfeet were a result of the dorsiflexed and abducted talonavicular joint.
    Interestingly, he did not use frontal plane corrections in his serial castings (makes you think of the oblique axis of the midtarsal joint).
    It was my impression that this was his own theory (the columns in relation to flatfoot). Since no one was able to find this theory in the literature, it would seem that this is the case.


  18. Stanley:

    How do you know that "no one was able to find this theory in the literature"? Have you ever looked in the literature or have you ever instructed anyone to do a thorough literature search to be certain that this indeed was an original theory of Ganley's? Or are you just guessing?
  19. There are no simple questions or simple answers regarding the biomechanics of the foot and lower extremity. If it was simple, then I would have lost interest in the subject many years ago.:cool:
  20. efuller

    efuller MVP

    I saw a magazine article by Ganley on the two unit tarsus concept. The two units are the talus and rest of the foot. He described how the foot deforms around the talus with motion. At the time I heard it (I was a fourth year student) it really helped me conceptualize rearfoot motion. I don't quite think my brief description did it justice, but it really did tweak my thinking at the time.


  21. Stanley

    Stanley Well-Known Member

    Kevin, thank you for your interest in keeping my writings accurate.
    If you noticed there are words I used such as impression and seem, which does not indicate assuredness. After reading the posts of such eminently qualified people such as Dr. Craig Payne, Dr. Simon Spooner, and Dr. Eric Fuller added to my original impression of Dr. Ganley’s lecture, it seems that no one was able to remember Dr. Ganley’s theory (which means that no one is as old as I am). I met Dr. Ganley in 1976 when I was visiting his residency program at Norristown PA where I had the privilege of picking his brain for an afternoon. Several years later, I had him lecture at a podopediatrics seminar at OCPM, where he also conducted a workshop on Calcaneovalgus casting technique. I attended several of his surgical lectures at places such as Hershey, PA where he also taught in the surgical workshops I attended.
    No one can be 100% sure that something is not previously in the literature, but Dr. Ganley did not mention prior authors in his lectures.
    I am however certain that if this theory in the literature exists, you will be the first to find it.

  22. No, that honor goes to Dr. Spooner:

  23. Stanley

    Stanley Well-Known Member

    No offense intened to Dr. Spooner, but his articles did not talk about the relative lengths of the medial and lateral column and their effect on transverse flatfoot.
  24. No offense taken. I think Morton may have discussed the importance of segment length and it's relation to flat-foot.
  25. TedJed

    TedJed Active Member

    No I'm not, can you direct me to a site?

    As a 'manipulative podiatrist', I mean a manual therapist who uses 'hands on' therapeutic techniques of joint mobilisation and manipulation. Not the 'frightening' definition of manipulative that is:

    ma·nip·u·la·tive adj
    1. using clever, devious ways to control or influence somebody or something

    The anterior talus is readily palpated by mildly distracting the ankle (in the frontal plane of the leg) and then rocking the talus within the mortice. An anterior sublluxated talus clunks and grinds (because the articlar surfaces have lost their correct relationship) whereas a normally positioned talus has no perceivable/detectable movement felt.

    You can confirm the anterior talus on a weightbearing x-ray and check the cyma line. Both the DP and Lateral views will show the talar distal articular surface displaced anteriorly relative to the calc:cub joint space, hence a 'break' in the cyma line will be evident.

    This comes from Gamble & Yale's Foot Roentgenology and Christman's Foot & Ankle Radiology.

    Hope this makes sense?

  26. Demp, PH: A mathematical model for the study of metatarsal length patterns. JAPA 54:2 1964 p.107-110

    Demp PH: Mathematical medicine. JAPA 60:9 1970 p352-353

    Demp PH: The metatarsal hyperbola and the pathomechanical forefoot. Currrent Podiatry 20:3 1971 p15-17

    Demp PH: A numerical taxonomy for evaluating the angular biomechanics of the human metatarsus. Current Podiatry 24:5 1975 p.9-11

    Demp PH: Biomechanical optimality and the mathematical measurement of diagnostic patterns in the human foot. Arch Pod Med Foot Surg 3:1 1976 p.11-21

    Demp PH: Biomechanical foot roentgenometry. Yearbook of podiatry 1978-1979. Ed: TH Clarke. Futura Publ. Co. New York 1978 p. 64-70

    Demp PH: An anthropometric index for screening foot dysfunction. Current Podiatry. 28:6 1979a p.11-13

    Demp PH: A mathematical taxonomy to evaluate the biomechanical quality of the human foot. M.S. Thesis (unpublished) Polytechnic Institute of New York, USA June 1979b

    Demp PH: A correlation of length, width, height and pathomechanical quality in the human foot. Current Podiatry 31:8 1982 p23

    Demp PH: Biomechanical profile analysis of the foot radiograph based on mathematical modelling. Current Podiatry 32:10 1983a p15-17

    Demp PH:Mathematical modelling in podiatric surgery. A new approach to biomechanical evaluation. J Acad Amb Foot Surg 1:1 1983b p72-73

    Demp PH: A mathematical taxonomy to evaluate the biomechanical quality of the human foot. Mathl Comput Modelling 11 1988 p341-345

    Demp PH: A mathematical taxonomy to evaluate the biomechanical quality of the human foot. Mathl Comput Modelling 12 1989 p777-790

    Demp PH: Using conic curves to classify pathomechanical biostructure of the metatarsus. Mathl Comput Modelling 14 1990a p668-673

    Demp PH: Pathomechanical metatarsal arc: radiographic evaluation of its geometric configuration. Clin Pod Med Surg 7:4 1990b p765-776

    Demp PH: Numerical diagnosis of pathoanatomy in the human forefoot: A pilot study. The Lower Extremity 1:2 1994 p133-138

    Demp PH: Geometric models that classify structural variation of the foot. JAPMA 88:9 1998 437-441

    I'll come back to your radiographic interpretation of subluxation when I have more time.
  27. TedJed

    TedJed Active Member

    Thanks Simon,

    It looks like I'll be occupied for a while too now.

  28. Dananberg

    Dananberg Active Member

    From a slightly different perspective, the antropologist, OJ Lewis, published a thesis some time ago about the evolution of the human foot. He noted that it was previously believed that when primates evolved to upright humans, the hallux moved "in-line" to the lesser digits. He theory, however, filled with anthropologic references, was that the hallux (ie, medial column) was already "in-line", and that what needed to take place was a medial rotation of the LATERAL COLUMN. In other words, the lateral column rotated in a supinatory direction, creating the medial arch shape we have come to now accept. Considering that these two "halves" of the foot developed into a our modern day foot, maybe there is validity to the medial and lateral column theory.

    Happy holidays everyone.

  29. TedJed

    TedJed Active Member

    If primates evolved to upright humans, how come there are still primates around? Why did some evolve and others did not? :bash:

  30. Stanley

    Stanley Well-Known Member


    Primates evolved to match their environment and to fill ecological niches. Those that didn't do it well became extinct.
    The primate tree has several branches. http://whozoo.org/mammals/Primates/primatephylogeny.htm
    I am surprised at the question. It sounds like you do not believe in evolution.


  31. TedJed

    TedJed Active Member

    Hi Stanley,

    Hey, yes, I agree they would/should. My question is if humans evolved from chimpanzees, our closest genetic relative, how come there are still chimpanzees AND humans. It makes no sense to me that some of the chimpanzees would evolve and some wouldn't. Or woulld you say that some chimpanzees filled an ecological niche but others didn't? Does this explain why we now have chimps and humans? Hmmmm...

    I'm not 'creationist' in my beliefs.:pigs: I am yet to come up with or hear of a satisfactory explanation for the reason why chimpanzees still exist when they were supposed to have evolved into humans.

    We digress though... time to open another bottle, (or another can of worms).

  32. Chimpanzees didn't evolve into humans! And evolution is ongoing. Ted take a look here to gain a better insight as to how evolution works:
  33. TedJed

    TedJed Active Member

    And clarification from the journal 'Nature, May 2006' states:
    'A detailed analysis of human and chimp DNA suggests the lines finally diverged less than 5.4 million years ago.'

    Well, if we humans continue to evolve as quickly as this thread, we're in for exciting times!

    Thank you Simon,
  34. NewsBot

    NewsBot The Admin that posts the news.

    Here is the latest from Nester et al on the movement between different foot segments:

    Invasive in vivo measurement of rear-, mid- and forefoot motion during walking.
    Lundgren P, Nester C, Liu A, Arndt A, Jones R, Stacoff A, Wolf P, Lundberg A.
    Gait Posture. 2007 Dec 18 [Epub ahead of print]
  35. Brian A. Rothbart

    Brian A. Rothbart Active Member

    Hey you guys, now you are threading into my area. The columnar theory is pivotal in the understanding of the Primus Metatarus Supinatus foot and how to treat it.

    Basically we divide the foot into two columns, medially and laterally. However, it is the embyological division that we (Posturologists) refer to, which comprises the talar head, navicular, medial cuneiform, 1st metatarsal, and two phalanges.

    During the embyological development of the foot, the unwinding of the talar head takes the entires cartilaginous medical column with it, that is, the medial column unwinds as the talar head unwinds. If the talar head does not complete its ontogenetic torsional development, the entire medial column remains in supinatus. This can result in one of two genetic foot types: (1) Primus Metatarsus Supinatus ( http://www.rothbartsfoot.info/RFS.html ), or (2) Preclinical Clubfoot Deformity ( http://www.rothbartsfoot.info/PreClinCFD.html ). You can read an abstract of this paper at http://www.rothbartsfoot.info/PMsFootType.html

    Prof B
  36. :deadhorse:This is contentious; the study of McPoil et al. disputes the statement above (McPoil, T., Cameron, J.A., Adrian, M.J.: Anatomical characteristics of the talus in relation to forefoot deformities. JAPMA 77:2 1987 pp.77-81):sinking:
  37. Brian A. Rothbart

    Brian A. Rothbart Active Member

    My Dear Simon,

    Nothing contentious (as you put it) about my quote.

    It appears that you have not read my paper. I say this, becasue McPoil's paper concluded that there was no relationship between ontogenetic development of the talar head and forefoot varum. I agree 100% with his conclusion. However, the foot structure that I first presented and termed Primus Metatarsus Supinatus, is an embryological foot type very very different from forefoot varum. I believe this is quite obvious after reading my paper (Rothbart BA, 2002. Medial Column Foot Systems: An Innovative Tool for Improving Posture. Journal of Bodywork and Movement Therapies (6)1:37-46). When McPoil wrote his paper, he was unaware of PMS. This is obvious because his paper was published in 1987 and I did not write my paper until 2002. So please, when you quote someone, make sure you are quoting them accurately.

    Simon, if you want to discuss this in more detail, I would be delighted to do so. However, cut the diatribes and inflammatory comments that you have been so prolific with. It is so unprofessional and unbecoming.

    Prof B
  38. What I just can't understand is how you can name a type of foot after your own self, Brian. Within the 150 years of recorded medical history not a single physician, not even the many very respected and eminent physicians that are legends in foot surgery and biomechanics, ever had the audacity to name a type of foot after themselves, as you have. Not only do I think that this concept of "Rothbart's Foot", that you call it, is basically the same foot type that has been described by various authors for over the past century or more, but I also think that the whole idea that talar head frontal plane structural position contributes signficantly to the posture and function of the foot is ludicrous.

    Even more disturbing is reading your various websites and your ridiculous suggestions that your insoles will cure everything from female infertility to chronic fatigue syndrome. I feel very sorry for those many people who live in chronic pain and are desperate for medical cures for their condition and waste their hard-earned money by purchasing your insoles in hopes of curing their medical condition as a result of them believing the misinformation on your websites. Unbelievable!!
  39. Brian A. Rothbart

    Brian A. Rothbart Active Member


    I just can not understand why there is so much misinformation being generated.

    I, in fact, did NOT name this foot type after myself. This was done by others, and it just seemed to take off. Now Primus Metatarsus Supinatus is linked to my name all over the world.

    As I suggested to Simon, when you make a statement of supposed fact, make sure your information is correct.

    Prof B
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