Kevin Kirby Questions
What do you like best about being a podiatrist?
Podiatry is unlike any other medical profession. In my podiatry office I am a surgeon, a dermatologist, a vascular specialist, a neurologist, an endocrinologist, an orthopaedic specialist, a radiologist, a physical therapist, a shoe expert, and a mechanical engineer, all rolled into one. Since the foot is the only part of the human body that regularly receives external forces that are greater than our body weight and is the only appendage whose mechanical function affects nearly all other mechanical parts of the human body, what other medical specialty can claim such a diverse scope of practice for such an important part of the human body?
I greatly enjoy being a member of the one medical profession where patients walk into the medical office in pain and walk out without pain on a regular basis. I love helping people feel better and I love being one of the few medical professionals that can give people the ability to enjoy life more fully through improved foot and lower extremity function. My decision to become a podiatrist was the second best decision that I have ever made in my life. The best decision of my life was made 31 years ago when I asked my lovely wife, Pamela, to marry me.
Do you expect custom foot orthoses to become more or less popular in the next 20 years? Why?
I expect custom foot orthoses to become even more popular over the next 20-30 years. Over the past 10 years, we have seen a virtual explosion in scientific research showing custom foot orthoses are highly effective at positively altering the kinetics and kinematics of gait and at healing injuries of the foot and lower extremity. I predict that there will come, with further research evidence of their therapeutic benefit, a gradual realization that custom foot orthoses are a relatively inexpensive, very effective treatment that has a minimum of side effects for individuals that suffer from painful mechanically-based pathologies of the foot and lower extremity. With the obesity epidemic growing every year, the therapeutic value of foot orthoses will become more widely realized as one of the few conservative medical treatments that is able to effectively reduce the harmful mechanical effects of obesity on the structural components of the foot. Yes, the future is very bright for custom foot therapy in the coming decades.
What new developments do you expect to occur within the science and practice of podiatric biomechanics within the next 20 years?
As knowledge of the biomechanics of foot and lower extremity function increases, there will likely also be an increase in new developments that may further help us determine the best orthosis prescription for our patients. I believe that we should see, within the next 20 years, foot orthoses with integrated circuitry that allow the motions of the foot and pressures between the foot and orthosis to be remotely transmitted to the treating podiatrist.
There will be foot orthoses manufactured with miniature accelerometers that can monitor the motions of the foot and lower extremity during normal walking and sports activities. Combination pressure mats/force plates, improved three-dimensional motion analysis systems and improved computer technology should allow researchers to better understand the intersegmental function of the human foot. Improved MRI imaging technology within the next 10-20 years will allow us to better understand the microscopic pathophysiologic processes that occur within the bones, cartilage, tendons and ligaments of the human foot.
This technology will allow us to better appreciate the mechanical factors that lead to injury and how mechanical therapies, such as custom foot orthoses, can positively alter the function of the foot to heal these injuries. In addition, three dimensional foot scanners that transmit digitized three-dimensional information to orthosis labs that then rapidly mill foot orthoses with cad-cam orthosis manufacturing processes will become the norm, and not the exception, within the next two decades. The next few decades will be a very exciting time within the field of podiatric biomechanics.
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