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Foot Orthotics for 1st MPJ Pain

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Aug 28, 2010.

  1. NewsBot

    NewsBot The Admin that posts the news.


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    A case-series study to explore the efficacy of foot orthoses in treating first metatarsophalangeal joint pain
    Brian J Welsh, Anthony C Redmond, Nachiappan Chockalingam and Anne-Maree Keenan
    Journal of Foot and Ankle Research 2010, 3:17
  2. The conclusion a bit hard to undestand until you read the results.

    Change in moments/force acting on the joint, but no change in kinematics (motion).

    Indeed it´s all about force, not motion The call of Craig Payne, genius.

    Which would have been a much better conculsion ie Through orthotic intervention the altering of both the internal and external dorsiflexion moments acting on the 1st MTP joint a reduction in pain was noted, no kinemetic change was noted in both the 1st MTP or STJ joints.

    or something like that.
  3. CraigT

    CraigT Well-Known Member

    While I agree with you that this is a plausable and likely explanation, you cannot make that conclusion as I don't believe they measured force. You cannot make a conclusion about something that was not measured...
  4. Hi Craig heres the way I see it, will I agree with that they didnot measure forces, they came with the conclusion that Kinematics of the joint did not change and that only leaves kinetics .

    - when we look at joints we consider Kinetics and Kinematics of the joints.

    the above is taken from wikipeadia , maybe not the best source.

    while maybe no making a conclusion that in the view of the author this indicates..... and then further reaserch is required into this.
  5. CraigT

    CraigT Well-Known Member

    I am not sure why you think I need a explanation of kinetics v kinematics.

    I think the paper came up with a very clear and reasonable conclusion- they found that there was symptomatic improvement, but no kinematic change.
    You may then take this to suggest that the change, therefore, is due to kinetic change, but for the author to state this in the conclusion of such a paper would be incorrect. This may be part of the discussion in the paper, and, when you read the paper, the author does indeed state-
    My comment was simply to suggest that your statement...
    ... while being reasonable speculation, is not supported by the study (but also not disputed).
  6. Sorry Craig no offence was ment. Anyway have a good day or night, not sure of the time zones in Qatar.
  7. CraigT

    CraigT Well-Known Member

    No worries.
    We are only an hour ahead of European Summer Time.
    It is 8:20 pm and has been dark for a couple of hours- it is still, however 35c, but with 70% humidity my thermometer tells me it 'feels like 47'...
  8. Graham

    Graham RIP

    The problem here is did they make them "better" or just "different"? That is my primary concern with "pure" tissue stress theory ( I do remain a follower to a point :drinks). However, In reducing "stress" to a particular symptomatic tissue, how do you know you haven't initiated a different "pathological" stress to another tissue? After all, it may take years to demonstrate an adverse effect!
  9. This could be used to discribe any orthotic treatment, I would say. by adding a device the forces placed on the foot will change, which may mean increased on some tissue, decreased on others and some may stay the same.
  10. Graham

    Graham RIP

    Exactly! So how do we go about looking at +ve Vs -ve changes other than symptom relief? Anyone using F-SCAN care to comment.
  11. Good question, Graham. If they made them better, by definition they also made them different. The key is that none of us know the long term effects of our foot orthoses unless we follow a specific group of patients over time. I can say with anecdotal evidence that I have patients who have (thus far) been able to function pain free post orthotic dispensation, I also have patients who have developed new symptoms after their orthoses were dispensed. The question is; did the orthoses cause these problems? In some of them you can work out a hypothetical pathway using inverse dynamics, tissue stress etc, in others it appears more random and down to other factors. if you understand the mechanics of foot orthoses, it better arms you to spot the potential side effects of the devices you have dispensed.
  12. Graham

    Graham RIP

    No argument here! This arena and my own studies and practice has expanded my "tool shed" with "Sharper" tools. It all helps.

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