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Here we go again.......Snakes, oil and salesmen.

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

  1. LCBL

    LCBL Active Member

    Members do not see these Ads. Sign Up.
    http://www.springboost.com/index.html :eek:

    Heard about these today from a patient who attended a Leisure Management conference in Dublin yesterday. The guy was dissing MBT's too .... :rolleyes:
  2. LCBL,

    Thanks for adopting a quote from me as your quote. Fame in the 21st century.

    Your anonymity though is somewhat contentious, do you not feel comfortable with letting other people know who you are?
  3. LCBL

    LCBL Active Member

    No. Just not used to 'coming out ' on internet forums so never thought of introducing myself.

    Im Dave. Im an Orthotist in private practise in Ireland. The last time I met you was in Boston with your lovely, whilst heavily pregnant, wife. Were you worried I might be a troll from a rival forum?

    I used your quote as I have to fight this on a daily basis. However, it is also a large reason I make a living from disgruntled patients.

  4. Dave:

    That photo of you in your avatar is how I remember you in the bar at the hotel in Boston. (Or maybe that was Sir Elton John?) Simon Spooner and Simon Bartold were trying to show me how to make better paper airplanes at the bar in Boston......my airplane definitely lost the contest.
  5. LCBL

    LCBL Active Member

    Yeah I'd forgotten about the plane races. The third Simon was probably involved too..... ;)

    The avatar is actually a character called Brian Potter from a comedy series set in the north of England by the name of
    Phoenix Nights but I think Elton John will be flattered :p
  6. I think that three Simons at one table are a little much, don't you?? :p
  7. That was Simon Dickenson (sp?)? We should get him on here on Podiatry Arena to talk about his upcoming research. At the last PFOLA meeting he was telling me a little bit about it. Dave, do you know what he is doing now?
  8. LCBL

    LCBL Active Member

    I agree. I'll give him a ring and point him in this direction. BTW Close....Dickinson.
  9. Dikoson

    Dikoson Active Member


    I am highly disappointed you spelt my name incorrectly!!

    Dave Kingston informed me about the arena so i thought i would come and have a look.

    Am currently looking at what we discussed and have 4 other projects on the go. I will be at PFOLA again this year, look forward to seeing you there.

    With regard to MBT's i have met with there technical guys twice. Their embrace of sagittal plane biomechanics as a cure all was enlightening!!!

    I tried a pair for a week. Unfortunately i got low back pain! Removing the MBT's from my feet did however resolve my back pain. Another MBT successful outcome!

  10. Simon:

    Sorry, mate, about the spelling thing. It won't happen again! ;)

    I think it would be interesting if you could tell us all about some of your research since there are many on this forum who don't know you and would benefit from your expert opinions on matters relating to all types of lower extremity orthoses. Of course, I won't mention anything about what happens after the seminars with you and Dave. Just as long as I don't have to have all three Simons at one table again.....almost too much for my poor heart!! :p
  11. LCBL

    LCBL Active Member

    Id be more worried about my liver
  12. As I recall, we did one martini, two martini, three martini, floor.

    Good times and good to have you two contributing here. This site can only benefit from your knowledge.

    BTW Alison's bump turned into our beautiful baby daughter Grace who is now 19 months old.
  13. Dickinson- get yourself a suitable avatar- it's the law!
  14. Dikoson

    Dikoson Active Member


    hope the avatar is ok, my acl snapped during a tackle like that.

    Congratulations on the bump's emergence into Grace. Hope she has your wife's looks... :)

    Are you going to PFOLA? will buy you a beer or 2 to belated moisten Grace's head

  15. Dikoson

    Dikoson Active Member

    Arthrodesis: The quick fix


    As you know I am investigating the effects of ankle fusion on midtarsal function and its inevitable degeneration.

    The long term effects of ankle fusion have been shown to cause significant degeneration in the midtarsal joint. Many orthopaedic surgeons state that "when your ankle is fused the joint in the middle of your foot will compensate for it!" Dorsal osteoarthritis of the talo-navicular and calcaneo cuboid joints are inevitable as is the likely hood of anterior knee pain and low back pain due to the loss of sagittal ankle motion.

    Tha angle the ankle is fused at is often "eyeballed" (i.e. not measured). Achieving plantigrade appears to be the gold standard (without any evidential back up) but yet is still not measured. Retrospectively it is apparent that an ankle joint fused in increasing plantarflexion will develop midtarsal osteoarthritis quicker than a plantidrade ankle fusion.

    Post-operatively patients are discharged with no orthotic/biomechanical intervention. Patients are simply informed that they have a significantly increased risk of midtarsal OA.

    I am therefore attempting to calculate the internal stress in the midtarsal joint relative to midtarsal stiffness, angle of fusion and forefoot function.

    The footwear these patients wear will change these internal stresses due to the ratio of heel height to sole thickness.

    The purpose of the study is to try to optimise the most ideal angle of fusion. Secondly to investigate which ratio of heel height to sole thickness will reduce internal MTJ stresses. Finally to theorise provide evidence that these specific dimensions will reduce the likelyhood and severity of midtarsal osteoarthritis?
    Last edited by a moderator: Oct 20, 2006
  16. LCBL

    LCBL Active Member

    Sounds interesting. Looking forward to seeing the results.
    Last edited: Oct 20, 2006
  17. Dave:

    I don't know if this phenomenom that Simon describes only occurs in the medical specialties that prescribe foot orthoses and the prescription foot orthosis labs that work to provide a service to the clinician. Unfortunately, the same statement Simon made about those that prescribe foot orthoses and those labs that provide these services could also be made about any medical provider using any medical service facility for either a service or a durable equipment which would include radiology facilities, pharmacies, blood and chemistry labs, brace and O&P shops, etc. Just plug in the appropriate name into the Simon's statement and see if it also works for other medical service facilities.

    Are practitioners that prescribe foot orthoses and prescription foot orthosis labs any different from the rest of the medical profession and their medical service facilities??? I don't think so. By the way, I don't know many podiatrists or orthotists or pedorthists or medical doctors who work for free, do you?
    Last edited: Oct 23, 2006
  18. LCBL

    LCBL Active Member

    Point taken Kevin and Ive adjusted my sig to clarify my point a little. To explain my feelings I'll explain the Foot Orthotics market in Ireland.

    Any Tom, Dick and Harry can provide foot orthotics in this market. Orthotics, and their provision, is a totally unregulated sector here. My friend, a farmer, can dish out orthotics in a room on the side of his house and he doesn't have to have any qualification to do so.

    Back in the 80's a certain lab from the UK with a connection to a big US lab came to Ireland and found that the number of Pod's/Orthotists was a big fat zero.

    They started 'weekend' biomechanics course for the physiotherapy population. Those countinued for some years.

    Today we have physiotherapists, chiropractors, osteopaths, nurses and non-medically qualified people providing orthotic therapy services as part of their clinics.

    The afore mentioned lab, along with a couple of others are still providing these 'weekend' courses. They have now been joined by the '2D force plate and computer does it all' brigade. Then there are the snakeoil salesmen.

    So, knowing that this is a reputable and international forum, I gladly alter my sig to prevent any offence to labs/members of labs here that are fine practioners of best practice.

    I hope this clarifies my point....made in a 'tongue in cheek' manner but with a serious background that I am fighting 'day in day out' through the education of my patients.

  19. Dave:

    I can see where you are coming from. Must be frustrating. As you said, patient education is the key.
  20. LCBL

    LCBL Active Member

    Absolutely. I am convinced that I lose potential patients because they've 'spent a fortune on those bloody insoles' before. Word of mouth about a clinician that is up front, honest and has successful outcomes is what is growing my business. This is totally down to educating my current patients and in turn them doing my promotion for me with friends/familiy/work colleagues.

    The battle goes on.......
  21. Simon:

    How are you determining midtarsal joint stiffness? I have written some Newsletters on this subject and am lecturing on it at PFOLA in December in Chicago. Would be interested in how you are also calculating internal MTJ stresses. What type of model are you using?
  22. pgcarter

    pgcarter Well-Known Member

    Your situation in Ireland sounds much the same as Australia....anyone can do it. But I see the incompetents as the leading edge of the free advertising campaign for good practitioners.....they make a mess and you clean it up.....just be good at your job and these guys just raise awareness of the possible use of this kind of stuff.
    As far as ethical prescribing...I have no guilt....a cosmetic boob job is $10K PLUS and these people are still allowed to call themselves doctors and surgeons.....who are they kidding?....not me. Just offer a money back guarrantee with what you prescribe....it focusses the mind and ensures accusations are baseless.
  23. Dikoson

    Dikoson Active Member


    Boy i knew that one was coming...

    One of the reasons for me coming to PFOLA this year is to hear that lecture.

    I am attemting to creat a jig that will measure deflection through the mtj with a known load. Isolating the mid tarsal joint is more than difficult on a living patient and made almost impossible during gait.

    I have developed some digital analysis software integrating force data onto sagittal and coronal digital video instantly. That part is done. High speed digital video has helped. Auto-digitisation is now nearing completion. This synchronised capture has lead to the development of kiematic and kinetic data capture to be transposed into 3d data. This is currently being verified with comparison to traditional vicon analysis.

    I'm getting there slowly...will show you were i am at at PFOLA

  24. Craig Payne

    Craig Payne Moderator

    Simon D

    Have you got picture of the jig? (for reasons that will very soon be obvious I have had to pull out of PFOLA and as things are happening sooner than expected, I have now also had to pull the plug on the UK Society conference as well)

  25. Dikoson

    Dikoson Active Member


    I have but cannot send it, sorry, manufacturer currently going through patent process

  26. Simon:

    Sounds interesting. Just got off the phone with Chris Nester and he will also be presenting at PFOLA on some of his latest research on his bone-pin studies with Arne Lundberg of the midtarsal-midfoot joints of live subjects during gait. In my lecture, I'm doing a historical review of MTJ research, including Nester's more recent stuff, along with a little about clinical application of the three reference axis model of the MTJ.

    In a set of Precision Intricast Newsletter I recently wrote, I theorized that variable MTJ dorsiflexion stiffness explains the reason for gastroc-soleus equinus (i.e. increased ankle joint dorsiflexion stiffness) causing very different effects on the longitudinal arch of the foot, such as: 1) a very early heel off with no longitudinal arch flattening, 2) early heel off with some longitudinal arch flattening and, 3) a normal heel off with excessive longitudinal arch flattening. This makes more mechanical sense rather than our current theory that the "MTJ breaks down due to gastroc-soleus equinus deformity". The dorsiflexion stiffness of the MTJ is probably largely inherited but may also be acquired (e.g. children's ligamentous laxity, ligamentous rupture, post-menopausal ligamentous changes, peripheral neuropathy or muscle weakness) and largely determines whether MTJ collapse occurs in late midstance and, therefore, whether functional hallux limitus will occur or not during gait.

    BTW, Chris Nester really liked this approach to MTJ stiffness also. See you in Chicago in a few weeks, Dickinson. You're buying at the bar, from what I understand. ;)
    Last edited: Oct 25, 2006
  27. conp

    conp Active Member

    Still a complete misunderstanding of MBT's. Sagital plane cures all??? These were technical guys??? This is not the my understanding of MBT's. Seems you have been misguided.

    It also seems that you also have been misguided in another way........ Well it is interesting that the MBT's have the ability to give you a sore back. So they have the capacity to make changes. In your case the wrong changes because I suspect you were given generic instructions to wear them (from what they said above probably completely wrong instructions) instead of specific instructions for you. This is why depending on person's gait and symptoms, I give different instructions for people to wear them. AND REMEMBER THEY ARE ONLY A TOOL. Not even close to a 'cure all' device. Although attached to the MBT company only in a small way (technical advice), I apologise for your misguided experience.
    Last edited: Nov 4, 2006
  28. gwilson

    gwilson Member

    Back to the original post - has anyone actually tried Springboost shoes, I'd like to know as my girlfriend just bought me a pair. I've only tried them on for a few minutes so far, so I don't know how they'll feel when walking distances, but they are very comfortable! I tried on mbts once - they weren't! (comfortable, I mean).

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