Hyperpronation

Note to self- have a word with your shrink about this toilet fixation you seem to have tonight, Spooner.

It's Bri, he just reminds me of toilets for some reason...

 

Thank You very much Simon! I am newbie in modern podiatry and biomechanics, and I sometime not understand good this sciences as You... Some time it's difficult speak and understand , especially when participants of the forum use podiatric English slang or when use a proverbs. Thanks to all and for Simon for explanation. Don't worry Simon, neurons is died when You worry)))

 

Gendel, I wish you well in your quest for the truth, but I really think that on this particular topic I have taken you with me as far as I can for now. I suspect you've already travelled further than you expected. Here's an old English proverb: "keep out of the black and in the red, nothing in this game for two in a bed"- cheers, goodnight.

 

Thanks! Good night!

 

Gennadiy:

Gendel99=Gennadiy Koshman, MD, from Grodno, Belarus

I have been following your discussion in this thread and thought I might be able to offer you some assistance.

The term "hyperpronation" is a imprecise term that will mean different things to different clinicians. Does it mean that the foot appears too pronated in relaxed bipedal stance? Does it mean that the calcaneus everts too much during the stance phase of walking or the support phase of running? Does it mean that the subtalar joint is maximally pronated? Does it mean that the appearance of "too much pronation" is correlated with increased pronation-related symptoms? Or does it mean something completely different all together?

I don't know what "hyperpronation" means, since I don't use this term for the very reason that it lacks a precise definition.

Do you know what "hyperpronation" means to you or to your colleagues? It might be helpful for you to ask your colleagues what their exact definition is for this term so you can see how useless the term is.

I believe the larger question you are asking here is what is "too much pronation" in any foot. This is not an easy question to answer since we certainly know that reducing the pronation motion of feet with foot orthoses can make many symptoms improve so we could probably say that "too much pronation" for one individual may have been the cause of their injury. However, we may perform a 3D motion analysis of the previous individual mentioned, and then do the same 3D motion analysis of another individual, see the same amount of pronation in both individuals and but the second individual may have no symptoms and have a more "normal appearing gait pattern" also. So, the question then becomes shold this asymptomatic individual with "greater than normal pronation" of the foot be also considered to have "too much pronation"? I don't think we have the research evidence at this point to answer that question.

I have spent the last 27 years of my life thinking about the questions you have been asking, doing research on these questions, writing and lecturing on these questions and doing trial and error experimentation with my patients' foot orthoses to see if I can get better answers for these questions. My current belief is that clinicians (podiatrists, orthopedic surgeons, physical therapists, physiotherapists, chiropractors) spend too much of their mental energy worrying about calcaneal position and calcaneal motion during static stance and gait and too little time worrying about the kinetics of gait. In other words, I believe that we, as clinicians that treat mechanically-related pathologies of the foot and lwoer extremity, should be focusing our attention on the forces and moments occurring across the joint axes of the foot and lower extremity and whether they are normal or pathological rather than worrying about absolute calcaneal position as an indicator of whether the foot is normal or pathological. As you know, musculoskeletal injury is caused, not by calcaneal position or calcaneal motion, but by abnormal forces and moments that act across the joint axes of the foot and lower extremity during weightbearing activities. We must realize then that only worrying about calcaneal position and the appearance of static radiographs and not considering the abnormal magnitudes of forces and moments and not considering the symptoms that may be occurring in the patient may not be in the best interest of the patient or in the best interest of the clinician seeking to offer the patient the best treatment, that has the fewest possible negative sequellae.

All of my papers and videos are available at the following website, along with some of the classics from other authors, and I think you may find many of them quite helpful at answering some of your questions.

http://www.box.net/shared/z9vvdj6lt8

The password to my website is in your private mail.

In addition, as I mentioned to you privately a few days ago, I think that if you were to read my three books, you would then develop a much deeper understanding of the questions you are seeking to answer.

Hope this helps you get started in the right direction. Good luck with your adventure in learning and I greatly admire your tenacity in seeking knowledge.

 

Thank You very much Kevin!

 

This thread reminded me of this track -http://www.youtube.com/watch?v=sTUIHK7gHRE&feature=list_related&playnext=1&list=AVGxdCwVVULXfLwUiIVFhSirhskGrTF-IH

Have a good day folks

 

Can we ban all talk of FPI influencing the jaw? I'm not saying it's completely and utterly ridiculous and beyond our scope of practice....but I didn't learn about this and it's making me edgy ;OOO

 

Indeed! There is a pattern of threads which come back around periodically. New people ask old questions. Old salesmen try to reach new customers. Circle of life.

Although to be honest, I'm rather glad of the oppertunity to ask Brian about the whole forefoot Varus / PMS thing. Whatever else we might think about the model and its claims, this seems to me to a pretty fundamental issue. If the "previously unreported foot type" is not in fact previously unreported...

Actually, what is that from an academic point of view. Plagerism? Intellectual theft?

So I'm quite keen to answer this one for me.

What, in fact, is the difference? Both involve torsion of the talus, inversion of the forefoot and and both descriptions mention that the rearfoot must evert to get the forefoot on the ground.

Pray silence for Bri's answer...

 

http://www.youtube.com/watch?v=h-S90Uch2as

 

Classic.