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GIB test of foot flexibility

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Simon Spooner, Oct 19, 2006.

  1. Members do not see these Ads. Sign Up.
    Can anyone tell me how to perform this test?
  2. Craig Payne

    Craig Payne Moderator

    Simon - there was a PDF file on Ed Glasors site all about it, but I just went to look for it and all the PDF files not there (they were a week or so ago). Hopefully Ed can make it available.
  3. StuCurrie

    StuCurrie Active Member

    Simon and Craig,

    Here you go. It's still on the website, but can be difficult to find unless you know where to look.


    The general idea is to get an assessment of foot flexibility. Over the years, we've come up with various contraptions (and yes, I'd call them contraptions) to try and get more accurate/reliable measurements of foot flexibility with varying results. There is a grad student working on a study with one of these "flexometers" now, determining inter and intra-rater reliability.

    Hope that helps,
  4. Craig Payne

    Craig Payne Moderator

    Stu - trust me - when I previously looked, it used to be accessible from this page:
    http://www.solesupports.com/downloads.htm - all the links from that page appeared to have gone when I last checked --- I now notice that the links take a very very very very very long time to load.....so long that I previously thought they had been removed. I think you need to talk to your web host as to why becasue its still doing it.
  5. Craig Payne

    Craig Payne Moderator

    Stu/Ed - can you enlighten me as to where the name 'Gib' came from?
  6. Last edited: Oct 28, 2006
  7. StuCurrie

    StuCurrie Active Member

    Yup, I think that's him. I wasn't around when the test was devised so I can't provide much more insight on the origins than you already have.
  8. Could you shed any light on the validity of the test? For example, how were the intervals decided upon? Why do the intervals cross each other? What was the "gold standard" the Gib test was assessed against to determine that the test is a valid measure of foot flexibility?
  9. Obviously Stu you don't have access to this information. After all, you're just employed for research. Perhaps someone else from your company could supply the answers then? Or should we conclude that this is a test lacking validity, with arbitary intervals? Maybe I should ask Gib?
  10. Atlas

    Atlas Well-Known Member

    What does the GIB test tell us?

    If the GIB test is clinically relevant, then surely the 'reverse GIB test', whereby one would presumably pronate the forefoot on the midfoot, may be indicative of other factors such as orthotic tolerance, supinatus confirmation/questioning etc.
  11. That's part of what I was trying to find out.

  12. Atlas

    Atlas Well-Known Member

    I have as many questions as you about the GIB test.

    I assume that the reverse (of the) GIB test would investigate how readily a supinatus could be corrected. Accordingly it would provide information on how readily a 1st ray could plantar-flex.

    Lets say a considerable supinatus was recalcitrant to therapist correction, how would this foot conform to the typically prescribed device? It would not surprise that this foot-type (and certainly the forefoot varus foot-type) would perhaps not tolerate the typically prescribed device that attempts to 'plantar flex the 1st ray and provide a supinatory moment at the STJ'.

    Which lends itself to a detoured question. What device would you devise for such a foot-type Simon?
  13. I'm not sure this test is a good indicator of 1st ray plantarflexion since the test does not isolate the joints of the first ray.

    Ron, I don't believe in treating "foot-types" or "foot positions", as these are not pathologies, rather I like to identify the pathological tissue and design an orthosis which will relieve the biomechanical stresses which are causing the pathology within that tissue. SO given that forefoot supinatus is said to be associated with numerous pathologies, the type of device I would design is dependent on the exact pathology the patient presented with, amongst other things.

    Still not sure on how this test predicts orthotic tolerance?
  14. Atlas

    Atlas Well-Known Member

    Lets put it another way. Are you content to allow a patient to have a device under such a foot whereby the 1st MPJ is not in contact with the ground? Do you consider forefoot-varus wedging? Some form of reverse kinetic wedging?
  15. EdGlaser

    EdGlaser Active Member

    Please be patient....I am under some time constraints to come up with a new lecture for the Canadian Federation of Podiatric Medicine right now. I will give a full explaination of the the Gib test and the NEW Flexometer which is being tested at Bridgeport University (where I am also lecturing next week). I appologize for my schedule being so hectic...there is quite a demand for my lectures.

  16. Again, it depends on the patient. Only ever made devices which held the 1st MPJ off the ground for sub 1st MPJ ulcers. Yes I still use varus forefoot wedging in some cases- this may be 2-5 of 1-5, again depends on the patient and what you are trying to achieve.

    How does this relate to the GIB test as a test for orthotic tolerance?

    P.S. what is it with you guys down under and reversing everything: reverse windlass mechanism, reverse GIB test, reverse kinetic wedge? Is it because the water runs the wrong way down your plug holes?
    Last edited: Nov 2, 2006
  17. As Eric has pointed out to you before: in the time it took you to write this, you could have answered the questions.
  18. EdGlaser

    EdGlaser Active Member

    Not true, I am writing a well thought out detailed response.
  19. Looking forward to seeing the data.
  20. BTW I forgot to wish you good luck with your lectures in Canada. I hope it's money well spent since I think you may have your work cut out:

    From the Health Canada website:

    "Health Canada is the Federal department responsible for helping Canadians maintain and improve their health, while respecting individual choices and circumstances.

    What is Health Canada's Goal?

    According to our mission and vision, Health Canada's goal is for Canada to be among the countries with the healthiest people in the world.

    To achieve this goal, Health Canada:

    Relies on high-quality scientific research as the basis for our work."

    Also from their site:

    "Following a comprehensive review of scientific literature, NIHB policies regarding the provision of custom-made foot orthosis were developed in consultation with clinical experts in the field of biomechanics and the provision of foot orthosis."

    "The accuracy of each casting technique and its ability to capture forefoot to rearfoot positions were the main criteria used to determine that only the following two methods of casting are accepted by the NIHB Program in dispensing a functional device:

    plaster of Paris bandage wrap / slipper cast
    contact digitizing method
    The NIHB Program does not accept the use of a foam box, laser or optical scanning devices for the dispensing of functional foot orthosis. These methods demonstrate a significant reduction in accuracy and reliability in obtaining the positional relationships regardless of the experience of the practitioner."
    Last edited: Nov 2, 2006
  21. leslietrotter

    leslietrotter Member


    Hello Simon…

    I would like the opportunity to respond to your thread regarding NIHB and their position on certain casting techniques. I recognize that the original thread pertained more to the Gib test but somehow my area of interest, casting, found its way into the discussion.

    I am a first-time entrant into the Podiatric Forum even though I have read a few topics here and there. I am indeed Canadian (eh!) and have intimate knowledge of some of the “goings on” regarding the decision of NIHB to allow only plaster of Paris off-weight bearing casting. I was a Board member of the Pedorthic Association of Canada (PAC) when this issue initiated discussion between PAC and NIHB (around 2003).

    As an aside, for those international readers, NIHB or Non-Insured health Benefits, is the government body which oversees the delivery of health care to Canada’s First Nations and Inuit People. To be clear, their policies are unique to their beneficiaries and are not representative of all Canadian government agencies and are not “generalizable” to the delivery of health care for all Canadians. Devices such as foot orthoses are not covered for Canadians other than those covered by NIHB and DVA (Department of Veterans Affairs) so this applies to a very small group of people.

    Back to PAC and 2003….According to NIHB administrators, they made their “plaster off-weight-bearing policy” based on the advice of their consultant, a chiropodist, and a recent study which appeared to favour plaster casting. Despite what the website may claim, there was no comprehensive review of the scientific literature because there was but a single study at that time (Critique Of A Comparison Of Four Methods Of Obtaining A Negative Impression Of The Foot By Carrie Laughton, Irene Mcclay Davis And Dorsey S. Williams, 2002). The study basically fit their, and their consultant’s, view of “correct” so plaster of Paris became policy.

    The debate regarding plaster, foam, laser, dental wax etc. as a casting medium of choice predates any NIHB decision regarding perceived superiority and likely will continue for many years. What concerns me is when someone suggests a reasonable alternative or variation and the profession/policy makers, disregard it completely.

    I have taken the time to critically analyze the aforementioned study because I feel strongly that we not fall into the trap as Craig Payne so eloquently pointed out, “Facts should not be confused with theory, and science should not be confused with theoretic coherence…Paradigms call for critical engagement, not dogmatic adherence.” (The Past, Present, and Future of Podiatric Biomechanics. J Am Podiatr Med Assoc 1998;88(2):53-63.)
    While this critique uses the issues raised in reading Laughton’s article, the same could be raised in any discussion between “opposing” sides of the casting debate. Laughton and colleagues (2002) compared the reliability and validity of four methods for casting the foot in preparation for fabricating an orthosis. They reviewed the most popular off-weight-bearing plaster casting technique and three alternative methods.
    The theoretical framework forming the basis of their work is contained within the so-called Rootian paradigm…. subtalar neutral posture as a reference point for “normality” and the ability of using the “ideal” position to gauge abnormal relationships of the foot.

    1. The validity of Subtalar Neutral
    Many use the word “valid” far too liberally when referring to casting posture. Have we determined a valid posture yet? We have developed an entire industry around the construct of subtalar neutral (STN), however there is no validity associated with it. The work of Pierrynowski and Smith (Rear foot inversion/eversion during gait relative to the subtalar joint neutral position. Foot Ankle Int 1996 Jul;17(7):406-12.), suggested that the foot does not assume the position of STN during the gait cycle. McPoil conducted a similar study with similar results a few years before (McPoil T, Cornwall MW. Relationship between neutral subtalar joint position and pattern of rearfoot motion during walking. Foot Ankle Int 1994 Mar;15(3):141-5.)
    2. The reliability of casting
    What have we really concluded about casting reliability? We speak of the “gold standard” being off-weight bearing plaster but closer examination reveals that inter-caster reliability is poor. While investigating a group of experienced and inexperienced podiatrists, 16.5° (10º everted to 6.5º inverted) was the range of the forefoot-to-rearfoot relationship of a single foot. Additionally, cast consistency was not associated with experience. (Chuter V, Payne C, Miller K. Variability of neutral-position casting of the foot. J Am Podiatr Med Assoc 2003 Jan;93(1):1-5.)
    Other significant research contradicts the notion that practitioners can reliably find subtalar neutral (Pierrynowski MR, Smith SB, Mlynarczyk JH. Proficiency of foot care specialists to place the rearfoot at subtalar neutral. J Am Podiatr Med Assoc 1996 May;86(5):217-23).
    3. Clinical instruments
    The Laughton study, like many clinicians, used the visual bisection of the calcaneus as a reference point, however studies have concluded that this is not valid (LaPointe SJ, Peebles C, Nakra A, Hillstrom H. The reliability of clinical and caliper-based calcaneal bisection measurements. J Am Podiatr Med Assoc 2001 Mar;91(3):121-6.)
    No clinical or experimental evidence exists suggesting that bisection of the calcaneus creates a plane perpendicular to the plantar surface of the calcaneus (Payne C. The Past, Present, and Future of Podiatric Biomechanics. J Am Podiatr Med Assoc 1998;88(2):53-63.)
    Furthermore, the angular relationship between the forefoot and the rearfoot employed in the Laughton study was assessed with a hand-held goniometer. The literature argues that podiatric biomechanical measurements show poor reliability including, but not limited to, the two-arm goniometer ( Mathieson I. Restructuring Root. An Argument for Objectivity. Clin Podiatr Med Surg 2001;18(4):691-702.)
    4. Internal bias
    Internal bias exists in the study under review because the “clinical standard” by which each of the casting methods is compared, mimics the off-weight-bearing plaster technique. This weighted the measurement outcome in favor of plaster casting.

    Presumably conceived in the spirit of lending insight to a profession that is experiencing the tremors of a paradigm shift, the study (like we clinicians) possibly lacks the willingness to subject the underlying theory to more rigorous evaluation thereby creating a barrier to the possibility of alternative approaches.

    While I am certainly not an expert, I do believe that a certain amount of healthy skepticism (not cynicism) regarding the status quo is important to advance foot science. I am not here to undermine the works of Laughton, nor the immense contributions of Root. What does surprise me is that Root proposed his theories during the mid-1960’s, at a time when there was relatively little professional unity regarding the theory of foot mechanics amongst the podiatric profession.
    Nearly forty years of significant scientific observation have passed since Root’s preliminary ideas, yet many studies reflect adherence to a conceptual framework that is unproven and shows little hope of being more than theoretical fiction.

    Phew! I feel a bit exhausted and I have probably dropped about 95% of the readership…but I tend to get on a roll when I have to do a literature search.


  22. Nice reply Leslie. Perhaps you could now take the time to review the literature relating to foam impression box casting with specific reference to the mass position, then let us hear you conclusions?
  23. Leslie:

    I very much liked your reply and admire your work at going into the literature in search of answers to questions that I have also been struggling with for over two decades. I have written quite extensively on the subject of STJ neutral position in my Precision Intricast Newsletters but I think the definitive work in this regard is that done by Eric Lee, a podiatrist in England (Lee WE: Podiatric biomechanics: an historical appraisal and discussion of the Root model as a clinical system of approach in the present context of theoretical uncertainty. Clinics Pod Med Surg, 18 (4):555-684, 2001). You must read Eric's very thorough review of the history of STJ neutral and Root's approach to the subject before you make too many conclusions on the subject.

    I knew Drs. Mert Root and John Weed personally, was taught in podiatry school by John Weed and talked to him nearly every day about biomechanics when he was at CCPM. Bill Orien is the only one still alive, is semi-retired but still gives occasional lectures. Tom Sgarlato is also a friend of mine, is retired, and is also a very bright individual who I have learned from. Because of my first hand knowledge of the works of Root, Weed, Orien, Sgarlato and others from CCPM who were also my professors, let me try to clarify some of their ideas for you in response to some of the things you wrote above.

    1. Root et al did not mean "normal" to mean "average". They meant normal to represent "ideal". In other words, they proposed, at a time in medical history when there was very little organized or systematic ability to communicate foot and lower extremity structure and deformity between medical professionals, a classification system that was based on the concept of a "neutral position" of the STJ so that they could better teach foot and lower extremity biomechanics to podiatrists and podiatry students. Therefore, it is not fair to them and what they have done for podiatry, to take a number of subjects in a study who are "asymptomatic" and "have no prior history of trauma or diseases", call them "normal" and see that their feet are all pronated from STJ neutral position in the study. Root and colleagues very well knew that just because people were young, asymptomatic and had no history of foot trauma/disease processes, that this had nothing to do with whether their feet and lower extremities were "normal" using their criteria. Having seen each of these men in action clinically, they would have been able to take each individual in that study and tell you why they were pronated from STJ neutral position and that they were not "normal" using their criteria for the ideal foot.

    2. All this fuss about negative casting technique is quite interesting to me and I believe it totally misses the point about overall orthosis construction and function. What is just as important as to whether an orthosis works or not is how the positive cast is modified, what type of orthosis material is used and what shoe these orthoses will fit into. Whether foam, plaster, contact digitizer or an optical scanner is used to capture the three dimensional image of the plantar foot is only one small factor that can either make or break an orthosis for a patient. So I wouldn't get too excited about casting technique, even though it is important. All of these "casting methods" may work well, as long as the practitioner is aware of their limitations.

    3. The heel bisection is highly practioner dependent, but was never meant by Root et al to represent "a plane perpendicular to the plantar surface of the calcaneus". I don't know where this idea came from. Mert Root and colleagues used the heel bisection to be able to measure STJ range of motions and "deformities". I think the heel bisection is a good idea and I find it very helpful for me in comparing one foot against another. The problem is, unless another practitioner uses the same heel bisection on a patient as I do, communicating information about the foot between one me and that practitioner may lead to confusion. However, once the practitioner has been trained on how to use this technique correctly, I find it helps them assess foot structure better, as long as they understand its limitations.

    By the way, Leslie, since you say that the subtalar joint neutral positon has not validity to it, unless the subtalar joint has a neutral position, then the words "pronated" and "supinated" become undefinable and meaningless. What do you propose that we use as better terminology for a midrange rotational position of the subtalar joint?
  24. leslietrotter

    leslietrotter Member

    subtalar neutral/Mass casting


    Gentlemen, you are both “frequent flyers” on this site. Unfortunately, I cannot devote a similar amount of time. I will try and respond to both of you then I must sign off.

    I have indeed read Lee’s article (or should I say novel…it was very comprehensive!). I certainly do understand the magnitude of Root’s contribution and I believe I prefaced my constructive criticism of Root’s work by stating such in my first response.
    Kevin…I am not certain my comments are as much “conclusions” about Root’s work as they are queries based on scientific contradictions of aspects of his theories.

    I did indeed imply that STN is not a valid position for measurement. Poor reliability is automatically evidence of low validity. Without consistency how can we produce a meaningful measurement? This is supported by both definition and previously cited literature. Several researchers have demonstrated the subjectivity of STN due to lack of inter-caster reliability. Secondly, as previously cited, the fact that the foot does not assume the position of STN during the gait cycle, calls into question the validity of the posture altogether for the purposes for reproducing an idealized foot (the cast).

    I do not agree that pronation and supination become “undefinable and meaningless” simply because STN is invalid.
    STN has, by definition, (and execution) a very vague range of positioning… "neither fully pronated, nor fully supinated”.
    I can, however, fully dorsiflex, abduct and evert the foot and “meaningfully” call this pronation. Conversely, I can plantarflex, adduct and invert the foot and define this as supination. How does the lack of a single neutral make pronation and supination meaningless?
    The contentious issue with STN is that we all have our own sense of where we palpate that position. Your neutral and my neutral are different. And if it were not for the fact that we chose STN as a “standardized position”, then it really wouldn’t be problematic what kind of range it demonstrates from practitioner to practitioner. We as an industry have assigned a specific “value” to STN and we have erroneously suggested for years that it is a functional posture (valid) and assumed we all meant the same position (reliable). The works of Payne, Pierrynowski, McPoil and others have uncovered the flaws of our definition of STN.

    Kevin, I like your suggestion regarding the term “midrange” rotational position of the subtalar joint. At least this terminology does not imply a specific point (ie. STN), but rather the fact that when the STJ is neither pronated nor supinated, it’s somewhere in the midrange.

    Simon, regarding foam box MASS as a casting posture, I find many aspects theoretically reasonable.

    I (presumably, like you) was taught off-weight bearing plaster casting.
    From the outset, the “foot in flight” posture did not make sense to me. It makes even less sense after 16 years of practise.
    At what point in the gait cycle is controlling the foot important? Mid-flight or ground contact?

    Use the “ground as the frame of reference” for casting? Why not? We do know that the metatarsals and heel are all in contact with the ground at some point in the gait cycle (ie. “midstance”). As previously referenced, STN is not a functional posture (doesn’t assume the posture in gait) of the foot so why would I choose that as a reference for casting?

    As far as “maximizing the arch height”, it does seem reasonable that this would limit the rate and amount of pronation (assuming over pronation is the issue).

    As far as fabricating an orthosis to “fully contact the arch”, the works of Nigg from University of Calgary (another Canadian!) is substantiating the importance of enhanced proprioception.

    Simon and Kevin...in reading this blog backwards, and a few previous topics which include yourselves and Ed Glaser, I can’t help but notice that you have both taken the opportunity to chide him a bit. I know nothing of your relationships other than what I read.

    Clearly Ed Glaser is “not like the other reindeer” but does that mean that our industry’s academics should dismiss his ideas?
    Won’t we all feel a little timid if one day he, like Rudolf, is “leading the sleigh”?
    What is so offensive about some lateral thinking?
    Was one of the criteria for our entry into institutions of higher learning to simply check our brains in at the door and never question the status quo?

    I recognize that I have now asked you a series of questions for which you will undoubtedly feel compelled to answer given your prolific contributions. You could just consider them rhetorical.

    Sorry to “perturb and run” but that’s about the extent of my free time. Perhaps others might be able to advance the blog?

    Thanks guys, it’s been fun!

  25. Leslie:

    I did not say that the words "pronation" and "supination" would be meaningless if there were no STJ neutral position. Here, again, is what I stated:

    Again, Leslie, how can a foot be "pronated" or "supinated" unless we have a neutral position where it is neither pronated or supinated? If there is no neutral position then these words "pronated" or "supinated" are meaningless, have no definition, and are open to opinion as to what defines them.

    We can still use the words "pronation" and "supination" without a STJ neutral position since these words describe the direction of motion within the joint. However, since the words "pronated" and "supinated" are words that describe a position within that joint's range of motion, unless we have a midrange reference position such as a "neutral position", then we can't use these words and have them mean anything of substance. In other words, where do we say within the STJ range of motion that the foot is neither pronated or supinated without a neutral position, Leslie? When you have some answers for this question and some more "free time", then I would be happy to hear some more of your opinions.
  26. Sorry Leslie, I asked you to review the literature with regard to foam box casting. I don't see anything here but your own rhetoric. I will comment in greater detail on your contentions this evening when I have more time.
    Last edited: Nov 6, 2006
  27. javier

    javier Senior Member

    Effects of Custom-made Foot Orthoses on Dynamic Plantar Pressure Distribution Journal of the American Podiatric Medical Association
    Volume 96 Number 1 9-18 2006

    I think it is common sense that casting technique should be chosen based on the type of device you want to manufacture.
    Last edited by a moderator: Nov 6, 2006
  28. leslietrotter

    leslietrotter Member

    Gib test etc.

    Simon and Kevin…

    I’ll answer briefly, and together, as you seem to work well as a tag team.

    There is but the single study which includes foam box casting (Laughton et al) as I mentioned in my first response. So there really can’t be much of an extensive literature search on that topic.
    My comments regarding MASS as a technique are that it is theoretically reasonable and I listed my rationale…not “conclusions” because I am open to continual improvement.
    By “rhetoric” I hope you meant the definition” the ability to use language effectively” rather than the “the undue use of exaggeration”.

    I absolutely did comprehend your question regarding pronation, supination and STN. And I believe I answered it.
    You stated, “unless the subtalar joint has a neutral position, then the words "pronated" and "supinated" become undefinable and meaningless.”
    We agree that pronation and supination do have meaning and definition. STN has meaning as well but the not the way we in foot science have chosen to use it. Research has shown that when you introduce humans into the equation, STN has a range not a specific point. The “specific point STN” that our industry uses to cast is invalid.

    Let’s reverse the onus of proof in this dialogue.
    Perhaps either of you gentlemen would care to substantiate, with recent scientific research, that point specific STN does have validity and that off-weight bearing plaster casting shows inter-caster reliability.

  29. Last edited: Nov 7, 2006
  30. What do you know of the reliability of this technique?

    Actually I was taught a variety of techniques these include weightbearing, semi-weightbearing and non-weightbearing using a variety of mediums. I still use all of these techniques for different patients with different pathologies and different types of orthoses. As Javier stated- horses for courses.

    At what point in gait is the foot in the mass position? At which point within the STJ RoM is there least net stress within the tissues which control and limit STJ motion?

    And there is the big assumption! These arguments regarding rate of pronation are interesting- see comments in the biomechanics of tendon and ligament.

    Can you point to where Nigg suggests that orthoses that do not fully contact the arch are devoid of proprioceptive effect, or if you like where he says that orthoses that fully contact the arch have greater beneficial effect via proprioceptive mechanisms?
  31. Never said that either of these two statements are true. In fact those of you who remember my battles with Jeff Root over casting on JISCMAIL will recall my viewpoint. To reiterate- I don't believe that neutral casting is repeatable. Don't believe a single point is important- hence we have the term Spooner's ZOOS. However, I do believe that orthoses manufactured using this technique do "work" to relieve symptoms in a large proportion of the population.
  32. Craig Payne

    Craig Payne Moderator

    I am not aware of any work from Niggs group that shows that. They have done a lot of proprioceptive research, but not sure about that one.

    See this thread:
    Sensory effects of foot orthoses
  33. Benno Nigg is a German who started out as a nuclear physicist, then got into biomechanics in its early days, and now has developed one of the most impressive foot/shoe biomechanics research centers in the world at the University of Calgary, Canada. However, Leslie, I am sorry that I don't think Benno would call himself a Canadian. As an aside, I think this may be similar to Craig Payne not like being called an Australian since he will always be a Kiwi at heart.

    I have lectured with Benno a few times and I would have to agree with Simon and Craig that I don't know of any of Dr. Nigg's research that says that the propioceptive effects of orthoses have anything to do with medial longitudinal arch height or medial arch contact pressure. Nigg's "Preferred Motion Pathway" theory does state that orthoses have some influence proprioceptively that alters muscle recruitment and firing patterns during weightbearing activities. However, I have not seen any of his papers state that a very high medial arch is necessary for an orthosis to show "proprioceptive effects". Maybe you can provide us with a reference and quote from one of Dr. Nigg's papers that states such.

    By the way, I do make orthoses that fully contact the arch, contrary to what another podiatrist has said recently a few times on Podiatry Arena about the orthoses I make. I find it amusing and interesting that he made that statement several times on Podiatry Arena even though he has never seen (in person) a single one of the 10,000+ pairs of foot orthoses I have made over the past 20+ years of practice.
    Last edited: Nov 7, 2006
  34. leslietrotter

    leslietrotter Member


    Yes, Kevin, that is indeed me.
    You're a curious little rascal aren't you!?
    Probably not something I would have chosen to draw attention to on a site that values brains rather than brawn, however...

  35. Leslie:

    On the contrary, being an former competitive athlete myself, I tend to have the greatest respect for those individuals who are multi-talented. But as you say, when the written word is the only parameter to judge an individual by, having great physical gifts has little effect in influencing the judgement of others.

    By the way, I read some of your thoughts about foot orthoses on your website and think they were very nicely done. Hope I didn't scare you off and you can find time to continue contributing to Podiatry Arena on an occasional basis.

    Yes, even though I have never been called such, a "curious little rascal" pretty much sums it up for me. However, one could put a more positive spin on such attributes and, alternatively, a description such as "inquisitive and eager to research all subjects of interest" could be offered. However, I think your original description of me is much more accurate. ;)
  36. markjohconley

    markjohconley Well-Known Member

    Still battling with the basics here. So the terms "dorsiflexed" and "plantarflexed" (say in regard to metatarsal or phalangeal position) are also without definition and not to be used?, mark c
    .... and a big hullo to all my fans ......
  37. Mark:

    Why did you post this comment on this thread??

    The non-dorsiflexed and non-plantarflexed position of the hallux, for example, can be defined as when the bisection of the hallux is parallel to the weightbearing surface of the foot. Can a similar definition be given for the subtalar joint?
  38. markjohconley

    markjohconley Well-Known Member

    Goodaye (or good evening) Kevin and thanks for the quick response.
    I've been working my way through the posts from podiatry-arena's inception and am up to this thread. You were discussing with Leslie Trotter? re same and I was unaware / have forgotten the definition for the phalanx. I assume the non-dorsiflexed / non-plantarflexed metatarsal 'position' has to do with alignment with the tarsus. Thanks again Kevin, Mark. (It's a beautiful autumn day here in Canberra)

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