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Is there a need for orthoses to have a rear foot post

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Tensegrity, Oct 12, 2008.

  1. Tensegrity

    Tensegrity Active Member


    Members do not see these Ads. Sign Up.
    Well here goes.
    Over the years I have questioned the need for such a posting simply because of the alignment issues arising for the forefoot and knee.
    By holding a calcaneum in an inverted position it generally increases the load traveling down the lateral edge of the foot which usually increases the rotation onto the first ray as the foot progresses towards toe off which in turn goes back up to the knee. What happens next in the swing phase depends on whether the knee is in full extension, flexion, internal or externally rotation or a combination of these.
    Simply by showing a patient how to move the femur so that the 'Q' angle is reduced to normal limits will create the potential for a square heel strike then by controlling how the forefoot is rotating on the mid-tarsal joint and stabilizing the spring ligament the forefoot can be brought back into a parallel alignment with the rear foot. Hence there would be no need for a rear foot post.
    Is there any one out there with a similar view?
    Is there a flaw in my logical approach if so please point it out. http://www.podiatry-arena.com/podiatry-forum/images/smilies/cool.gif
    :cool:
    Now I wait with a keen interest as to what sort of response I will get to this thread
     
  2. perrypod

    perrypod Active Member

    It's all a question of balance. What works for one may not work for another.
     
  3. Admin2

    Admin2 Administrator Staff Member

  4. Tensegrity

    Tensegrity Active Member

  5. Welcome, Kevin, to the Forum!

    Firstly i will say that you will probably get a better response if you post under your real name. ;) . Some feel it discourteous to enter a dialogue without identifying yourself. However.

    Some interesting ideas. Lets examine them

    Do you have evidence for this? Also what makes you think this is a bad thing?

    Not sure what you mean here. Do you mean it increases the eversion moments around the MTJ?

    Lost me now. What goes up the knee exactly?!

    Hmmm. 'k.


    As always, you need to define your criteria for "normal".

    WHOA there.

    Firstly, is this an In your opinion? In your experiance? Have you data?

    There was a study done on Conciously changing running pattern

    http://www.viconstandard.org/_archi...aining_in_runners/gaitretraininginrunners.htm

    http://www.asbweb.org/conferences/1990s/1999/ACROBAT/087.PDF


    The concept of gait retraining is one i can quite see being useful in running which is something most will do for a matter of minutes per day (short enough for the patient to maintain focus and concious control of gait) and with higher global tone than walking. I would be interested to know if their are any similar studies carried out with patients walking rather than running.

    Also The "package of care" in these studies was fairly intensive. Most patients will not manage 3 visits a week for 8 weeks (the protocol used!




    Saying that simply showing a patient how to walk differently will adjust their gait once they leave the office is a huge claim which needs verification!

    Secondly, why are you aiming for a square heel strike?

    Few things here. How are you planning to control forefoot alignment? How are you planning to stabilize the spring ligament.

    Also what makes you think that the forefoot should be in paralell with the rearfoot (by which i presume you mean 90 degrees to calc bisection.


    There are some interesting ideas in your post, however there are also a great number of assumptions both of baseline ideals and on how the body will react to the forces you exert on it.

    Kind regards
    Robert
     
    Last edited: Oct 13, 2008
  6. Tensegrity

    Tensegrity Active Member

    Thank you for replying to my posting. I will be in touch with my responses to your questions however at the moment I am very tired yet curious to know how you found out my Christian name.

    I did not use my name when I registered because this the first time I have ever joined an internet forum and I feel the need to be cautious.

    I chose Tensegrity because of its relevance for biomechanics.

    Kindest regards
    Kevin
     
  7. hey kevin.

    I watch spooks. Amazing what you can pick up!

    Might be worth having a look at the threads on tensegrity here before we get into that! Save us going over old ground.

    Regards
    Tom quin
     
  8. Griff

    Griff Moderator

    Kevin,

    In the interest of your 'need to be cautious' maybe you should remove the link to your website from your profile ;-)

    Regards
    Lieutenant Columbo
     
  9. Tensegrity

    Tensegrity Active Member

    Robert

    These are my thoughts on the issues you have raised. My focus is on movement itself not particular conditions. Experience has shown me that once a body is in a balance then generally painful conditions tend to be resolved on the way.
    I will answer the points as you have raised them.
    1 'Evidence' - In word 'yes'
    2 'Bad thing' - It is bad for the foot simply because eventually load passes across the foot in the region of the first MPJ rather than along the plantar surface of the hallux.
    3 'Rotation' - Obviously weight has to come out of the foot somewhere due to frontal and sag. movement. The integrity of the spring ligament is a major factor in how this manifests.
    4 'knee' - What happens in the knee is a continuation of how the body mass passes out of the foot. As i see it,it has to do with the external rotation of the leg which turns the foot into a rigid lever at toe off.
    5 'Hmmm' - Movement by its very nature is a continuum and cannot be compartmentalized. How a knee moves, assuming it is normal, is determined by what is happening in the thigh and upper body.
    6 'Normal' - As we both know there huge variables and a lot effort is put into minimizing them however the way our lower limbs are designed/created the knee,in walking in a straight line should be pointing in the direction the body is going and the foot should do the same.
    7 'Whoa' - Squareness relates to the frontal plane as a heel comes to ground in the sag. plane and there should be minimal if any transverse plane activity.
    8 'Running' - What I have mentioned relates to walking only. It reminds me of the saying ' You should walk before you run'.
    9 'Control of forefoot alignment' - In many ways this is the critical factor because at the MTJ there are 24 bones at 90 degrees to the rest of the body and it is taking such a huge load. For it size the foot is truly amazing do you agree. The key here is tensegrity.
    10 'Forefoot/ rearfoot' - When they are parallel and stable less muscle activity is involved in transferring load through the foot.
    11 'Assumption' - There is only one assumption and that is does the individual have the ability or desire to work with their own body because the really big issues are at the other end of the body in the brain.

    Well that is it. What are your thoughts?

    kindest regards

    Kevin
     
  10. Tensegrity

    Tensegrity Active Member

    Robert

    Is Tom Quin a nom de plume of yours!

    Regards

    Kevin
     
  11. Tensegrity

    Tensegrity Active Member

    I am new to all of this so any helpful pointers would be appreciated.
    With hind sight I should have phrased that part of my reply differently.
    Thank you for taking the time to send me a response.

    Regards

    kevin
     
  12. Tensegrity

    Tensegrity Active Member

    I totally agree with you in every sense of the word it is all about a state of balance.

    Thank you for responding to my posting.

    Kindest regards

    Kevin
     
  13. David Smith

    David Smith Well-Known Member

    Tensegrity Kevin



    Kevin

    My thoughts are, its good that you are prepared to discuss your illusions in public on the Podiatry Arena. It takes some guts to put new ideas in front of old dinosuars and traditional thinkers. I think Robert said you had some interesting ideas, he may have meant challenging ideas, which IMO they certainly are.

    I may be completely wrong and someone might put me straight (which they usually do) However I think, (it's just me tho) that you should reread some of Howard Danenburg's writing regarding saggital plane theory, have a look at some anatomy books, rediscover some of the classics of podiatric biomechanics by Hicks, Root, Kirby, Payne, to name a few, pass some time digesting the works of Winter and Perry describing gait, normal and pathological, delve into some stuff on Tensegrity by K Miller, Levin and Chen, if that's where your at, take some time to understand some biomechanical principles as explained in papers by Winter, McPoil, Nigg, Fuller, Kirby etc and then have a rethink about your theories. In my opinion they are a little of the wall and you may be getting a bit confused but well done for discussing them here. This is how you learn (I hope I did and still do) and many lurkers should take note.

    Your terminology, writing style and replies are difficult for me so perhaps you could take more time to explain you ideas more clearly Kevin.

    All the best Dave Smith
     
  14. I've been following this discussion and debating with myself over whether to join in or not. To be frank, Kevin your online tag "tensegrity" put me off, as I'm sure it has other potential contributors here, having been around that stump and been dissapointed too many times before. I couldn't help thinking to myself, here's a guy trying too hard to be contentious just for the sake of it, forgive me if I'm wrong. Contentious and I are happy bed fellows, but as a prof. once said to me when I turned up to a tutorial with a Mohican haircut- "you can be too avant-garde, Simon. You look like a nob and you're not serious about that hair cut are you?". I've waited to see if you'd start discussing tensegrity, and you didn't disappoint. I have an open, enquiring mind and if completing my PhD taught me one thing alone, it was that I (we) don't know everything. To that end regarding tensegrity, in Vegas at PFOLA 2003 I was lucky enough to hear some presentations by individuals who apparently have a far greater understanding of tensegrity than you. After listening to these lectures Kevin Kirby, Erin Ward, Chris Nester and myself even sat in a bar there and made tensegrity models to explore the concepts further. I've also read the postings of Kevin Miller both here and on the old podiatry mailbase regarding tensegrity and the references he provided to support his conjectures; In fact I'm still waiting with baited breath for the research Kevin Miller (who incidentally appears to have a far better understanding of tensegrity than yourself thus far) has been promising us for too many years to remember. But Kevin, in short I think for the benefit of everyone's learning that it may be better if "we walk before we can run" and drop the "tensegrity" thing for now. Since at the moment, you are coming across as someone whom I wouldn't trust to sit the right way around on a toilet seat, let alone prescribe me foot orthoses. Sorry if this seems harsh, but I am.

    SO.... Back to where you came in, and lets take it one step, one point at a time (don't worry, we'll work through them all) to make it easier for everyone to understand:

    You wrote:
    Can you please provide references that support your contention that foot orthoses with rearfoot posts "hold the calcaneum in an inverted position"?

    Thank you.
     
    Last edited: Oct 15, 2008
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