Foundational Wellness Biomechanics: 2011 Abstract

How does that principle apply to this type of gait and functional foot posture?

Dave Smith PS here is the youtube link (how does the embedding work?) http://www.youtube.com/watch?v=r_C8qTkL-jk

embedded Video for Dave - Mike

 

I only just figured it out.

its [ youtube] the bit after the = in the link [ /youtube]

so your link was

http://www.youtube.com/watch?v=r_C8qTkL-jk

so the bit between the youtubes would be

r_C8qTkL-jk

As in (without the spaces after the first brackett [ youtube]r_C8qTkL-jk [ /youtube]

 

Dave I embedded the video for you

to enbed you need the youtude code you vide had the code r_C8qTkL-jk

then you click on the insert link thingy

in there you type [ youtube] insert video code here[/youtube]

and that should work - obviously you don´t write insert video code but paste the code in with no gaps anywhere

Hope that helps and works !

 

1. Ok (static stance is static, so are buildings, can see the logic).

2. Why? Why midstance? What is special about midstance? And given that midstance is only static as an instantaneous snapshot (eg not static at all) how is a model based on something specifically designed to be rigid and static applicable to a structure with dynamic moving parts?

Whenever you take the snapshot, it comes back to the same problem. Architecture is largely static. Engines have moving parts and are designed to do more than just not fall down. The foot has moving parts and is designed to do more than not fall down. Ergo, engineering terms are more applicable than architecture.

 

And thats kinda the point. That building could not just be propped back up! Nor is it designed to fall over, then come back up, then fall over, then come back up.

 

Robert

Great pic, how did you come across that one I bet the people living next door are feeling a little nervous.

Dave

 

No one lives there yet! Its a new build in china. Somebody forgot to carry the 5 in the planning stage (or something) with the result the the building was sat on a hollow space (car park) which was not reinforced.

It just... fell over.

 

It was designed by an architect but the plans weren't checked by an engineer.

 

Just following and wanted to say excellent point.
But as Robert eluded to earlier I'm curious as well to the importance placed on midstance.

 

Mr. Smith symbolizes the worst of The Arena.

In discussing Static Stance and Midstance, he shows a video of heel contact gait (The Arena Default) and a foot type that is unfixable non operatively for all of us (isn't it)? What would tissue stress do for this foot Mr. Smith or Robert or Eric or Kevin or Craig?

His purpose is not to share, to exchange to expand but simply to make me and anything I say look like an Ass.
I feel so sorry for him. I feel pity, not anger or the desire to retaliate.
Robert took the time to find a picture of a building that collapsed, not one that has stood for centuries as he could have easily displayed in order to visit the notion that although biomechanics is a physical, biological and engineering phenomenon, it's foundation is a structure that has an Optimal Functional Position from which to be engineered. Shame on you Robert.

Eric states that he (no bias here) wrote an article in 2000 on the engineering of the windlass (I read it in 2000....anything new?) and that his model "works" for static stance and in midstance, case closed...we don't have to look at any alternatives...simply use STJ Neutral and find ORF's that will stop a presenting complaint and voila..even if it means pronating a pronated foot with lateral wedges to relieve medial knee pain,,,we have EBM and tissue stress.

Root knew his stuff would evolve in 10 years. Eric is still fighting to keep his alive and in his control a decade after his now stale and infantile article.

I will try to start a new thread on the subject of static stance/midstance and BioArchitecture and lets see where you guyz/gals let it go.

I dare you to be open minded and have the gumption to chastise Mr. Smith and Robert when they tend to divert and minimize the thread instead of allowing ideas to be examined and judged.

Dennis

 

Ya, Don´t Dennis - I would suggest the best way forward re discussions of Bio-Architecture is not on the Arena at this stage.

Get your FFT paradigm published in a peer review journal, pictures definitions etc - then people can read it and then discuss the paradigm.

That is the only way forward from now IMO.

 

Ya don't Get it Dennis.

Dave asked How the principle (architecture) applied to the type of foot shown. The type of foot shown is collapsed and looks fixed and unrecoverable. As is the building. Hence for me to have shown a building still standing would not really answer the question of how the foot shown is expressed in architecture would it?

Which, I believe was Dave's point as well.

What position?

We agree that the joints of the foot, lets say the STJ, operate within a range not in the same position throughout gait right? What point within that range is the optimal position?

The talo crural joint operates in a range between, lets say 90 + 5 degrees dorsiflexed and 90 - 20 degrees plantarflexed (as a hypothetical). The "optimal" position of the talo crural joint (if such a beast exists) therefore depends on the point in the gait cycle. At heel lift, optimal might be 90 + 5 degrees. But that would not be the optimal position at, for eg, midstance. What is the optimal position of the TC joint? There is no such thing! An optimal range perhaps. Position, no.

The same is true for all the joints in the foot. Even if we accept the concept of optimal position (we don't), it will be different depending on the point during the gait cycle. Where then is the "optimal" point for the Calcaneo cuboid joint? Or the cuniform / 1st met joint? Or our old friend the sub talar joint? The most supinated? The most pronated? The mid point between these? The point it is at in mid stance (which will be close to maximally pronated)? When you say "position to work from" I'm afraid I don't know what that means!

That is the problem I have with achitecture as a model for the foot. It stays still! Its designed to stay still! The foot CANNOT stay still during gait.

 

Mr Smith doesn't need to try very hard to make you look like an ass - you do an admirable job of that yourself. Both Mr Smith and Mr Issacs sh!t more sense than you will ever muster, Dennis, of that I have little doubt.

 

Contender for quote of the year, again?

 

I've long since learned not to read any of Mr Russells posts with a mouthful of anything...

 

Everyone else thinking it , mark just says it

 

Obviously not directed at Mark...just reminded me of the `tongue in cheek` smiley....

 

What has happened to this arena? So much personal attack........ I have been known to be more than critical on more than one occassion - but it was and never will be personal. Where did we lose our direction?

 

Mr Shavelson, Heel contact gait is not a phenomenum of the Arena it is the most common gait progression pattern, or do you not agree with that?

The foot shown is 'unfixable' only if your criteria of 'fixing' is in terms of a paradigm that says that pathological functional foot posture = pathological conditions of the foot.

This does work if you define pathology of the foot as abnormal foot posture but that a just a tautological argument.

However from your statement above it appears to be your proposition is that: pathological foot posture = pathological feet - ergo - if you can't reinstate the foot to a non pathological posture then of course the foot will remain in a pathological posture!! DoH! :dizzy:

Since our discussions on Podiatry view and after reading podiatry papers on foot function and pathology from the 70s 80s and 90s I am beginning to understand your point of view. Let me explain:

In the past, many have tried to correlate pathology with functional or static foot posture in open and closed chain and all their permutations. There was a great struggle with this postulate mainly because each system's/paradigm's measurement criteria were unreliable and unrepeatable and so defining a foot posture that was communicable was difficult and led to confusion about the actual correlation of posture to pathology. This is where you came in:

You have tried to devise a system (successfully you would say) whereby the classification is clear and the definition of a certain foot position is unequivocable and the measurement unambiguous - ergo - if the classification and measurement systems are absolute then it becomes much easier and reliable to correlate foot posture to foot pathology and so your FFT system appears to fulfil and satisfy the quest for the holy grail of podiatric biomechanics at that time, started by those folks such as Hicks, Hiss, Root, Inman, Mueller and others, et al, etc, because, of course it's (FFT) measurements are accurate and repeatable..

Therein lies the problem or two problems, several problems actually.

First is the assumption that pathological foot posture correlates = a pathological foot - is that correct? – Yes of course it is.

Does a given foot posture correlate with a particular tissue pathology? Maybe, but arguably not and not always perhaps!

Even allowing that assumption (a given foot posture = a given tissue pathology) then:

The second problem is that although your system can be said to be accurate in its measurements of each foot classification, it is not at all precise.

E.G. It is accurate to say the distance to the moon from the earth is between 200 and 300,000 miles but it is not very precise. A precise figure like 283,390 miles for instance would have to account for many variables such as orbits and the relative positions of the two.

Your system allows a lot of variation within classifications and therefore there could be many / any number of positions within that range and so therefore any number of classifications of foot type.

There is also the problem of defining where one classification ends and the next begins, both in terms of precise measurement and of segment orientation.

If you precisely define the point of change from one position classification to the next then you hit on the problem that others have had in the past, i.e. inter and intra clinician reliability and repeatability.

Problem is, Mr Shavelson, that at about the same time, Some of the podiatric biomechanics community, who were up early, after being given a wake up alarm call by Kevin Kirby et al, upon seeing something on the tracks approaching the Podiatry station, caught hold of the real Biomechanics train and started a journey, at high speed, off to a new destination. Their journey was to consider the connection between Tissue pathology and the forces applied to them. What is the 'mechanism' that causes pathology in the tissues? I.E. They started using Mechanics to analyse the mechanism that causes excessive tissue stress levels in the pathological tissue of interest.

(Edited out that last paragraph as I felt it was a bit unnecessary and done with a spiteful spirit)


Regards Dave

 

Tissue stress would do more for this foot than functional foot typing. Dennis as you've described functional foot typing, you would type this foot and then give it an arch support (centering). You have not described how this arch support would differ from the arch support from any other type of foot.

Tissue stress would analyze this foot. Looks like an extremely medially positioned STJ axis. And then change the orthotic prescription to increase supination moment from the ground. If the orthotic was insufficient we would look to other devices that can add supination moment.

Dennis, the age of the article has nothing to do with how good it is. The Hicks articles from the 1950's are still good. Even though the article is old the information in it can still be relevant. Old articles become stale when their flaws are pointed out. Dennis, calling an article infantile, without explaining why, really is childish.

Eric

 

Eric, I'm sorry I used the word infantile in that it does not go to the limits that you stretched reality in a biological sense in your 2000 article in order to prove your Newtonion definition of Applying The Windlass Model to the foot.

You talk about a living, functional, mechanical system as to the applicability of your theory and work.....

Then you discuss your model in static stance..... because acceleration would be difficult to measure and it varies and.... so in your article, there is no movement allowed.

Then you further state the premise that we should fantasize as: (see image from early on in your article)

Paraphrasing your words:
Lets assume there is no muscle contraction in the rest of this article (the biological system is dead) and we wiil only discuss gravity and grf and proceed to act as if you are discussing BioMechanics not a dead, immobile, nonliving entity.

Static Stance....no acceleration, no muscle activity.... "a position in which no muscle activity is required". Is that neutral position, Optimal Functional Position or Fuller's Position? Can you describe that position, measure it, put a foot into that position in real life? Any EBM?

I think infantile is kind.

Dennis

 

Actually, I'm sat here wishing I had popcorn to hand so i can sit back and truly enjoy this thread.
More fantasy than I get for $ at the cinema

 

Classic straw man argument. Of course movement is allowed. Acceleration is not difficult to measure and is accounted for in Newton's laws. Force = mass x acceleration. Moment = moment of inertia x angular acceleration. It is much easier to explain, to those that try and understand it, when the acceleration is zero. The physics still works when the acceleration is not zero.

Experiments done on loaded cadaver limbs use this position all the time. The Hicks articles do this. It's the position the foot rests in when no muscles are acting. It can be achieved in a living person. When you add the force from a muscle you can take that into account. I don't understand the problem you seem to have with this concept.

This concept looks at the bones and ligaments as they would be in real life. It doesn't try to cram the bones into a hypothetical construct like a vault or some other architectural term. Analysis in this position can help us understand the causes and treatment of pathology. The use of architectural terms to describe the foot does not add to understanding. Dennis, take that as a challenge to prove me wrong.

Eric

 

My point Eric, is that Hicks and yourself are describing an Optimal Functional Position where the first ray rocker of The Windlass is working freely and the plantar fascia is taught enough to raise the arch as demonstrated by Hicks.
In your estimation, how many feet presenting with biomechanical faults are in their OFP and have a Windlass that works as well as Hicks cadavers or your drawings?

I'm sure the cadavers were placed on the ground stretched out enough to make the PF taught enough for the windlass to work by the researchers.
Your drawings are similarly ideal but do not exist very often clinically in my opinion.

Now, lets take the flexible forefoot foot types, where the first ray has dorsiflexed all its life reacting to dorsiflectory stiffness moments inherent typically allowing the plantar fascia to stretch to a pathological length. Now lets combine that with a flexible rearfoot foot type where the CIA has collapsed all of its life stretching the plantar fascia from the the other end, pathologically.

That patient, in stance would have a first ray rocker that doesn't rock (advanced fhl) and a plantar fascia not strong enough to lift up the calcaneus into a higher CIA or lower the first ray and its Windlass would neverendingly fail (I refer you to Mr. Smiths video).
P. tibial would try very hard to raise the medial vault but fail and so PTTD. P. longus would be so poorly leveraged that it couldn't provide a plantarfectory stiffness moment to the first ray strong enough to raise the forefoot vault. Goodness, now we would have pathology predicted by foot type!
Flexible/Flexible cadavers would produce a different result for Hicks. Their drawings would look comical in print as part of your article.

Wellness Biomechanics, by placing that foot in a more vaulted, closer to OFP position, raises the CIA and drops the first ray, foot type-specific utilizing a Centring and then by additional training, strengthens P. tibial and leverages P. Longus enough so that over time, Wolf's and Davis's Laws "Reverse" some or all of the damage done by the lengthening, widening and collapse of that foot during its Biomechanical Lifetime.
This allows that foot to morph into one with a more OFP even after the orthotic prop is removed. The plantar fascia and friends can compensate positively and shorten and the first ray rocker begins functioning again and your tissue stress theory is left in the dust waiting for its next clinical painful compensation.

The difference between the two of us is that I know so much about your work and you know so little about mine and I remain totally comfortable with that. I haven't asked you to spoonfeed me your theories, I examined, inspected and tested them on my own. You are still waiting for answers from me. Maybe you should try holding your breath.

Way back when (2008, I think) I offered you (or Kevin) or someone else a clinical challenge on The Arena and the reaction from the group was that challenges were not to be taken seriously and we were all clinical peers.

Now you recant and offer me a challenge stating:
"The use of architectural terms to describe the foot does not add to understanding. Dennis, take that as a challenge to prove me wrong".

Let's get it on once and for all Eric.

I will be at The NY Clinical Conference the end of January. I have a stage rented to do demonstrations all day on that Saturday of The Conference.
I challenge you to present yourself and we will let innocent random subjects (lets say 4 of them) unknown to either of us be examined, diagnosed and given both immediate ORF care and then casted and prescribed foot orthotics which can then be evaluated for effectiveness and even long term results and followup. I will have it videotaped at my expense and place it on YouTube for all to see.

Let's see who will be the fool in public Dr. Fuller. You have ten days to reply and two months to prepare.

I will remain silent on The Arena until you respond.

Dennis

 

Eric:

:bang::deadhorse::drinks

 

Eric

We haven't met personally yet, however I would like to inform you that I am six foot four inches tall and 288lbs in weight and can manage forty four single arm pull-ups with my weaker arm without a break. Should you respond to the above, I will find out where you live and I'll be on the next airplane to pay you a visit which you will not enjoy terribly much.

Just so you know.

Kind regards

Mark

 

I'd say that in itself is an epic challenge, Dr. Sha silent; cataclysmic world events...cats and dogs living together and NY ravaged by the Stay Puft marshmallow man!

http://www.wholesalehalloweencostumes.com/kids-costumes/boys-costumes/tv-and-movie/boys-inflatable-ghostbusters-stay-puft-costume-884331R.html?CAWELAID=931269656&cagpspn=pla&gclid=CPucn8_z3qwCFe1dtgodpzdjHg

Not everyone's new ideas are met with opposition and criticism as Dr. Sha repetitively drones on about. Consider this thread:

http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=68145

All very civil and light although we don't know much about the product. The gentleman is performing testing, a reasonable idea rather than just habitually attacking those that disagree. Food for thought.

This one statement made me realize that Dr. Sha lacks a foundational knowledge of pedal biomechanics:

I'd take Mr. Russell seriously, he's probably ex SAS or something and holds a cleverly disguised pint in the other hand that is really a Swiss army truncheon/firearm/bayonet/phone/WMD....

 

Good man, Eric. I'm also renown for my generosity. First drink's on me.....






Is it too early to say Hooorraaa!

 

I got what I wanted.
:drinks