Hyperpronation

No worries Craig. What it does show is that we don't know what's going on inside the shoe, unless we've got x-ray spex. If the rearfoot is at end of range eversion and there is a "residual" eversion moment (i.e. the external eversion moment has not yet been matched by the foots internal supination moment), the shoe is likely to continue to evert until the moments are balanced via compression of the medial sole and /or distortion of the upper on the sole unit and if necessary movement will occur between the foot and the shoe- any way it can to get the system to static equilibrium.

I've never disagreed with the concept, Craig; just pointed out the flaws in your proof.:drinks

 

Moreover, if the eversion "stiffness" of the foot is greater than the eversion "stiffness" of the shoe, the magnitude of eversion observed in the shoe for a given external eversion moment, will be greater than the magnitude of eversion observed in the foot. And vice versa. In other words the stiffness determines the deformation observed within the elements of the system, for a given load. :drinks Now that was useful little discussion, Craig. I think I taught myself something useful there, thanks for the help.

 

OK. What references with "high evidence" I must show to my boss that change his point of view? That we accept and change our approach to understanding biomechanics and treatment options? If I say to him that I read it in Internet forum... he will be laugh and may discharge me from hospital. I need in strong arguments.

 

Hyperpronation, excessive pronation, over-pronation, excessive foot twist (my particular favorite) or which ever term you choose to use is linked to the transverse oscillation of the hips during gait.

Normal pronation (normal foot motion) is where the foot is driven by hip drive (internal hip rotation pronates the ipsilateral foot, external hip rotation supinates the ipsilateral foot) - See http://rothbartsfoot.es/NormalPronation.html

Abnormal pronation (abnormal foot motion) occurs when the foot has escaped hip drive and whose motion is being driven by some other cause (usually a structural deviation in the foot) - See http://rothbartsfoot.es/NormVsAbnorPron.html

An excellent book that goes into more detail regarding the coupling of the foot to the pelvis is:

Inman V 1976. The Joints of the Ankle. II. Biomechanics of the Subtalar Joint. Baltimore. Williams & Williams.

Hope this helps.

Professor Rothbart

 

Apart from all the ones we've given you so far??

 

If only it was that simple. You need to look at the direction of power flow during gait. http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=49332

 

The closer you get to the cause, the easier it is to understand

Understanding abnormal foot motion (e.g., abnormal foot pronation, abnormal foot supination), in my opinion, is that simple, when you correlate it to the coupling of the foot to hip.

Professor Rothbart

 

Thanks to all. I will try to show him this... but I feel that he show me links with another point of view and said that he right. How I can him to prove that this links have more high level of evidence?

 

The mean coupling between the rearfoot and hip has been shown to be only "moderate" and if power is flowing from distal to proximal, the foot is more likely to be driving the hip, not the other way around. Simple, Bri.

 

Find all of the papers which demonstrate that rearfoot eversion beyond 6 degrees is linked with pathology- then critically evaluate them. That way you will see the weakness in the argument.

 

Gendel 99

There is a lot of free information on the Arena to help you become more up to date and many PDF´s you just have to read and spend time.

Try this thread and a small guide re threads etc - http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=67340

 

Excuse me Simon! But I don't understand fully... Greek prefix hyper- mean over; beyond; above or "Hyper- is used to form adjectives that describe someone as having a lot or too much of a particular quality" - Collins Cobuild Advanced Learner’s English Dictionary 2008 Ed. What is the difference between "hyperpronated STJ" and "maximally pronated STJ". Explain it please. Maybe it's simple difficulties in translation:bang: Why it's NOT synonyms? Thanks for understanding!

 

Simon,

Thank you for informing me that the coupling between the rearfoot and hip has been shown to be only moderate. In my 40 years of research and clinical practice I was not aware of that.

Would you be so kind to direct me to the double blind study that has shown this coupling to be only moderate?

Professor Rothbart

 

How would you Double blind a study on Force coupling ?

In my 10 seconds of reading Wikipedia

 

In your 40 years of research, you should have perhaps tried to understand more about research methodology. A double blind study is completely irrelevant to this.

Anyway here is the reference to improve your awareness, Bri.
http://www.ncbi.nlm.nih.gov/pubmed/20621756

Lots of love, Simon xxx

 

Dear Simon,

Until you can direct me to that double blind study(s), you comment regarding moderate coupling between hip motion and foot motion can only be taken as your opinion.

In my clinical experience I have found that hip-foot coupling to be an invaluable aid in evaluating whether I am dealing with (in my opinion) normal (hip driven) or abnormal (gravity driven) foot motion (that includes both pronation and supination).

Oh, by the way, I believe I was involved in research and publishing (in JAPA now JAPMA) while you were still in diapers.

with regards,
Professor Rothbart

 

Hi again Bri,

It's pretty obvious to me and at least some of my colleagues that you don't even appear to know what a double blind trial is. Take this little gem from you in May this year:

As my colleague pointed out to you in that thread, that was a reliability study, not a double blind randomized trial as you stated. Suggestions of not knowing your arse from your elbow when it comes to research methods?

Can you explain why double blinding should be required for the study which I cited? Moreover, can you tell me why the study I cited is flawed?

As I did not publish this study, the findings of the researchers who concluded that coupling between the hip and rearfoot was only moderate is clearly not just my opinion, it is the opinion of the authors too. Do you have data which challenges theirs?

I'm pleased for you that you have led such a long career. When you talk about clinical experience, was this the experience you gained before or after you lost your license to practice in the State of Washington http://www.podiatry-arena.com/podiatry-forum/showpost.php?p=16244&postcount=18 ? As we all know, your clinical experience has led you to make all kinds of extraordinary claims, including treating infertility with insoles. Now's there is one which might have benefitted from a double blinding, and I'm not talking kinky sex games, Bri.

Best wishes,
Si xxx

 

Dear Simon,

My experience in Washington has nothing to do with this discussion. However, since you brought it up, I suggest you read my book - Forever Free From Chronic Pain. It discusses exactly what happened to me in Washington State (which I think everyone knows about by now).

Simon, you still have not cited any reliable studies to collaborate your statement. Until you do, it still stands as your opinion and nothing more.

Professor Rothbart

 

Bri, What is unreliable about the study I cited? Here it is again: http://www.ncbi.nlm.nih.gov/pubmed/20621756

As you can see, published in a highly respected, peer-reviewed journal.

As for reading your book :deadhorse:, I'd rather eat my own turds.

Big hugs,
Si xxx

 

Well that has to be embarrassing! Boasting about something being a double blind randomized study when it is in fact neither double, nor blind, nor indeed randomized (it is a study, so one out of four ain't bad).

Also, as an aside Brian, you said:-

It doesn't do that either. It measures how repeatable a biovector is at measuring how high off the ground the 1st met is when the patient is in static stance.

I had a small epiphiny when I was reading your recent publication in Podiatry review. Your previously unreported foot type is not, in fact, previously unreported.

You said, and I quote

Later you say

Right, so PMS, this unreported foot type is what happens when the talar torsion is 35 degrees or more and causes the forefoot to be inverted when the STJ is in neutral. In fact, it is said to exist any time the 1st met is off the ground when the foot is in neutral.

My copy of Valmassy says:-

Forefoot Varus
This is an Inverted position of the forefoot relative to the rearfoot.... it is due to inadequate frontal plane torsion of the head and neck of the Talus.... Calcaneal eversion is required to.... allow the forefoot to purchase the supporting surface.

So, just so we're clear,

Rothbarts foot is an inversion of the forefoot relative to the rearfoot caused by torsion of the talus which requires the rearfoot to pronate to get the forefoot to the ground.

Whereas Forefoot varus is an inversion of the forefoot relative to the rearfoot caused by torsion of the talus which requires the rearfoot to pronate to get the forefoot to the ground.

Unreported foot type my bum!!! . Hats off to you Brian. You took the oldest condition in the world, rebranded it with your name, and sold it back to everone as something you discovered. Whilst I abhor your debasement of science, I have to admire your bare faced gall!

 

I don't. I think he's a prick. Although, he may well be the re-incarnation of J.R. "Bob" Dobbs, in which case I think he's the messiah. What if Bri really is the leader of the Church of the Sub-genius? He has all the credentials.... No, he's just not slack enough.

 

In other news, I've discovered a previously unreported foot. Its called cum digitorum pedis
and is now commonly called "Isaacs foot". It's an embryological condition in which 5 long thin growths take place at the end of the foot. Having these growths (or "toes" as I like to call them) is pathognomic of Isaacs foot. Isaacs foot is though by Isaacs to be the cause of cancer as in a recent study, 98.9% of cancer sufferers tested positive for Isaacs foot. Isaacs also reports CDP to be the cause of mental health disturbance by an ascending pattern of neurological disruption.

Read all about it in my book, "forever free from having to learn research methods".

 

But such a BOLD prick.

 

All in all I would like to know why you would even consider a double blind study design in a hip to foot force coupling experiment.

I understand research can be a little boring with number working but Im not sure being drunk and wearing a blindfold would help.



Confused of Stockholm

 

Juliet:
"What's in a name? That which we call a prick
By any other name would smell of cock (and bull)."
Romeo and Juliet (II, ii, 1-2)

 

Simon,

Your elegance in expressing yourself is truly laudable and very impressive. Congratulations!

One last time and I do mean One last time -

Sorry, the study you cited does not meet the Gold Standard that you have set up in so many of your responses (Evidence Based Studies, Blinded Studies, etc etc). So why are you baulking about it now.

First of all, the study you cited is a 3-dimensional kinematics study using Pearson correlations to interpret the findings. As you know, probability studies are just that, they only suggest a correlation (mild, moderate, strong etc). They do not prove the correlation.

Secondly, as I have asked, do you know of any double blind studies on the foot-hip coupling? Does anyone know of any double blind studies on this coupling? I think not.

Now Simon, if you continue with your (in my opinion) childish diatribes and unprofessional behavior, I am going to graciously withdraw from making any other comments. However, if you can discuss this subject professionally and make it into an interesting exchange of ideas, I am all for it.

Professor Rothbart

 

Nah, he`s not:

http://www.youtube.com/watch?v=Zjz16xjeBAA

 

Bri,

This study is a good study. It's design was suitable and adequate for the purpose of the study. It was not a trial of treatment X versus treatment Y, so to repeat myself once again, why does this particular study require double blinding? Moreover, how would YOU design the study?

Actually, correlational studies show the strength of the relationship between two or more variables or how well a given model fits the data. Thus, they measure the strength of a relationship and/ or how well the model fits the data; what you cannot say is that they prove causality. Which is, I think, where you are getting confused. Yet, since this study does not investigate nor make inferences regarding causality, nor needs to, your contention is completely hatstand. Rather, it is you who is trying to prove causality, with your contention that hip motion causes foot motion- now, since it was you that put forward this premise, it is not for me to disprove your contention, it is for you to evidence it.

Frankly, you don't understand the research or research methods do you? Explain to me why you think this research is invalid.... bet you can't, Bri.

Bri, do you concede the point that this is not merely my opinion that hip motion is only moderately coupled with rearfoot motion, or will your ego not allow you to admit that you were wrong?

Sweetness and light,
Si xxx

BTW, if we take the r square, what this study tells us is that roughly 75% of the variance in rearfoot motion cannot be accounted for by hip motion. Which tells me your contention is a pile of sh!te, Bri. But since you built yourself a parachute in your last post, Bye-bye, Bri.

P.S. you know when I was "still in my diapers"? I was sh!tting harder and more intelligent things than you, even back then. Sleep-tight. Professional my arse, you wouldn't know professional if it came up and lamped you, you can't see further than your own ambition.

 

Ah its good. Its all good. In many ways, Brian does bring our the eloquence in Dr Spooner.

When you get a minute Bri, is there any chance you could explain to me the difference between forefoot varus (inversion of forefoot caused by torsion of the talus) and PMS (inversion of the forefoot caused by torsion of the talus)?

Thanks buddy.

 

I nominate this sentance for the Pod arena, laughing baby award.

Seriously Brian, do you even know what a double blind study is? I'm not sure its even possible to do a double blind study on foot - hip coupling.





Seriously Brian, do you even know what a double blind study is? I'm not sure its even possible to do a double blind study on foot - hip coupling.

 

"His silence speaks volumes" Hope you get better soon, Bri http://www.youtube.com/watch?v=EaCaSb-109k "Take him away"
"We'll all be smiling then".

 

geeeeeez.

 

Nominations for 2011 posts of the year! :hammer:

Brian; don't threaten the Arena with a good time!

http://www.youtube.com/watch?v=ehdWE19bS84

 

Gentlemen! You are distracted from topic! And all forgot about my question...:morning:

 

Quite true. See Craig for a full refund of the money you paid for our undivided attention.

 

It hasn't been forgotten - it's already been answered!

 

The parents of a child with AHDH have a lot of stress and hard work.

Craig how does he do it - :craig:

 

No, we gave you answers to your question. The horse has been led to water, now you have to choose whether to drink or walk away.

 

I remind

 

maximal: of, relating to, or achieving a maximum; being the greatest or best possible.

i.e. end of range pronation

hyper-
pref.
1. Over; above; beyond: hypercharge.
2. Excessive; excessively: hypercritical.
3. Existing in more than three dimensions: hyperspace.
4. Linked or arranged nonsequentially: hypertext.

viz. hyper-pronation is beyond maximal pronation- thus it should require the joint to be subluxed or dislocated. Why do I get the feeling I'm repeating myself endlessly in this thread?

Gendel, we have entertained you at our table. Now it's time to sh!t or get off the pot- really.