Dismay when reading recent paper on lateral heel wedge treatment for knee OA

If you have confidence in Root Biomechanics and that is the paradigm you use in you practice, that is your choice. Good luck with it.

If you wish to ignore the current research on foot embryology and how it is reshaping our understanding of foot function, that is your choice. Good luck with it.

 

In the 1970s, I was a strong advocate of Root Biomechanics. I published many papers in the American Journal of Podiatric Medicine on Root Biomechanics. Yes, I am familiar with their measurement protocol.

Rearfoot varus is a hypothetical foot structure. It is not an embryological foot type.

The behavior of the hypothetical rearfoot varus involves abnormal (gravity-driven) pronation at heel contact. The behavior of the validated medial column supinatus (the hallmark of Rothbarts foot) does not abnormally pronate at heel contact (e.g., hip drive pronation). That is, they behave entirely differently. They are different structures.

Just to set the record straight, I named the foot structure I discovered: Metatarsus Primus Supinatus foot structure (Rothbart 2002). It later became known as Rothbarts Foot as more and more researchers read my research and publications.

Rothbart, B.A., 2002. Medial column foot system: an innovative tool for improving posture. Journal Bodyworks and Movement Therapies (January)

 

Do you still contend that Forefoot Varum and Rothbarts Foot are the same structure? If so, go to the thread entitled Forefoot Varum, a Theoretical Construct, reply 3. I have outlined the morphological differences between these two foot structures.

If you are still in doubt, I suggest you review your notes on Foot embryology. You will quickly understand how Rothbarts Foot is an embryological foot structure, Forefoot varum is not.

 

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Do you still think Forefoot Varum and Medial Column Supinatus (Rothbarts Foot) are the structures? If so, I encourage you to read the thread entitled Forefoot Varum. A Theoretical Construct, Reply 3, in which I again delineated the differences between these structures.

How can you contend plagiarism when the foot structures are totally different? From your comments, it appears foot embryology was not one of your strong subjects.

 

I was describing a forefoot varus and you mistook my description for your "foot type". Clinically, there is no functional difference. We treat the foot in front of us, not the foot in the womb. This embryological hand waving is irrelevant to clinical treatment of the foot.

 

The useful parts of Root, Orien and Weed's ideas (STJ neutral position biomechanics) should be taught at the same time as tissue stress. The useful parts of neutral position theory are 1 feet are different and they don't all behave the same. 2 A partially compensated varus foot will affect the tissue stress. 3. Intrinsic forefoot valgus posting is useful in some cases. You are welcome to add any other parts you think are useful.

 

There is nothing more I can add on this subject. I have explained, and I believe adequately, how understanding the embryological development of the foot clarifies our understanding of the foot structures we are dealing with as healthcare professionals.

I believe the Biomechanical Postural Model is a flawed paradigm, a paradigm you appear to be a strong advocate for. Your commitment is laudable. I wish you only the best of luck.