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Its all about the 'fit'

Discussion in 'Biomechanics, Sports and Foot orthoses' started by David Smith, Feb 22, 2014.

  1. David Smith

    David Smith Well-Known Member

    Members do not see these Ads. Sign Up.

    Any orthotic that is going to work has to address the underlying repetitive motion of "overpronation" (overpronation is the maximum range of motion the arch makes with each step, which results in, "wear and tear" over time). This biomechanical damage, once it occurs, is due from a lifetime of footsteps.

    Comparatively, each footstep is like a mile in a car. So every decade of life is like 100,000 miles. In order to repair that cumulative damage a proper fitting orthotic is essential.

    The fit of the orthotic, must meet 4 criteria:

    the orthotic must be supportive; the person must feel the support such that it is full or snug fitting
    it must be comfortable to wear all day without it causing more discomfort or problems (this comfort does not relate to symptoms).
    it cannot overcorrect your alignment position on the ground; you must be stable.
    It must fit the way your muscles and feet walk and not necessarily the way the foot is shaped.
    The one thing no one can tell is how long it will take to get better. Not "feeling" better, right away does not mean the orthotic is not working for you. In fact, if the orthotic meets the "criteria of the fit," it is working for you.

    To reverse the inflammation that is now felt as pain can take weeks, months or even years to restore to complete health. Remember every step you take (including around the house, let alone high activity), antagonizes the time it takes to get better.

    Various factors can result in a long delay in starting to feel better: Age, weight, mandatory daily activities (which antagonize the healing process), and if the problem is chronic (more than 1 year).

    So, how does one know their orthotics are working? Simply by establishing the "criteria of the fit." In order for that prescription to be precise, there is no compromise in the criteria. If an orthotic is helping you, but is uncomfortable to wear, then that is not a precise fit.

    How long will relief take? There is no exact way to tell that. However, correcting your alignment position to the ground will improve your lower extremity mechanics and will reverse the damaging effects that a lifetime of overpronation has caused.

    :dizzy:Look into my eyes, look into the eyes, the eyes, the eyes, not around the eyes, don't look around the eyes, look into my eyes(clicks) you're under, Now its all about the fit, ignore the symptoms, you have no pain, its all about the fit, nice and snug, nice and snug aaand, 3, 2, 1, you're back in the room.:eek:


  2. Griff

    Griff Moderator

    Dave - what is the original source of this nonsense?


  3. David Smith

    David Smith Well-Known Member

    If you smell something fishy Dr then it was probably D. smoked fish you had for breakfast (cryptic clue);)
  4. David Smith

    David Smith Well-Known Member

    Just to reiterate incase the hypnosis has worn off

    Look into my eyes, think oly of the 'fit':D

    Don't you just love it :empathy:

    Dave (sorry I'm having a fit - a laughing fit- Lemon Monster gone everywhere
  5. Griff

    Griff Moderator

    And all this via the internet without even assessing the patient...

    I don't know how some clinicians happily look at themselves in the mirror.
  6. David Smith

    David Smith Well-Known Member

    What's that you say madam, your foot still hurts? don't worry your silly little haed about symptoms Mrs, think onlyof the fit. Is it snug eh, is it? Yes snug, it must be a snug fit under your arch - that the fit you know madam, once you have the 'fit' your there. The pain? that'll be ok just give it a year or two, no problem - Byeeee!
  7. David Smith

    David Smith Well-Known Member

  8. Craig Payne

    Craig Payne Moderator

  9. Griff

    Griff Moderator

    Wow. Just skimmed the site. Turns out time travel is possible. For 5 mins there I was definitely in the 1980s....
  10. Dennis Kiper

    Dennis Kiper Active Member

    Dr Smith---you really are a knucklehead.
  11. David Smith

    David Smith Well-Known Member

    Thank you

    BTW I'm not a Doctor

    I'm sorry to keep having a go at your ideas and writing,this format does bring out the best and worst in me. When I was a newish podiatrist Kevin Kirby taught me to be precise in what I say and how I say I in this medium. This is because unless you do that there is so much ambiguity and Lee way in the written word that without any other clues or context it can become meaningless, worthless and very frustrating to discuss in a rational way.

  12. And, I must say, Dave, that you now write with great clarity and show good biomechanical insight in your postings. Unless an author can write with great clarity, lack of ambiguity, and good biomechanical insight, the words that they write here are nothing more than gibberish that has very little purpose other than to fill space.

    When I read Dennis Kiper's advertising on "Silicone Dynamic Orthoses" I could see immediately what he was trying to do. Not only does the information on his web pages not make good biomechanical sense, it is obviously being written to sell his product on the internet.

    I don't know, Dave, why you are bothering to get into these discussions with Dennis Kiper? Maybe, it was like me trying to argue with Dennis Shavelson, Brian Rothbart or Ed Glaser? Probably, the only good that will come of it is that these individuals will become more exposed to the rest of the podiatry profession as to what they really represent within our profession. You cannot expect to change them, but certainly you can expose them for what they are.
  13. Dennis Kiper

    Dennis Kiper Active Member

    As a scientist evaluating biomechanics thru an advertising site, tells me you're a coward, unable to address the “senseless” biomechanics in my article.

    If you ever have the nerve to try a clinical trial at the school, ...you don't have the nerve!
  14. David Smith

    David Smith Well-Known Member

    Don't give me that old cods, it might be an advertising sight but your presenting the information like it's a serious explanation of biomechanical principles but in my opinion it's misleading and plain wrong.
    So how about addressing my query about the pressure mat scenarios that you present.
    You are using a mat scan not F SCAN INSOLES and purport to compare a bare foot, A foot with a rigid shell orthotic and a foot with your SDO. But each one clearly shows the bare foot shape. So how did you manage that? Did you tape the orthotic to the foot before walking over the mat scan? What we seen then on the SDO example as you walk over the mat scan is the forces applied to the sensors by the plantar surface of the SDO IE THE BOTTOM OF IT and not the interface pressure between orthotic and foot, how is this useful?

  15. Dennis Kiper

    Dennis Kiper Active Member

    Don't give me that old cods Is that the same as BOLLOCKS!!??

    walk over the mat scan is the forces applied to the sensors by the plantar surface of the SDO IE THE BOTTOM OF IT and not the interface pressure between orthotic and foot –I don't want to waste my time with you, there is a principle of physics here that addresses your answer. And since it eludes you entirely, I'm not going to bother with you. If you are not familiar with the simple science here, I've got nothuing for you.

    BTW—I already gave you an answer to your lateral column—not even a thank you
  16. Dennis:

    Just because I read some of the propaganda on your website about silicone orthoses and think you are making up stuff about your product as you go along, you think I am a coward? You are funny.

    Let me tell you a little story about silicone filled orthoses. When I was a Biomechanics Fellow in 1984 at CCPM, myself, Dr. John Weed, Dr. Chris Smith and a few of the other members of the CCPM biomechanics department trialed silicone filled insoles when a podiatrist named, I believe, Dr. Krinsky, was trying to peddle them to our department saying they were "next greatest thing in orthotics". We all thought these silicone filled plastic bladders that were put into our shoes were an interesting gimmick but useless for most purposes....and that was three decades ago.

    You aren't still using Dr. Krinsky's 30 year old design and claiming that these are the "next generation prescription in arch support", are you?? If so, how have you improved Dr. Krinsky's silicone filled plastic bladder shoe inserts, that, to me, and the other members of the CCPM Biomechanics Department were interesting but certainly weren't, even 30 years ago, the "next generation prescription in arch support"?

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