After reading the comments of Jeff Root and Eric Fuller today in the MASS Discussion thread, I thought it would be interesting to find what everyone thought are the absolute essential theories/subjects that need to be taught to both the podiatry student and the practicing podiatrist on the biomechanical function and treatment of the foot and lower extremity given our current state of knowledge.
Members do not see these Ads. Sign Up.
-
-
1st assume that anatomy knowledge is very good if not students are in trouble.
I still beleive that Teaching Root in a historical sense is a great place to start......
1. there is huge amounts of information out for the students to read.
2. It gets them to think about terms such as Varus, Valgus, Pronation, Supination etc.
3. The Root biomex exam gets the students to feel and touch feet and it can easly be built upon as the days go past.
4. it gets then to measure, discuss and think about gait and " the Normal foot"
Then after the Root exam is understood the students are taken thru the process of looking at the problems with the ´cookbook´approach. It gets them thinking about understanding to who, why and where of what they read not just in biomechancis but in all readings.
So then Subtalar joint axis Rotation and Equilibrium theory is introduced. This is where I find the students start having light bulb moments - It somewhat starting to make sense.
The Nester module of MTJ is introduced and discussed
Then different models of biomechanical treatment must be introduced such as sagittial plane, tissue stress etc.
The above level 1 biomechanics.
Level 2 looks in more detail the things that we throw around here such as internal, external moment, vectors etc. Now these things have been introduced in level 1 in discussed of the STJ and MTJ but they get expanded on in level 2. Level 2 becomes much more physics based.
I´m sure I could expand but thats it for now. -
I'm not a podiatrist so can you tell me what percentage of the curriculum is currently devoted to biomechanics - approximately. The school that an ex colleague of mine attended seemed to be as little as 10%. That was a few years ago so has this changed. I would guess that in the US and AUS it is slightly different?
Robin -
Eric -
Some thoughts on what should be taught:
Anatomy. Terminology (definitions varus etc.)
Biomechanical anatomy including seeing joints move and how motions are limited. (ligaments and bony block of motion.)
An axis of motion is an imaginary line that describes motion and an imaginary line cannot limit motion
Physics: Newton's laws (if it moved something caused it to move) (if you use the term compensation, explain what forces cause the compensation.)
Free body diagram analysis.
Rotational equilibrium
Stress, strain and failure (Causes of mechanical pain)
Above applied to anatomical structures. Modeling (Kevin's rotational equilibrium model) (Windlass mechanism) HAV formation.
Orthotic Theory (How an orthotic alters the internal and external forces within the foot.)
Muscle biomechanics (length tension curves.) Muscular input into the mechanics of the foot is variable. pennation, tendon excursion, lever arms at various joints. Multi joint muscles.
Maybe not necessary but would be helpful to understand research
Joint power
Physics of walking
Not necessary, but helpful historically
The concept of paradigm/ paradigm shift
Comparison of different paradigms Neutral Sagittal plane
Those are some quick thoughts
Eric -
Better to have it integrated into the curriculum, biomechanics is not a specialist area of practice, forces and their effects on the human body influence all areas of practice. Teach fundamental mechanics then integrate into curriculum from paediatrics to gerontology (and everything in between). Foot orthoses do not = biomechanics, nor ever will.
-
Regards,
Eric -
-
If you are teaching a student to become an automobile mechanic, you first teach him how an engine and all of its components function. You then teach him how to take an engine apart and how to put it back together again. Finally, you teach the student how to diagnose engine trouble and how to repair it. Mechanics is mechanics, be it auto related or bio related. Anatomy, physiology (at the functional level need), diagnosis and then treatment.
Regards,
Jeff -
-
I agree that biomechanics needs to be integrated within the curriculum of the multiple disciplines taught within podiatric medical colleges. However, biomechanics also needs to be taught separately as a discipline to enable deeper understanding of important biomechanical concepts.
In the first year of study, along with typical lower extremity anatomy courses, there should be a good basic course on biomechanics terminology. Forces, moments, kinetics, kinematics, axes of rotation, rotational and static equilibrium, rigid body modelling, moment arms, elastic modulus, stress, strain, pressure, shearing, tensile, compression forces, vector analysis, free body diagram analysis and modelling concepts, to name a few, should be introduced and taught so that students can have a firm undertstanding of the basic concepts that are discussed in musculoskeletal biomechanics research.
In addition, somewhere within the first or early second year, I would teach Root et al's concepts of lower extremity deformity classification to allow the students to better appreciate the various structural abnormalities within the foot and lower extremity that exist within the population. I would discuss the limitations with the subtalar joint neutral position concept but also try to emphasise how range of motion examination and examination of the relative three dimensional relationships of the foot components to each other may affect foot function and foot pathology. Gait function for walking and running would be introduced and gait examination techniques started.
Within the second year foot orthosis the competing biomechanics theories would be introduced, subtalar joint axis rotational equilibrium theory and tissue stress theories would be particularly concentrated on, along with how foot orthoses may be designed to minimize pathological stresses in injured tissues. The history of orthoses and standard orthosis types and modifications would also be taught along with orthosis casting/imaging techniques and manufacturing techniques. Gait examination techniques would be practiced.
In the third year, practical skills for examination, orthosis casting, gait examination, orthosis modifications and diagnosis and treatment of various common foot and lower extremity pathologies would be taught. Emphasis here would be in trying to integrate the concepts learned in the first and second years into a more mature ability to use these biomechanics concepts, along with tissue stress concepts, to understand how best to treat mechanically-based injuries of the foot and lower extremity. Also emphasis would be placed on the biomechanical effects of common foot surgeries and how changes in internal structure of the foot and lower extremity can positively and negatively affect the kinetics and kinematics of gait.
Of course, the list above does not represent a comprehensive list of concepts that should be taught in podiatry school. Rather, these suggestions outline a basic idea of the more important biomechanical concepts that I feel should definitely be taught to podiatric medical students to make them better clinicians in the future.:drinks -
Jeff -
How is that cloning technology coming along anyway....? -
Thank you,
Daniel-
Dumb x 1 - List
-
Loading...
- Similar Threads - Should Biomechanics Taught
-
- Replies:
- 1
- Views:
- 313
-
- Replies:
- 3
- Views:
- 720
-
- Replies:
- 5
- Views:
- 1,143
-
- Replies:
- 5
- Views:
- 2,162
-
- Replies:
- 4
- Views:
- 1,971
-
- Replies:
- 41
- Views:
- 8,709
-
- Replies:
- 3
- Views:
- 2,571