Confused podiatry student about biomechanics

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I am currently very confused with my studies...
I have been doing more readins on biomechanics as I am far from being confident at it at the moment.
I have found the more I read, the more I question...
Many of our underlying theories come from Root, especially biomechanic assessment performed. Many of the assessment is performed in open-kinetic and we don't take into consideration factors such as a person's centre of gravity, body proportions etc. So is STJ neutral really as important as we are taught at uni to be?????

 

Re: Confuse Pod Student

Hi Bonbons & a BIG warm :welcome: to Podiatry Arena,

Pull up a pew sweety.

The Arenas ladies & gentlemen will be along shortly I'm sure.

Happy reading Bonbon :drinks

PS. Have you checked out the threads on 'Education & learning' yet? Lots of information.

Regards,

 

Re: Confuse Pod Student

Bonbon

That question covers almost everything in podo biomechanics.

First please could we have your real name, you will get a better response than posting anonimously.

It's good to question but don't forget you need to pass your exams in the way that the examiner expects you to answer.

I suggest reading books and publications by Kevin Kirby, Howard Dananberg, Craig Payne, Eric Fuller, McPoil, B Gelhuwe, Wright & Rennels, HB Kitaoka, MW Cornwall. To name a few of the more prolific writers of modern biomechanical principles. Its a long journey but worthwhile and fulfulling. Also Root and Weed theory are still extremely relevant when used in the right context.
Don't try to know everything at once.

Cheers Dave Smith

 

Re: Confuse Pod Student

Thanks for the encouraging replies
It is quite a daunting experience at the moment...

I have taken your advice and tried to change my name on this ... but obviously I am quite uselss when it comes to computers.. :bang:

My take is that... the models are all relevant, and need to be taken into consideration when devising treatment plans~ I guess I would need to pick bits & pieces out of all the theories & apply them when necessary

 

Brilliant quote. I did a decade of physio before graduating. I had the luxury of 10 years of knee, shin, ankle; whilst learning pod. I, like you, struggled with this.


Podiatry biomechanics gives you too much....almost an overload of potentially irrelevant information.

The thing to do is learn it and try and understand the theoretical concept underlying it.


One day, try to get a day under a clinical podiatrist. See how they operate. From my limited dealings with pods, someone like an Augusta or an Appleton get to the crux of a diagnosis and implement the necessary intervention.



Good podiatry/physiotherapy is all about getting the basics right....nothing more.




Ron

 

At my graduation I good portion of the class did not feel confident at biomechanics. Many who got good grades felt they did not understand it. That means there is a problem with the paradigm and not with the students. There are many inconsistancies in the Root et al paradigm.

Some of what I was taught is quite valid. There is such a thing as a partly compensated varus. However, the STJ does not know the difference between forefoot varus and rearfoot varus. So, you do need to understand the concept of using up all of the range of motion, but the rearfoot forefoot stuff confuses the issue.

Also, there are two definitions of normal. The biopysical criteria of normalcy. (Which are inconsistant in that you cannot stand in neutral position with MTJ's maximally pronated. ) And the other definition loosely paraphrased is normal is what does not hurt under normal usage.

One of the best quotes from a teacher that I've heard is that half of what I teach you is wrong, and I don't know which half. This is especially true for biomechanics.

Figure out what they want for answers on your tests and be prepared to discard those right answers when something better comes along.

Regards,

Eric Fuller

 

Dear Bonbon, I agree with David Smith eg. his suggestion of Dr. Howard Danaberg's publications. I had the honor of listening to Dr. Danaberg's lectures as a student at NYCPM. He is good people to know and is very approachable and always willing to take the time to answer your questions in person or by letter.
Included in my goody bag I received at registration booth in Leipzig, was a copy of the German periodical, Orthopaedie Schuhtecknik. In it was a very interesting articile, "Sensomotorische Einlagen, ein Konzept von Fuss bis Kopf?" Translated,
Sensori-motor orthosis, a concept from foot to head. In the article, they mentioned the relationship between TMJ syndrome and faulty foot mechanics eg.:drinks due to hyperpronation; this is something that Dr. Danaberg discussed many times in publications and lectures and now the Germans have caught on. I plan to send Dr. Danaberg a copy along with English translations when time permits. But you can see how important Biomechanics is eg. in a country where good foot health "ist sehr wichtig (is very important)! So don't let it scare you. It is what makes podiatry special.

 

G'day Bonbon,

Welcome to the wonderful world of podiatric biomechanics and teh frustrations which will ensure. I'm a fairly recent graduate myself (5 years now), and have completed post-grad studies (including biomechanics) and have found exactly what you're experiencing: the more I learn, the less I know. Everyone who has posted here has suggested the same thing, and I'm going to be no exception: go out and read as much as you can. Michaud's book 'Foot Orthoses' I found a really useful starting point when I was at uni, as it seems to explain things quite simply, uses a good Root foundation, and will give you enough information to complete your exams satisfactorily. From there, the more you see and the more people you speak to your knowledge and understanding will develop.

The other big piece of advice which I can recommend, and I do strongly push on my students on placements, is know your anatomy and physiology. If you know what is there and what it is supposed to do you can always work from there in trying to discover what went wrong. A really good example of this is Kevin Kirby's work with longitudinal subtalar joint axis deviation. Essentially this will come back to joint shape, angulation and shape of calcaneum and talus. I'm often back in anatomy books for biomechanical help!

Podiatric biomechanics is one thing that we as podiatrists have left that isn't being managed by other health professionals. We have foot care assistants for primary care, diabetes educators and nurses doing ABIs, doctors doing dermatology and nail surgery, physios, chiros and osteos dealing with injuries, but we as podiatrists have a very unique and in-depth understanding of foot function that is unmatched in any other health field. Take the challange!

Good luck!

 

Ditto ...

It doesn't take 3 or 4 years to learn podiatric biomechanics. It will take probably the bulk of your career.

Try and break it down, make things simple and think logically. And think forces.

When you start treating patients, you'll stuff up from time to time, that's a good thing because it forces you to try and understand why your intervention failed and forces you to have to come up with another one. When it works, its gold!

Chin up

Rebecca