Forefoot Varus Predicts Subtalar Hyperpronation

Simon,

I was referring to the non-weightbearing neutral position cast used today by the vast majority of podiatrists. Although you aren't willing to, most podiatrists credit Root with developing the modern day functional orthotic. Root initially objected but later accepted others calling it the Root Functional or Root Type Functional Orthotic. A number of labs including mine still off methyl methacrylate posting as it is the most rigid post material available. We offer a number of other alternatives as well.

We manufacture several types of accommodative orthoses not listed with our other products, but as you know there can be no such thing as an accommodative orthosis since they also influence function. That's why we used the name Dwyer for the accommodate/functional (hybrid) device we make for Daryl Phillips. We also developed a TMA device that is unique in design. I think I will call my next new patented device the Tissue Stress Orthosis and start the late night t.v. infomercials asap! Times they are a changing!

Jeff

 

The point was he stared using methyl methacrylate for posting. And yes it was a material recommended by someone else. He popularized it.

 

Jeff, I see that you have now changed your original post which stated that your father "developed the functional foot orthotic" to read that he "coined the term functional foot orthotic"- this is probably more accurate. And indeed, you have actually changed pretty much most of that original post now. If that's the way you wish to play it...

He didn't invent non-weightbearing casting, as you inferred since I provided a reference prior to him at your request; he didn't invent the concept of intrinsic and extrinsic posting, I referenced this too; he didn't find acrylic because it was never lost and if memory serves your father referenced Bergmann labs as introducing him to this material and he wasn't the first to use acrylic rearfoot posts either.

Perhaps you should therefore revise the rest of the orignal post (I see you've done that now too) which I responded to in order to make yourself (and by proxy, your father) look better.:hammer: Well played, chap.:deadhorse:

 

Who are these individuals and how did they directly influence the design of the modern day functional foot orthotic?

Jeff

 

Sorry for changing my original post Simon after you had replied and demonstrated me to be wrong in my assumptions...?

Never mind.

Here's a lecture I gave a few years ago which provides a somewhat abridged history, I've had to split this up an convert to .pdf, so some of the fonts may have altered from the original. I apologise to anyone I left out as I was invited to provide a one hour lecture., sorry too for the multiple posts.

 

Nope, can't get the other parts to load due to mismatched token? I'll try again another day. Suffice to say, the names I already listed as making contributions along with Durlacher, Thomas, Roberts, Shaffer, Crandon, Morton, Sayle-Creer, Ogden, Smart, Levy, Rose, Root, Henderson and Campbell, Carlson and Berglund, Blake, Dananberg, Staats and Kriechbaum, Kirby and many others too numerous to name, all of whom have been part of the evolution of the functional foot orthosis.

 

Correction Simon: Though Reed advocated a NWB type of cast, I don't think you'll find it being advocated being done with the STJ neutral nor with the MTJ fully pronated. The pictures Reed published definitely show the toes dorsiflexed, something that is definitely anti-Root. We can find bits and pieces of the Root technique scattered throughout the literature, but "the Root hypothesis" is what made Root's orthotic unique. Find me a paper before Root that puts the joints of the foot in the position Root advocated.

Thanks
Daryl

 

Jeff:

What I'm complaining about is not so much about my professors, since I respected all of them and they taught me a lot, especially John Weed, Ron Valmassy and Rich Blake. What I'm complaining about is that we were taught that there was only one right way to make orthoses, only one way to do an evaluation and that was the Root et al method. We were taught that cork and leather orthoses were "not functional" and were discouraged. We were taught that any material short of Rohadur was "not functional" because it was too flexible. We were taught that forefoot extensions made the orthosis somehow "less functional" since we were then making an accommodative orthosis. We we taught to not invert orthoses since this would somehow cause harm to the foot. We were taught that once the calcaneus pronated farther than 2 degrees everted, that it would always pronate to the maximally pronated position. And the list goes on and on.

In other words, I would have appreciated a more open-minded approach to teaching biomechanics and foot orthosis therapy and less of a dogmatic approach where if Mert Root didn't say it or agree with it, then it shouldn't be done or thought to be true. This atmosphere of "Root dogma" pervaded the teaching of biomechanics and foot orthosis therapy at CCPM for years until Rich Blake came along and dared to do his inverted foot orthosis (which a few of the professors at CCPM thought he was going to hurt people with) and until Eric Fuller started teaching subtalar joint axis/rotational equilibrium theory after I left CCPM to start my private practice nearly 30 years ago. Eric can tell you of the personal conflicts and fights he had trying to teach the same subjects we all give nationally and internationally now within the CCPM biomechanics department.

All I'm looking for is an honest appraisal of what we were taught and how it was right and wrong, and not a continual "reconstruction of history" all being done with the purpose to make Mert Root look better than he really was. All one needs to do is acknowledge that much of what Root and colleagues taught us all over the years was simply wrong. That is, I believe, the best way forward.

 

No, and the original post made by Jeff claimed that his father was the first to use non-weightbearing casting, no further caveats. This is patently not true and amongst the reasons why Jeff subsequently edited his post. Bad form, Daryl. Bad form.

 

Yesterday I scanned and tried to upload an interview with Merton Root from Podiatry Today but I ran into the same error message (a security token was missing or mismatched) so I gave up. The day before that I was rear ended while stopped at a stoplight while taking my wife's car in for new tires so my time has been occupied with other things than trying to figure out how to upload a stubborn file!

Jeff

 

So shoot me for not writing suspension neutral subtalar joint position cast with the midtarsal joint fully pronated.:bang:

 

Look no further than here tonight, with Jeff changing his post about four posts later, rather than admitting that the claims he made regarding his father's contribution's were massively overstated. Rather than concede the moot points, he changed his post.

 

I'd rather not shoot you for anything. However, changing your whole post which originally stated all of these things you believed your dad invented, when in reality he invented none of them as I demonstrated= bad form, Jeff.

Like Kevin said we don't need a squirming:

I'm reminded of a quote from Bill Hicks: "They believe the bible is the exact word of God - Then they change the bible! Pretty presumptuous, hu huh? "I think what God meant to say..."

 

He did invent the modern day functional orthotic! Bang, Bang!

 

No he didn't. End of Story. You American's and your guns. For example, the modern day foot orthotic might be made from a scanned foot and 3D printed, did he invent these processes too? In case you hadn't noticed, this isn't the 1970's

 

The modern day functional foot orthotic was invented/developed by Root just as the Blake Inverted orthotic was invented/developed by Richard Blake. Both were made according to a unique manufacturing protocol and specifications that can be traced back to the developer. It doesn't matter of some elements of these devices can be found in preceding devices, they are unique in design and that is what matters.

Jeff

 

Coincidentally, last night my son and I both purchased new guns.

 

And elements of your father's design can be found in those that preceeded his Jeff so they are not unique in design.

I don't get it. My dad was an OK kind of bloke, yet I don't feel the need to constantly make out that he was some kind of hero and saviour, nor to make out that he invented things that he didn't, but then I have no financial gain from making such claims. Why do you feel the urge to do this with your father, Jeff?

The last slide of that lecture on the evolution of foot orthoses therapy reads: Ecclesiastes 1:9

What is that which hath been?

It is that which is, and what is that which hath been done?

It is that which is done, and there is not an entirely new thing under the sun.

Your father was part of the evolutionary chain in foot orthoses development, nothing more nor less. Many modern foot orthoses are no more evolved from your father's ideas than those ideas of any of the others who have contributed to this field. Stop overstating his importance to modern foot orthoses therapy. Until relatively recently, no one had heard of your father in central Europe, it's only through Kevin, myself and others lecturing over there in the last 10 years that his name has even been applied to foot orthoses. Yet they have been making what they would consider successful foot orthoses for far longer than that despite not knowing anything about your dad and certainly not employing anything he said.

There is a big old world out there, Jeff- go read it.

 

Actually, Simon, I believe I was the very first clinician to make an orthotic for a real patient, from beginning to end without any plaster, it was fully digitalized. It all started in 1983. I can give you all the details when we get together sometime. I believe I've related some of the story to Craig Payne, Jeff and a few others. BTW, Root didn't have any input into the process.

As an aside, in regards to the hottest topic on the west side of the Atlantic today -- it turns out those blokes in Boston haven't been playing by the rules for over 200 years. Imagine people not dressing up in bright red coats, not marching in straight lines, hiding behind trees and shooting their own non-government issued guns at the king's regulars. Yep, it started in Boston.

Have a good evening.
Daryl

 

You seem to have a weird hang-up here, Daryl. There is a shop in Plymouth called "Westward Bound" which might suit you sir.

Meanwhile...

Lets take a look at Kevin's call:

Perhaps, Jeff and Daryl could make a list of the thing's Merton Root said that were wrong...

 

Actually, I doubt it Daryl, since in the very early days foot orthoses were frequently made from begining to end without any plaster, relying instead upon direct measurements from the foot. You may have been one of the first to use a digitiser. But once again, lets not overstate our significance here.

 

You said that out loud, it's nothing to be proud of by the way. Tonight, I purchased a bunch of flowers, since it would have been my late father's birthday. You can keep your gun's.

 

With this statement I think you just proved that you aren't Simon.

 

Why, is the grammar correct?

 

You edited your post!

 

But not after you and I had both responded and replied twice to one another- that's the difference.

 

Apparently you haven't heard of Raymond Anthony, his Rx Orthotics Lab founded in the UK, his Biomechanics Summer School nor his 1991 book titled The Manufacture and Use of the Functional Foot Orthotic which starts off chapter 1 with " The functional foot orthosis was pioneered by Dr. Merton Root, DPM between 1958 and 1959. By his own admission it was developed by trial and error, beginning with an oak wood flour and latex spatulated onto a leather-covered neutral position cast of the foot".

I realize that you have probably never heard of Ray Anthony given your comment about the lack of Merton Root's recognition until you, Kevin others were so kind as to make him know in central Europe, but Ray, who came to the California College of Podiatric Medicine to learn about orthotic manufacture had some impact on European Orthotics and biomechanics. You should check him out!

Jeff

p.s. I guess we will just have to take your word for it that your father was an okay kind of bloke.

 

I hit reply and was suddenly called out into the lab. I came back to my desk and proceeded to type and send my response but you had since edited and removed your comment that you are a better man than I am. I was responding to your unedited comment, which for some reason you felt the need to change.

Jeff

 

Originally Posted by Jeff Root View Post

Simon,

My father coined the term functional orthotic. He developed the non-weightbearing casting technique for the functional orthotic. He developed the use of Rohadur for the functional orthotic, and used the first semi-rigid material other than steel to the best of my knowledge. He developed intrinsic and extrinsic posting for the functional orthotic. He found methyl methacrylate and used it for posting. If he didn't discover the functional orthotic, then who did? Where in the literature is the term functional orthotic used prior to Root?

Jeff

Simon,

I certainly didn't change or edit my post above. The quote by me above was one made in follow up to my original post in which I said the my father invented the functional orthotic. For some reason, my original post appears to be gone. Don't know why or how, but it's gone!

Jeff

 

I guess you don't realise that the UK isn't part of central Europe, Jeff.

 

How strange.

 

I looked up the website. Sorry I don't see any connection between this shop and my comments.

I'm not sure why you want to make this a personal thing, of trying to tear down any person in history to the size you want to make them. It doesn't make you look bigger or smarter. I could do this with any historical person. George Washington (I realize that Simon, you consider him a traitor) is one such person that great historians either demonize or sanctify. People today judge him by the standards of our day and vilify because he was a slave holder. But by the standards of his day he was way ahead of his time and stood head and shoulders above all his countrymen. In fact he may be the only person in history to voluntarily give up being supreme commander of the military three times. That says something about his character, he was not power hungry.

Instead of bringing up Root's warts, I will instead praise a few of the people I admire, who came before Root, who were people ahead of their time, whose work was needed by Root and is still having a major influence on us all: Royal Whitman, Sir Arthur Keith, Dudley Morton, Russell Jones, Wheeler Haines, George Perkins, John Manter, Paul Lapidus, are just a few. I know you have your short list too. I have listed many things in these postings as well as many others that Root didn't do and there were some things he said that were just plain wrong. I think you read the letter he wrote to me, showing that he was very aware in the early 80s that the 2 axis model of the MTJ was not accurate. Because I knew him personally, I found him not to be the dogmatist, though I admit that in public he was. I had the advantage over Kevin in those early years of our careers, I came to Mert as a friend of Milt Wille, the one man who really had successfully challenged one of Root's tenets, so Mert may have been much less dogmatic and had more of an listening ear than he did with the young upstart Kirby. Interesting that I found Chris Smith to be more dogmatic than Mert Root, yet Kevin had a very different experience, which I gladly accept, because I really do want to have good feelings about Chris, and recognize the good he has done in this world.

I realize, Simon, that you feel that the Root pedestal is much higher than it should be, but you throwing stones at it isn't going to be what diminishes it. I am reviewing this week a paper submitted to a peer reviewed journal, in which some decent biomechanists (I don't know who they are) have as their basic tenet to tear down what they feel is a cornerstone of Root theory. Only problem is, they misquote Root all over the place in the article, take quotations out of context, and basically set up a straw man argument that Root was wrong. It's not a bad little bit of research, but their conclusions that "Root was wrong" does not reflect well on their own scholarship. If you want to decrease the size of the Root pedestal, then do more writing yourself. Only by producing literature yourself that people find more valuable in the future will you diminish the name of Root. Kevin has done a good job so far, but he's got more in him still. I hope to have a little more in me. A quick search of scholar.google.com shows that you have two articles published so far (which doesn't count your dissertation), both with Kevin. I don't believe that this is representative of your true talents and capabilities. I have discussed with you already your talent and interest in finite element analysis of orthotic deformation characteristics, and you know of my great interest in this subject as well. This is a subject that I don't remember Root ever addressing. I have to give credit to Bill Olson for starting me to think about this important subject.

Most of my criticisms of Root are not things he was blatantly wrong about, but things he didn't address. The longer I'm in practice, though, and the more I study, the more convinced, though that the two things I mentioned before I think he was basically right on the money, even if they need a little tweaking.

Have a good day,
Daryl

 

Not sure if this has ever been addressed, but with quite a few who meet and discussed biomechanics with Root.

Why did they not included windlass and the work of Hicks, seems a major miss from where I sit

 

You'll have to ask Mert that next time you see him. :dizzy:

He was aware of the plantar fascia effects, but certainly didn't spend much time discussing it. Guess he may just have been human too, picking the topics he thought were most important at that moment in time.

Best wishes,
Daryl

 

wasn´t a pot shot at anyone, just a question

 

Daryl:

I don't need to speak up for Simon, but we have discussed this subject between the two of us quite a bit since we have both spent a considerable amount of time analyzing the history of "podiatric biomechanics" and the evolution of foot orthoses. In fact, we both gave lectures on the history and evolution of foot orthoses at the 2012 Belgian Podiatry Lustrum Conference in Ghent, Belgium nearly three years ago in March 2012. I know I spent at least 20 hours researching that lecture and I know Simon felt he had also spent at least this much time. So we both have come to our own conclusions about Mert Root and his place within the development of foot orthoses and podiatric biomechanics theory from our research and lectures on this subject and we are very much in agreement about this.

I don't understand why you think that Simon (or myself) is trying to "make this a personal thing" or trying tear down Mert Root and his accomplishments. Could it be that you and Jeff continue to give Mert Root credit for more than he really accomplished? I think so. Could it be that, when our discussion is viewed by an informed outsider who doesn't have a familial relation or strong emotional attachment to Mert Root that Simon and I would seem to be more objective and less subjective and emotional on these subjects than you and Jeff are? I think so.

You accuse Simon of making "this a personal thing" but to me, I feel Simon is being more objective about this subject than either you or Jeff are. Rightly so, Jeff is defending his father and his business which has their name on it and you are defending Mert Root because you respected and admired him so much.

Ever see a mother think their son was the best player on the soccer pitch or on the baseball field? I have...all the time. Are these mothers being objective about their sons? No. However, their emotional ties to their son prevents them from being objective. In much the same way, neither you or Jeff, I believe, will ever be able to be sufficiently objective about Mert Root and his accomplishments since you have just too much emotional attachment to the man to allow a fair appraisal of what he accomplished and did for podiatry.

This is just human nature and not a character flaw since I respect you and Jeff otherwise for your opinions and thoughts on these matters. Maybe we should let this discussion rest for awhile before we all get too carried away. Maybe we can have a conversation about biomechanics without mentioning Mert Root every other paragraph...now that would be refreshing for me....and probably many of the others following along.

 

Mike,

This is a good observation. I'm not sure that the windlass mechanism is even mentioned in Normal and Abnormal Function of the Foot. Something in the backof my mind says it was mentioned once but I can't be certain. I know it was discussed in Root's lectures but I can't remember exactly when I first heard it discussed by Dr. Root. I don't think many podiatrists really appreciated the importance of the windlass mechanism until perhaps the late 1980's or early 1990's. Perhaps Kevin can provide some insight here.

Something or someone popularized attention to the windlass mechanism. My guess is that it was Howard Dananberg and his lectures on functional hallux limitus (sagittal plane theory) who really got people thinking about the importance of the windlass mechanism. Although plantar fasciitis is extremely common, I think Root et al were primarily focused on muscle function and osseous motion, position and deformity (osseous pathology) more than anything. This is why I do feel that tissue stress makes an important contribution to our understanding of symptomology. However, I don't think the two are mutually exclusive and on the contrary, they go hand in hand. In my opinion, we do need an updated version of the role of muscle and osseous function. In his first book (perhaps the others too, but I recently looked at his first book so it is fresh in my mind), Kevin does a nice job of describing the influence of some osseous conditions without making compensation for these conditions as absolute as it come across in Root's book. This is one reason why I encouraged him to write the next book on lower extremity and foot biomechanics. Just out of curiosity, when did you graduate from podiatry school? I find it interesting how years in practice influences one's view and historical perspective on some of these topics.

Jeff

 

Jeff:

Both Simon and I know Ray Anthony very well. I lectured for Ray four times in Heythrop Park, Oxfordshire, UK, for his Biomechanics Summer School in 2000, 2001, 2004 and 2007. Simon also has lectured for Ray and we do communicate privately with each other by e-mail on and off. To be honest, the reason that Ray probably had me lecture so many times in the UK was because I did not lecture on Root biomechanics since he wanted a fresh perspective on foot and lower extremity biomechanics. In fact, at the Biomechanics Summer Schools, Root biomechanics was rarely mentioned, except as a historical perspective. Here is a photo of Simon, Ray and Bruce Williams from a recent conference where Daryl and I were also at in Orlando, Florida. Bruce, Simon and I all lectured at that ACFAOM Meeting.

 

But this is the best photo of Simon from that seminar in Orlando...

 

I don't believe for a moment it's Simon. Looks more like his evil twin, Rambo Spooner. Just don't know where he's hiding his guns?

Daryl