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Ed of Mass fame has been going on about how foot posture is the most important thing in treatment plans.

ie improving foot posture.

Ive asked and well asked but Ed has never answered. But Ed and the Sole suppots Massive are not the only ones using posture when writing about feet in research.

So if and I say IF cause I´m not convinced posture of the foot is important.

What is normal Foot Posture ?

When is the foot ment to have normal Posture during gait? or are there various normal postures for different stages of the gait cycle ?

How do define or measure foot posture so that you can say the patient does not have normal posture?

How does foot posture relate to pathology ?

What if someone has perfect foot posture but still has pathology?

Theres a start, as I was writing the questions out - a thought came to mind, change foot posture to STJ neutral and we are back to the late 80´s.

Anyway Ed would love a few answers, or any other Massive types.

 

I'll play.

What is normal Foot Posture ?

I'd say its foot posture within 1 standard deviation of the mean for any given test of foot posture. By definition.

If we are assuming that foot posture is derived from a static weight bearing exam, then possibly never, and "meant to" is not really a statement one can make. Meant by whom? If we consider foot posture as a dynamic variable then yes, there would be a number of instantaneous postures during gait.

The only test I know which is validated is the FPI. However I don't know what a "normal" FPI score is. Certainly not zero.

I don't think we really know. Some foot postures have (I think) been shown to predict certain pathologies, but the relationship is neither exhaustivly described nor fully understood.

What is "perfect" foot posture? :rolleyes: . Normal is one thing. Perfect, quite another. Its normal for a 70 year old to have arthritic knees. Normal is not the same as good.

But otherwise, what if they do? Not all pathology is endogenic. Pathology can be caused by external factors. Or indeed internal factors unconnected with posture. Or trauma.

 

Mike,

This is too close to the questions that made me start reading on this arena and you are right, it takes you back in time. Too painful for me to be part of. It brings back bad memories!

 

This study showed the mean FPI to be +4. That certainly echoes what we see clinically in my opinion.

 

And for Afrocarribean feet? ;)

And for women?

And for athletes?

And for children aged 8-10?

Thats the problem with "normal". It depends on what group we are looking at.

N=...

 

Yep - all good points. (Although foot posture was not thought to be influenced by gender in the Redmond study).

You know we are on the same page re: 'normal'. But if we use the mean foot posture (+/- 1 S.D) as our definition of normal as you suggest, then I'd bet it'd be 'mildly to moderately pronated' and not 'neutral' as once thought. I certainly see that in clinics day to day, as I'm sure we all do.

http://www.japmaonline.org/cgi/content/abstract/89/5/258?maxtoshow=&hits=10&RESULTFORMAT=&author1=sobel&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

 

No doubt.

I don't know if Root ever believed that what he described as normal was normal in the mean distribution sense of the word. I get the impression that he thought of it more in terms of best structure than average function. It has left its footprints throughout the profession though. Normal is so often considered synonomous with ideal.

It strikes me that it is a great loss to the profession when so great a mind as Merton Root is lost to us. Not only for the loss of their future work, but also because it means we are left to attempt to interpret their meaning from their words.

 

Robert:

I attended many of Mert's lectures, Rich Blake was in contact with him a lot and Jeff Root obviously is an excellent resource. Between the three of us, we could give you a fairly good idea of what Dr. Root thought about different subjects. Ask away and I'll send a note to Rich and Jeff to see if they could offer their opinions also. This would probably be better started in a brand new thread.

 

I'm sure some time ago Jeff posted a pdf attachment which was a newsletter his father had written, and it was surprising to read that the way we interpret 'rootian theory' with respect to normalcy had been lost in translation. I can't seem to find it on my laptop anywhere (I'm sure I would've saved it) - anyone remember the attachment I'm referring to?

Ian

 

Ahh! Normal

Here's Normal - there's a web site http://normal.org/ totally Normal Illinois.
Evidence of normal here http://www.youtube.com/watch?v=utjLlBbXCdg
Only Normal people live here http://www.normaltown.com/ so presumably they also have normal feet - go check them out.

Dave