Dudley Mortons Toe (and love of money) the root of all Evil

OK, I'm not going to turn into Robert here and post a dozen messages one after the next. However, this thread gives us a good opportunity to explore the biomechanical effects of a Mortons extension when used in isolation. So we put a shaft pad under the distal end of the 1st metatarsal extending to the IPJ of the halllux, what effects will this have?

Starter for ten, it will probably dorsiflex the first ray. The degree of this dorsiflexion will be dependent upon the thickness and stiffness of the shaft pad and the length of the metatarsal and of course, the dorsiflexion stiffness of the first metatarsal. It is likely that in static stance (at least) this will reduce the degree of 1st MTPJ dorsiflexion http://www.japmaonline.org/cgi/content/abstract/86/11/538. The consequences of this are...... Unfortunately, static weightbearing evaluation of 1st MTPJ dorsiflexion doesn't appear to predict dynamic angles http://cat.inist.fr/?aModele=afficheN&cpsidt=17996674. The shaft pad may increase pressure beneath the 1st MTPJ, this might lead to a medial shift in the Centre of Pressure, this could be good, or might not be.....

Over to you guys and gals.

 

Simon,

I have never put a pad into the distal ipj.

here is the difference, the pad starts at the met head and goes proximal down the shaft. this will lock the whole 1st ray limiting pronation. at toe off the foot will be much stable.

 

Nonsense

 

gentlemen,

I have come here with "clean hands" with some information that has helped many patients for many years. I was hoping you would try it to help your patients. Instead i am attacked for not bring "timely science" to the disussion. I have nothing to prove to you. All I am asking is for you to put a simple pad along the 1st metatarsal bone, yet this is improper to all of you.

Almost everyday of my life since October 1963, I have listen to "Bush House" for my news. I have read the Economist for over 25 years. Up to now my respect and love for the people of england was endless.

Cheers,
Dr. Burton S. Schuler,


P.S. my book is only #4 today on Amazon under podiatry, it was # 1 !!!, again yesterday

 

Am I supposed to be impressed? Try publishing "your idea" in a peer reviewed journal. Better, try collecting some research data, with your "pad" in position- then come back here and tell me it "locks the whole 1st ray"- utter cobblers.


Selling this crap might make you financially better off, but it doesn't make you any richer. I'm sure you'll sleep like a baby regardless of mine or any one else's views.

Now with your clean hands, try answering some of the questions put to you, as I said to the last clone of you-"bet you can't", he couldn't and neither will you.

And BTW, if you think that we have never used a Morton's extension or a shaft pad beneath the first MTPJ- you really are deluded.

 

So by inference you no longer respect and love the people of England because a handful of them dare question you. Castigate an entire nation because half a dozen podiatrists from there dare not to believe you? Boy, you're deep; I wished I could be deep as well as macho.

 

Simon,

I'm glad you joined in as you are far more articulate (and patient) than me and I was hoping you would succeed in getting Dr Schuler to answer some questions here and participate in some healthy debate.

I've relaxed, counted to 10, and decided to try and stop posting in threads that Dr Schuler is involved in. Rocking up on here telling all of us that he has all the answers but then is unable to discuss them any further than just copying and pasting the same paragraph into every reply is certainly not going to gain the respect of anyone irrespective of where they are from. On which note I apologise to all the people of England as I suspect I am one of the British trio who is responsible for the loss of Dr Schuler's respect and love... I wonder if they will ever be able to forgive us...

Currently there are 3 threads (including this one) in which Dr Schuler is 'preaching' to the Podiatry Arena community:

Dudley Mortons Toe (and love of money) the root of all Evil
No 1 Best seller
Pathology of the 1st metartarsal bone

Perhaps Admin should merge them? Then we can maybe try to get the good doctor to discuss his thoughts further than telling us about three 50 year old references (of which we were all more than likely aware of anyway)

 

Re: Pathology of the 1st metartarsal bone

That is absolutre rubbish. There is not one piece of evidence to support it. How do you explain all those feet that have a Morton's toe that do not pronate?

 

Burton

I can't pretend to understand what drives some clinicians to throw in the towel when it comes to lifelong learning and take up the mantra of evangelical horse**** - perhaps you will be kind enough to enlighten. Just when was your eureka moment? Was it when the marvellous Professor and saviour of all manner of moribund and catastrophic illnesses, Brian Rothbart, promised you all kinds of fame and fortune? Is it a benefit of procuring and selling his amazing proprioceptive insoles, because if, by association, you are simply another of his disciples seeking professional acclaim and adulation, I guess you have come to the wrong place. I note from a simple google search that you appear frequently together, indeed you feature widely on his website and elsewhere. http://rothbartsfoot.info/MortonsFoot.html
http://www.zaped.info/Morton's_toe
http://en.wikipedia.org/wiki/Morton's_toe


Please do us all a courtesy and stop trying to defend the indefensible by manipulating the theories of Morton to support the work of a conman.

Sincerely

MR

I WANT YOUR MONEY!

 

Burt:

Maybe I could help explain some of the reactions you have received here on Podiatry Arena so you can have a more pleasant experience on this website. It seems that you have found, as have a few other American podiatrists who have a financial interest in a product or method of treatment (e.g. Brian Rothbart, Ed Glaser, Dennis Shavelson) that many of the members of Podiatry Arena don't take too kindly to clinicians who have never performed research, never had research published, and have no academic appointments, coming onto the premier international podiatric medical academic internet forum and proclaiming the virtues of their product or idea that they have anecdotally found works for them.

You must also understand that many of the individuals who contribute to Podiatry Arena are the most respected academics in the world in podiatric biomechanics and foot orthosis therapy. These individuals are not a bunch of podiatrists, like so many podiatrists are, that learned a little about biomechanics and orthosis therapy during their time in podiatric medical school and have learned little more about biomechanics and orthosis therapy once they completed their training.

Therefore, for you to come on this academic website and proclaim that we should get excited about Morton's idea about short first metatarsals and "hypermobility" and as a result of Morton's 80+ year old ideas, put Morton's extensions under the first metatarsal heads of our patients [as if we have never done this many times before] is quite insulting to many who inhabit this forum. I suppose it would be like you going onto a website of the world's best automobile mechanics and telling them that you have found that changing your oil regularly really seems to help all your automobiles run better over the long run and that they should all try it sometime also. In other words, you are giving us old information, offering us nothing nothing new we don't already know, and have not yet shown us that you are at all familiar with the current controversies that have occurred within the field of biomechanics and foot orthosis therapy over the past 70 years.

Hope this helps you understand why you are being treated the way you are so that possibly you can get more enjoyment out of Podiatry Arena and learn some more useful and recent information about the subject which your "# 1" book discusses.

 

Re: Pathology of the 1st metartarsal bone

craig, out of respect for you, i sent you my book. i guess you did not look at it.
in the above quote "can" should replace will . Not everone with a Morton's Toe will have problems. What i am saying is this
It is now monday in melbourne, check the next 10 patients you see.
The majority of them will have either a short 1st metatarsal bone or hypermobilty (on xray) of the first . it is a simple concept? not everyfoot with a Morton's Toe will hurt, but the majority of the feet that do hurt will have these problems

 

Re: Pathology of the 1st metartarsal bone

craig

i need to know something
do the majority of your orthtics have forefoot posting ?
Dr. Burton S. Schuler,

 

Re: Pathology of the 1st metartarsal bone

I never got the book.

Never used a forefoot varus post in many years. The rersearch shows me how damgerous they are and my clinical experience shows me that forefoot valgus posts work.

 

Re: Pathology of the 1st metartarsal bone

I mailed you my book over 4 months ago because i value your opinion.

Please do me one favor, over the next week or two just check to see if most of the people you see have a short first or a hypermoble first.

Craig i have nothing to prove. It has been proven. It works.
looking foreward to hearing from you.

Dr. Burton S. Schuler,

 

Re: Pathology of the 1st metartarsal bone

Burt,

These types of statements are why you are receiving increasingly frustrated and cynical replies.

Perhaps you could tell us what you regard as "proof". Then maybe we could help you understand the current scientific meaning of "proof".

Burt, please don't take this as a critisism, but you appear to be extremely naieve with regards to biomechanics and what is a "belief" and what is a "theory" with some "scientific" basis.

With Regards

 

Re: Pathology of the 1st metartarsal bone

I never got it.

A first metatarsal that is somewhat short than the second is normal - that why its so common! I do not think you even know what a hypermobile first is. Are up up to date with the most recent concepts of "stiffness" and "hypermobility"? (I assume not, based on your writings)

You have proven nothing. I am familiar with almost all the research in this area and I have seen nothing that supports what you claim. (in case I missed the evidence, can you point us to it). I do see a lot of research that does not support what you claim and, in most cases, contradicts it. Are you familiar with that research? How do you explain it?

As the two threads have been merged, this thread is a bit confusing, but please read Kevin's message above.

 

Having just read through these threads again, perhaps it would be better to end them now rather than:deadhorse::deadhorse::deadhorse:

These Podiatrists are a distraction to the reason this arena exists. Rather than spend time discussing with them, and giving them air time they can use in their advertizing, I would like to get back to reading the real academic musings of Simon,Craig, Kevin et al.

 

Give me strength:bang:

You can't just say "its been proven" without showing the proof! And The musings of a clever man as recorded in a book are not proof! (I'm talking about Dr Mortons book there BTW). Nor are anecdotal reports of personal success, particularly when held against OTHER anecdotal reports showing the opposite!

OK. I'm going to try this one more time. Ignore the rest of my questions and try this one. Try hard to focus.

You observe that the majority of your patients

A: Have mortons toe

and

B: Have problems.

From this you extrapolate that they have problems BECAUSE of their mortons toe.

Now I've been watching my patients and I've noticed another pattern.

A: They all have a head

and

B: have problems.

By your logic I could extrapolate that having a head causes bunions etc.

CORRELATION IS NOT PROOF OF CAUSALITY

It is as logical (or more so) to state from your observations that "Pronation causes a hypermobile 1st ray" as to state that "a hypermobile 1st ray causes pronation". Or they could both be outcomes of a common cause.

Honestly, I'm interested. What is your thinking in presuming that pronation is caused by, rather than causes, a hypermobile 1st?

Regards
Robert

PS, and BTW you don't pronate because of a pathology. You pronate because you're designed to! Its not an accident, its a design. And not automatically pathological.

PPS

I nominate Mark russell for post of the year 2009 for this little gem!

Laughed so hard it hurt! Can I get a second?

 

Re: Pathology of the 1st metartarsal bone

Morton (Morton DJ. Structural factors in static disorders of the foot. Am J Surg 1930; 9:315-326) described hypertrophy of the second metatarsal as an associated finding in disorders of the foot related to a short first metatarsal. Harris and Beath (1949)
disputed Morton’s results based on an extensive survey of Army recruits (Harris RI, Beath T. The short first metatarsal: Its incidence and clinical significance. J Bone Joint Surg [Am] 1949; 31:553-565)http://www.ejbjs.org/cgi/reprint/31/3/553

Here is some more modern science:
http://www.ejbjs.org/cgi/content/abstract/86/7/1375

Like you said, "it's already been proven"- yes that's right, it has been shown to be incorrect.