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MASS Orthotics Require No Podiatrist, Functional Foot Typing Does

Discussion in 'Biomechanics, Sports and Foot orthoses' started by drsha, Dec 18, 2010.

  1. drsha

    drsha Banned

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    Re: Competing Theories of Foot Biomechanics Lectures
    Originally Posted by drsha View Post

    Just finished reviewing your lectures (I and II) on The Future of Biomechanics.

    As I have always maintained, "you are the future of biomechanics for the masses" Your machines will be in Walmarts and CVS's around the world and I am so pleased to know that you and my profession was the ROOT of it all.

    You go man>

    My question to you is what is the future of biomechanics when it comes to our profession as you and I know that you can teach your casting method to a 12 year old with pimples who then puts the two boxes into the unit that goes to the lab that produces the MASS device.
    That means the chiro/PT/Shoe clerk/athletic trainer and even two boxes on the internet, in addition to DPM's are the targets of your marketing and justifiably so.

    You are a patient advocate and I am so pleased to see you thrive at that level.

    But what does this mean to Podiatry in your future plans.

    We are the two that agree that MASS or Vaulting and postural care of the foot is the foundation of foot and postural care. These other guys are lost in their pronated STJ Neutral genotype.

    However, we differ , professionally that pedal evaluation and custom casting, ORF's and Muscle Engine evaluation and training also plays a part in the professional care of the foot and posture. That is the job of the DPM in the future of biomechanics and my functional foot typing and foot centering padding system is the current paradigm that will keep the Podiatrist professionally in the box that will live outside yours.

    Please consider our profession for the future as providing functional foot typing and foot type specific casting, ORF and muscle engine training for advanced cases or those that for some reason, do not work out in MASS devices.

    I say that as an advocate of podiatry and patients both.
    We need to maintain a doc in the box.

    Happy Holiday to you and yours.

    Reply From Robert Isaacs:

    Apart from the bit about everyone else still using stj neutral casting, which is pure fantasy, this is actually not a bad point from dennis. If the paradigm is based on the casting position (and so far as I know sole supports don't use any other position) and that position is easy to learn (it is) then how long before someone puts two and two together and starts punting them out at 40 quid a pop from the shoe shop up the street? After all, mass requires no assessment or diagnosis so it does not need a podiatrist. Any trained monkey who can do mass casting can undercut you!

    Good point dennis. I second the motion for a reply.

    This posting from another thread deserves a thread of its own so as not to divert the original thread's topic..

    MASS, Sole Supports Orthotics, although a great advance to the field of biomechanics, can be delivered by The MASSES

    Functional Foot Typing is an evaluation, assessment, custom casting, custom prescribing biomechanics paradigm that requires professional foundational knowledge and practical experience.

    Functional Foot Typing is deliverable by Podiatrists and those few adjacent professionals that have taken the time to develop a foundation and practical experience in FLEB .

    Dr Sha
  2. A valid point, deserving of an answer!
  3. David Wedemeyer

    David Wedemeyer Well-Known Member

    I have to agree with Dennis here and in the past have posted proof of where Ed sells his insoles to chain shoe store pedorthists branded under a different name (CBAS). In fact, Ed admitted to it and claimed it was due to "client request" that this was so. No one appeared to deem it important at the time but perhaps Dennis will have greater luck in exposing Ed's agenda here for all to see for themselves.

    We may not have agreed in the past on much Dennis but I agree with you 100% on posting this thread. Ed claims to care about podiatry but a closer look will reveal that he is clearly out for himself and for profit.

    It would be very interesting to know how many CBAS insoles are being dispensed and the percentage which are accompanied by a script for medical necessity from a physician...
  4. Actually I think both Ed and Dennis propagate their different yet highly reductionist theories to the masses who are willing to listen and that either idea could be taught to a shop assistant with very little training.

    So is this a bad thing? If they both relieve their patients symptoms, who cares?

    And that to me is the key: across this world there are any number of people putting forward their ideas on how to treat foot and lower limb problems. At the end of the day, who really cares about these people? Ultimately, I only really "care" for my own patients and my own "loved ones".:morning: Not Ed nor Dennis... So I'm not REALLY interested in what they have to propagate. Very little interest in either of these people.

    See y'all?
    Last edited by a moderator: Sep 22, 2016
  5. drsha

    drsha Banned

    I hope that Ed is taking his time in pondering a revisit to my original posting as I would even accept a pass on this one in order not to avoid inflammatory comments from The Arena.

    I also appreciate the common ground that is being displayed on this thread which I maintain is greater than has been appreciated in the past.

    We all have an agenda for living life that includes bias.
    On this Forum, our agenda's share Biomechanics in common and as we are human, we all have bias in the ethics and moral issues that govern the subject.

    Bias can take many forms:
    There is profit motive.
    There is acceptance of our ideas by others.
    There is the desire to develop a following.
    There is the desire to be celebrities.
    There is the desire to authenticate and certify ourselves with selfish motives, such as to impress those we work with and treat.
    There is the desire to create conflict and polarization within the biomechanics community.
    There is the desire to create a buzz.
    There is the desire to help our fellow men and women
    There is the desire to teach.
    There is the desire to create a legacy, good or bad.

    I myself own 6 or more of these biases.

    No one of these trumps the others or justifies the elimination of or the right to villify those that hold bias's different from our own.

    For The Holidays:

    Let he who has none of these bias's set forth to reduce the value and acceptance of the statements of those that are biased
    Let those with bias consider revisiting their own motives instead of focusing on the assumed motives of others so we can all do the stuff we love to do, more united.

    Dr Sha
  6. "Leave it behind
    You've got to leave it behind
    All that you fashion
    All that you make
    All that you build
    All that you break
    All that you measure
    All that you steal
    All this you can leave behind
    All that you reason
    All that you sense
    All that you speak
    All you dress up
    All that you scheme... "

    Walk on- U2

    "You've got to leave it behind"
    "It is easier for a camel to go through the eye of a needle, than for a rich man to enter into the kingdom of God." (Matthew 19:24)"

    Word up.
  7. Two types of people in the world. Those who are biased and know it and those who are biased and don't know it.

    The debate over whether MASS, or FFT, or indeed tissue stress work better than one another is the one we usually have. This one is a different debate, one I had not considered. If MASS is "true" is it the end of biomechanics? That should not influence our view of it, but it is an interesting question. Do I need to retrain against the day every monkey in a shoe shop does as good a job with mass issued MASS orthoses as I can? Was all the work I put into learning all those conditions, all that diagnosing, all the prognoses, all of it for nothing? Will future generations of students have only to learn the one position to treat every condition and not bother with finding out what the condition is?

    I restate. Dennis' question is a good one. I think we should let him explore it with Ed. I'm going to butt out now and let them at it without further interferance, but I will be watching with keen interest.
  8. David Wedemeyer

    David Wedemeyer Well-Known Member


    Someone said to me that the difference between you and Ed is that you truly care about your profession. I have to agree, at least based on what I know and have read thus far. This does not mean that Ed does not care about his fellow podiatrists at all, but I do feel strongly that he has chosen a market mainly outside his profession and that speaks for itself. Only Ed can truly know the reason for this but I don't think it takes a genius level I.Q. to figure out why.;)

    I will butt out now and let you colleagues discuss it as Robert has wisely suggested.
  9. Graham

    Graham RIP

    “Ordinary riches can be stolen, real riches cannot. In your soul are infinitely precious things that cannot be taken from you.”

    Oscar Wilde
  10. drsha

    drsha Banned

    Dr. Glaser:

    I remain respectful of you and your work.

    I personally believe that your driving force is to benefit the foot and postural suffering public with your work.

    You are successful enough that profit could not be your main interest any longer.

    There seem to be three possibilities for The Future of Biomechanics.

    1. Podiatry will once again reign at the top of The Biomechanics Pyramid in The MASS Paradigm.

    2. Your work is so universal in its reproducability and effectiveness and accomplishable by so many that Podiatry will someday have to accept they were collateral damage in the evolution of biomechanics en MASS.

    3. In the future, there will be places and times when the impact of a podiatric biomechanical education and practice will be necessary to assess unsuccessful outcomes and alternatives to MASS, before, during or after using MASS.

    It seems like the field is ready to recieve your answer to my question as a start to the debate and maybe as to the importance of this debate, it sounds like you and I can have a personal debate (lets say for 10 replies from each of us) before The Arena Police poison the thread.

    Then they can have at both of us.

    Are You Game?

  11. drsha

    drsha Banned

    This thread has gotten to the point, without Dr. Glasers involvment, where the other major posters seemed to have paved the way for an open debate of the subject that I raised as to The Future of Podiatry within the context of Dr. Glaser's "Future of Biomechanics" to proceed.

    This circumstance seems rare for these pages and may relate to the importance of this issue for most of us involved in FLEB.

    With Dr. Glaser's lack of a response to my invitation to revisit my question for some time and because I have never, to my recollection met, spoken or had an email exchange with him, I cannot deduce his reasoning for this lack of reply. That remains for Ed to explain.

    I assume that Ed's non response means that he agrees with my premise that although his MASS Theory elevates the scope of Biomechanics for many professionals and non professionals in order to provide better Biomechanical care for the foot suffering public, it reduces or eliminates the need for the foundational education and practical experience that has kept Podiatry at the top of The FLEB Pyramid for decades, morphing them into the less capable pool of practitioners of MASS as someone taking two foam casts and placing them into a MASS Evaluatiion Box therefore eliminating our profession's role in biomechanics in the future which I maintain deserves its place.

    I will also have to consider, after waiting for his response another day, beginning my ten posts without Ed's involvement and conduct a one sided open debate.

    Dr Sha
  12. Graham

    Graham RIP

    Unfortunately, with the general understanding of biomechanics within our clinical And Academic profession (the obvious not included) this may be true!

    However, and with respect, this is an opinion based on Non-Science. In a world increasingly demanding "evidence' of cause AND effect we have still yet to be shown any science apart from that of marketing.
  13. EdGlaser

    EdGlaser Active Member

    Your question is, I think: IF MASS were correct, but the technique was simple and easy does that cut Podiatry out? I don't see why. Podiatry is the largest single profession I sell to. They should be wanting to do the best job for their patients.

    It seems on this thread that I am holding the key to the future of Podiatry. The only way that would be true is if MASS posture orthotics were a quantum leap better than Orthotics based on Tissue Stress/SALRE and FFT. Thank you for that compliment.

    NO. Each Podiatrist should choose for themselves.

    Interprofessional politics aside...I do what is right for my patients..... I believe that is MASS Posture orthotics.

    My orthotics are not available in Walmart or CVS. Unless you know something I don't...can you send pics.

  14. EdGlaser

    EdGlaser Active Member

    I have no reason to get into a speculative debate on the future of Podiatry. Its future will be determined by the sum total of Podiatrists doing the right thing by their patients.

    The future is hypothetical and I can imagine a world with no hypothetical situations....anyway they are not worth arguing about.

  15. drsha

    drsha Banned

    Thank you for your replies. I will respond after dinner later this evening.

  16. drsha

    drsha Banned

    1. I never posted that your technique cut Podiatry out. I said that in MASS, DPM’s do the same casting and use of machine as the Chiro’s , PT’s and AT’s (do the DPM's do anything differently than the others when using your system?), placing them laterally among the lowest skilled and trained in your pool. The Shoe or Walmart Clerk could be included in the pool, hypothetically as long as you brought them up again..
    2. But DPM’s and not the AT or Chiro (unless additionally empassioned and trained) alone can assess, diagnose using FFT and custom cast and prescribe Centrings that include but rise above MASS position, when warrented, foot type-specific.

    3. Your first 50 slides and my first 50 slides (the content referring to STJ Neutral and SALRE being orthodox and in need of upgrading) are aligned. MASS shells are an upgrade to the current OTC, Foot Levelers, and STJ Neutral Shells being dispensed to the foot sufferers by most of the USA practitioners and shoe shops and Walmarts dispensing orthotics but you take my compliment too far as Wellness Biomechanics offers DPM care at a more scientific, custom and professional level than the others and yours as well.

    4. DPM’s, capable of performing a biomechanical assessment that delivers a treatment plan involving case-specific customization of shells as well as shell reactive modifications (SRM's) and using orthotic reactive forces (ORF’s) in the form of postings, skives, cut outs, and variations of the actual material and its qualities and thickness that can be applied to the epigenomics (holistic comorbidities) of that case in EBP sit on top of The Biomechanical Future in my paradigm and not MASS. MASS lacks incorporation of the “Doc in the Box”. The MASS box is an upgrade but too easy to step into sums up my compliment better.

    The FFT System, after taking an independent rearfoot and forefoot examination, determines each patient's functional foot type and then further determines the patient’s location on the bell curve of that foot type. This allows for customization of orthotic shells, modification of orthotic shells and the need for monitoring and modifying the program, foot type and patient-specific, professionally.
    I have amongst my clients, those that used your lab and enjoyed the upgrade you offered them from their STJ Neutral days further upgraded to functionally foot typing and Foot Centring dispensing anecdotally claiming that they are providing an upgraded custom service then Sole Supports allowed them to provide their patients. They prefer to leave MASS to the Chiro’s, PT’s and Shoe Clerks and provide care, with appropriate additonal compensation, only they can offer.

    I am asking you whether you think there are DPM’s that could go beyond “MASS” and offer more to their patients. Shouldn't our goal be to utilize our training and experience upon the foot suffereing public as the last resort that others can;t imitiate? You make everyone a foot specialist at Podiatry'sd expense.

    Dr Sha
  17. Graham

    Graham RIP

    Would you be good enough to share the scientific part of Wellness Biomechanics?

  18. drsha

    drsha Banned

    Since it has been stated over and over again that none of the current bio paradigms has valid high level evidence...

    I stand corrected.

    I should have stated:
    Wellness Biomechanics offers DPM care at a similar scientific and a more custom and professional level than the others and yours as well (personal bias).
  19. Graham

    Graham RIP

    Thanks for that but I wonder if you could clarrify some things for me please?

    What are the papers that you use to determine the 'similar' in scientific. I would really like to try and understand this more.

    Than who exactly? Other Podiatrists...?

    Thank you.
  20. Oh let the man alone. He wants to have a play with Ed. I say we step back and let them have at it.
  21. drsha

    drsha Banned

    These same questions have been raised and responded to on many other occasions and in addition, they are off thread.

    Please consider a creating a new thread or a having a private discussion as I am waiting for Dr. Glaser's reply or on thread input from others.

    Dr Sha
  22. Graham

    Graham RIP

    Responded to but not answered!

    Good luck with that! As Robert suggested, I will leave you and Ed to it!
  23. drsha

    drsha Banned


    I have pondered the accuracy, reproducibility and the laboratory ability to make modifications and corrections when taking and subsequently working with MASS Casting, the same as I (and Dr. Glaser) pondered STJ Neutral Casting. I come up with similar problems.

    As stated previously, I accept MASS Casts for fabrication of Foot Centrings at my lab so I have worked with them although I have never held a Sole Support, to my recollection.

    Lets start with the qualifications for becoming a MASS Casting Master.
    I understand it to be
    1. Take three acceptable casts and send them to Ed for fabrication. If not rejected, the caster is a Master.

    That seems to incorporate capable people of all ilk’s, late teenage and up as potential Masters.

    That fact allows the development of a motley group of Masters that have included Foot Solutions clerks, athletic trainers, chiropractors, physical therapists and podiatrists, listed on the www.solesupports.com website using the “find a professional location” feature.

    My zip code, 10021, asking for a ten mile radius, reveals the huge variety of stores and offices that Ed authenticates as Master Casters surrounding me. Then check out your own zip or another.
    From my position, DPM’s are certifying and authenticating the rest of the group as equals, biomechanically, by being among them committing biomechanical suicide.

    Next would be the ability of each master caster to take and deliver a MASS cast.

    This would change with the quality of the casting material itself as there are levels of casting material substance and “castability” when dealing with foam. There are foams that do not form a good impression.

    It would change with the destructive changes that occur to casting material in transportation and delivery (some of the casts come to me totally destroyed and in need of being recasted, some partially, some none but you get the idea).

    I ask the bad ones to be recasted by the doctor, perhaps Dr. Glaser can let us know what he does with his?

    It would change with the ability of the caster to accurately approach the MASS position as I am sure there is an error factor that could at least compete with the error factor of STJ Neutral Casting that Ed refers to as unacceptable.
    Try taking a MASS Cast in foam yourself to begin to appreciate the bell curve of possible casts that Dr. Glaser receives both on an intra and interpersonal level.

    It would change with the ability of Ed’s Lab to accurately translate the cast into a device that is the “optimal” sole support (Dr. Glaser can fill in the blanks here or does he hit “optimal” 100%?).

    Finally, it would change with the ability of the lab to accurately calibrate and fabricate the MASS device that claims to be accurate and reproducible. Again, I leave that for Ed to elucidate as he has set his own standards.

    If Root Devices are not scientific, I can only imagine how many inaccurate, poorly reproducible, flawed with failure, “almost” MASS or “overMASSed” Sole Supports are fabricated and dispensed on a daily basis by Ed’s Motley Crew of Master Casters.

    Summarily, I propose in debate that MASS Casting will suffer the same fate as STJ Neutral Casting for Podiatry as hypothetical, poorly reproducible and capable of being imitated.
    Technology and those of us empassioned, educated and practiced in biomechanics will do the job.

    For many years, and sometimes without the kindness my DPM colleagues would say they deserve, Dr. Kirby and I have alleged that a portion of our profession has been remiss in practicing biomechanics. We have called for, from different perspectives, an investment of time, energy and money in education, practice management, getting mentored and upgrading their biomechanical courswork, training and skills to the level that only a DPM is capable of rising to.

    I propose in debate that Dr. Glaser has made the separation for me clearer because I would lean towards thinking that those DPM’s dispensing Sole Supports are the very DPM’s we are speaking to. For me, the rest are still STJ Neutral casting and “posting to cast” or they have already taken the leap to Modern Biomechanics.

    I await Dr. Glaser’s reply or I will continue this personal debate in a day or two.

    Dr Sha
  24. Graham

    Graham RIP

    Interesting. From Sole Supports Web site!

    Intercaster reliability of Foam Box casting is BAD! As bad as plaster casting! Difficult for the lab to know if it is an accurate cast of the right posture I guess?

    Attached Files:

  25. EdGlaser

    EdGlaser Active Member

    I sell my product, as do almost all labs in the US to all professions that have a legal state license to dispense orthotics. Some states do not currently have a practice act for cPeds. Everyone learns the same technique. It would be unethical to deliver a lesser training or device to any profession we sell to. Which professions don’t deserve MASS as an option? I am not trying to gain political votes here: Our core value is We Make People Better and decisions have always been made on that basis. I feel strongly that if some patient pays their hard earned money on a custom orthotic device from any qualified healthcare practitioner, which is determined on the State level in the USA, that practitioner should have the option of advancing their education and offering the device that they deem best.

    If the only thing that separates you from a clerk at Walmart is the orthotic technology you choose for your customer / patient then turn in your license and apply at Walmart. The public knows what a Podiatrist is in the US, anyway. Most citizens here know the difference between a Doctor and a clerk. Maybe we’re just more edgeumicated here in Tennessee.

    Doctors have a higher level of training and therefore rightly command a higher fee, People make appointments, wait to see you, etc. etc. You expect when you go to the doctor that a history will be taken, tests will be run and a diagnosis will be made followed by a treatment plan that may include a custom foot orthotic or not. Who I sell to, has no effect on that. Actually in this economy, the DPMs have increased their sales and cPeds (the Foot Solutions Franchise) have decreased.

    I have no comment on FFT. Frankly I have not looked at it. I have seen only one of your orthotics. It was extremely flat with a 1st ray cutout and a massive forefoot post. This was on a doctor who attended one of my lectures, and to my knowledge, swithched to Sole Supports, Inc.

    What is interesting here is that you seem to feel that if an orthotic technology is too simple….it is wrong…….. Occam’s Razor.

    Simple is better but the proof is in the pudding.

    A good research question. I would like to comission an experiment. Would you like to co-fund it so there will be no bias?

    Just opinion.

    I have no comment on FFT.
    I am sure we have had clients move both ways.

    I haven’t seen evidence that FFT is going beyond MASS. So far it looks like the same old Mods approach just calling it something else and adding your classification, kinda like Dr. Scheerer’s “Pathology Specific Orthotics”. These mods for this pathology or foot type.

    MASS is different. It uses the geometry of the shell to do the work in full contact with the corrected posture, soft tissues compressed and calibrated. What of that sounds like FFT?

    What is it about your ideas that make them out of reach to other health care practitioners? Do you sell to other professions? Would you?

    Some of the brightest researchers in the field of foot biomechanics are from other disciplines. Tom McPoil, Peter Cavanaugh, Mike Pierrnowczki, etc. Should they be denied access to FFT or MASS Posture or Tissue Stress/SALRE or Neutral Position. That would not be Making People Better.

    Neither Medicine nor Science has a place for professional bigotry. Ask instead, what is in the best interest of the patient.

  26. EdGlaser

    EdGlaser Active Member

    This is a strange post. You use MASS casts then attack their validity.

    Traditionally in our company training was only offered through seminars. I would personally supervise the casting and training and QC the practitioners...all myself. The demand grew faster than what I could provide. Alyson Evans became a lecturer as did Stu Currie and Don Bursch. Recently we added Stu Wilson to speak. We are hopefully going to find another Podiatrist soon to speak for us.

    In 2005 we had a list of over 260 doctors in the US waiting for a lecture to come near them to attend. We decided to add another avenue for certification. I filmed a DVD at a local TV studio (The Renaissance Center, Dickson, TN) and we made a powerpoint of the workshop with detailed pictures, narration, videos, etc. This way a person could learn at home. We even secured CPME approval for the DVD and issued CME credits.
    After the client spends hours watching the lecture, and passes an online test, they practice casting, following the powerpoint step by step until they feel confident. Then they do three, what they believe are perfect casts, and mail them to us for evaluation. Our Tech Support department and QC department evaluates the test casts, if they are acceptable (and most common mistakes are easily identifiable) they may be used to make orthotics and after we document three acceptable casts, they are issued a certification. In 2010 and since the DVD we have had hundreds of certifications come via home study every year all over the world. The quality of casts from practitioners trained in this way have been very very good. The personal attention makes a difference.

    How does someone become a Zen Master FFT doctor?

    As the 2005 lecture got outdated, that is, we learned more from research (ours and others') new ideas and technologies emerged we replaced my old lecture with the one we filmed at Barry University in 2009. When Sole Supports Studios opens in January we will redo the entire educational experience. It is a major re-write. The trailer should be released soon.

    To my knowledge, we are the only foot orthotic company in the US that requires their customers to be certified in their technology....because it is so different. We make an honest effort to standardize casting and keep our clients up on changes as they occur. Will it ever be perfect....NO.

    Do you have a perfect system for capturing the corrected geometry of the foot?

    Would I like to make it simpler......and more fool proof.....absolutely. We are working on it at a feverish pace. Seems all I do anymore is sit in on think tank meetings in the Engineering Department.

    Mods necessitate space to put them in.....which necessitates arch fill.....which eliminates full contact, creating hot spots also increasing impact force. I think that the Mods approach to correction is inferior to full contact calibrated spring force in MASS Posture.

    I want to see the gait cycle change for the better. Form Follows Function.

  27. EdGlaser

    EdGlaser Active Member


    Thank you for bringing this article up. It clearly shows the complete lack of bias on the part of Dr. Trotter and Pierrynowski.

    Frankly, I think they biased the paper against us. The Canadian cPeds (different than US c Peds) performing the casting had 2 to 20 yrs of plaster casting experience and a few minutes of MASS casting training. Yet the Inter-rater reliability was equal to plaster. Although I see your point.....that a few minutes of MASS casting training is equal to 20 yrs of POP casting experience. Trotter notes that the cPeds admitted that they did not understand why they were doing it that way and some actually tried to achieve STJ Neutral.

    It would be more fair to take practitioners that had 2+ yrs experience in both techniques.

    Still Intra-rater, same cPed same Patient had a very significant improvement over plaster. So, once we get you to do it right....it is consistent.

    Although, I was disappointed that we did not blow plaster out of the water in both halves of the study. How we react to these studies is to question our casting technique, medium etc and begin research on a better technology.....which is coming soon. We like the results we get now, but can always do better.

    Our training can also improve, better graphics, animations, 3D stills and videos.

    Better more consistent training will improve casts more.

    Absolute perfection is unattainable. We get as close as we can within reason.

  28. Graham

    Graham RIP


    The paper I posted, from your own web site, indicates that intercaster and interater reliability is "POOR" for both Plaster and foam box. With this in mind, and as you only have the foam box, not the client, how do determine what is "good"? How does MASS account for this?
  29. drsha

    drsha Banned

    Dr. Glaser:
    I appreciated your responses and will reply in kind, in no special order.

    Unlike Sole Supports, where a MASS Cast is used universally, like STJ Neutral at other labs, my lab accepts MASS casts (and STJ Neutral Casts) when they apply to the case as per the diagnosed functional foot types.

    Some examples off the top of my head where MASS Casts may be problematic and therefore not acceptable:

    1. A Rigid Rearfoot, Rigid Forefoot Foot Type with a painful 1st met callus.
    The FootHelpers Lab rejects MASS casts
    2. Charcot feet, especially those with a midfoot collapse and a weightbearing navicular or cuboid.
    The FootHelpers Lab rejects MASS casts
    3. Rigid Rearfoot Foot Types that have a large equinus influence
    The FootHelpers Lab rejects MASS casts
    4. PAD feet, that too often cannot tolerate the large amount of Vaulting inherent in MASS Casting
    The FootHelpers Lab rejects MASS casts
    5. Rigid and Flat Forefoot Types with a callus or ulceration under the 5th Metatarsal.
    The FootHelpers Lab rejects MASS casts
    6. Extreme examples of The Rigid Rearfoot Types have too high an incidence of inversion ankle sprains.
    The FootHelpers Lab rejects MASS Casts
    7. Any patient that cannot tolerate the Vaulting of Foot Centering Pads applied foot type-specific on the IOV.
    The FootHelpers Lab rejects MASS casts.
    8. 4th Metatarsal IPK’s
    The FootHelpers Lab rejects MASS casts
    9. Patients with a history of inversion sprained
    The FootHelpers Lab rejects MASS casts
    10. Cases where TIP is greater than 8mm’s
    The FootHelpers Lab rejects MASS Casts
    11. Symptomatic 1st Met-Cuneiform Exostoses
    The FootHelpers Lab rejects MASS Casts

    Please feel free to critique

    II. How does your Tech and QC Departments know that MASS Position has been achieved by the caster?

    III. In my imperfect FFT System, when there are failures that have not been overcome by additional ORF's and muscle engine training, there is a full refund within 45 days for any returned device. This means my docs can offer a similar refund to patients increasing casting acceptance.
    Assuming you have some, how do you handle yours?

    From my perspective, most of the labs I am familiar with require a diagnosis and ask for a prescription for positive cast modification and shell ORF's. There is a level of education, skill and experience needed to fill out the prescription (Pharmacies don't certify docs, they accept prescriptions as per the docs orders). We have no need to certify, why do you?

    In reply to your query of how one becomes a Zen Master FFT Doctor, the key word you used was DOCTOR.
    Because in your system, one becomes a Master CASTER.
    The answer, Ed, is the same as the one to the query, "How do you get to Carnegie Hall" ---- PRACTICE

    I notice you call the sheet that accompanies your cast an order form. That seems to obviate the thought that it is a prescription perhaps requiring the certification that you require (and administer and grant).

    Here is a copy of The FootHelpers Centring Rx for your inspection. Each Client gets his own custom form generated from the computer so as to cater to specific needs. I look forward to you downloading a copy of your order form for comparison.


    Attached Files:

  30. Dennis

    Have to say I'm not really all the sure what your theory or paradigm is really all about despite several attempts at reading previous posts. That's probably just a reflection of me rather than anything else. Could you do me a great favour and describe in say a sentence (or two) what foot typing actually does to benefit the clinician or their patient.

    It's truly wonderful to see you back in the Arena, the absence of your wisdom and wit in recent weeks was, curiously, a great loss, to me at least. Were you somewhere nice?

    Kind regards

    Mark Russell
  31. I think Dennis' List is a good one. Whatever we thing about FFT, this is an interesting view of MASS.
  32. drsha

    drsha Banned

    Foam Casting Problems and Variables vs Off-weighted Plaster

    In my limited experience with foam casting for orthotics, I have come across moments where I find (and not to say that there aren't shortcomings for all casting methods, including plaster) reasons why FFT prefers working with an FFT Corrected Off-weightbearing cast. Dr. Glaser mandates a MASS Cast in Foam.
    So let the debate begin.

    Foam Materials:

    There are a variety of foam casting products available. By its very nature, foam is meant to compress to pressure and simultaneously hold its shape to form a negative impression.
    Foam materials vary from foam that molds poorly and cracks, chips and breaks easily to those that offer better molding and greater resistance to breaking.

    This youtube shows a good quality foam impression as a standard.
    Perhaps Ed can add a MASS Casting example for all to see.

    Packing, shipping and delivery of foam cast boxes may come into bumping, dropping, smashing ballisticallys and pressures that can deform, crack, chip or break the foam after casting from other containers and drivers.
    This is a huge problem.
    I wonder how many casts need repeating at Sole Supports?

    Heel Capture:
    As opposed to plaster, foam will show an impression of the widest surface that it is being asked to mold while plaster can capture widths at different levels with greater accuracy.
    See Figure 1: When pressed in foam, the negative will be as wide as the bottom and not reflect the middle and upper structural differences.

    Foam Reactive Force (FRF) vs. Ground Reactive Force (GRF)

    When Vaulting the foot, in order to find “the best posture” for the foot to be held in, or the “optimal position” to capture negatively for a full contact orthotic, there needs to be a counter pressure under the Vault of The Foot,, strong enough to overcome the biomechanical collapse inherent in a patients feet, foot type-specific.

    The pressure that we are looking to imitate is ground reactive force (GRF) under The Vault. The pressure that foam places upward into The Vault is probably 1/10th that needed (perhaps Ed and I can co-fund a research project).
    In off-weightbearing position, an examiner can develop a “feel” for applying GRF up into The Vault in order to gain “optimal position”. The example here would be the GRF that we apply to the 5th met from below in order to “lock the midtarsal joint” when working ROOT. Imagine how much greater that is than reactive foam.

    In FFT, using corrective Vaulting techniques, plaster is manipulated with counter pressure from the examiner that imitates GRF.

    The Supination Effect:

    Another point with reference to MASS Position (maximum supination) is that if a foot is pressed vertically into foam, it will leave a width negative of one length. If that same foot is held either supinated or pronated, it will leave a different width impression into the foam. Off-weightbearing plaster wouldn’t change in dimension when the foot is inverted or everted producing a more accurate impression (or there hasn;t been very much supination.
    Summarily, a MASS Cast, if in Maximum Supination, would produce a narrow Sole Support.

    I tell my clients that they can approach “optimal position” better than STJ Neutral in foam with MASS Casting technique, except or in the Rigid/Rigid and Flat Flat Foot Types where STJ Neutral is preferred but that Vaulting in Plaster, foot type-specific is the best we can offer our patients (one more co-funded study) and I mentor them through the learning curve as Ed does with his early casters (takes about two months).

    Sagittal Plane Relationship of Rearfoot to Forefoot

    In foam casting semi-weightbearing, it is easy to distort the relationship of the rearfoot to the forefoot. The rearfoot flexible foot types and the forefoot flexible foot types would be especially vulnerable to this fact (That is why I demand plaster for the Rearfoot Flexible/Forefoot Flexible Foot Types at The FootHelpers Lab).
    When pressing into foam, Ed mandates to have the rearfoot and forefoot on the same plane to ensure a good RF/FF relationship. My concern is the ability of the foam caster to do just that, especially in the flexible forefoot types (RF?FF).
    When working with plaster, off-weightbearing, one can physically see the rearfoot/forefoot relationship and capture it much more effectively.

    I will leave the fact that the sagittal plane relationship of the rearfoot to forefoot is different with the different FFT’s and therefore one casting technique to be applied to all feet probably borders on dangerous for certain feet. We can debate that at a different time (0pinion).
    Summarily, for example, The Rigid Rearfoot/Rigid Forefoot Type needs to have the forefoot lower than the rearfoot when casting).

    I look forward to Dr. Glasers reply.

    Children and Grandchildren in for The Holidays at Home, so I will not be posting for a few days.
    Good Tidings To All.

    Dr Sha

    Attached Files:

  33. That is NOT a good quality foam impression. In fact its bloody awful. He has NO control over position, thats why the medial arch is convex. And pushing only 3/4 way in complicates the process, makes it harder to derive your base plane, and means you don't get so much soft tissue deviation (which I think is a good thing).

    The MASS method is another issue, but don't think that the method here is "industry standard".
  34. drsha

    drsha Banned

    Thanks for the correction.

    Shows how little I know about foam casting.

    Is there a youtube of the standard that can substitute for my poor version.

    Dr Sha
  35. No need to apologise! Hard to speak knowledgably about what other people are doing! By definition we know less about that than our own practice.

    This is me doing it. I'm not saying its right, but its better!!!


    Whatever method you use, you have to be able to control the position.
  36. drsha

    drsha Banned

    I probably have 5-6 more posts to openly debate with Dr. Glaser.
    I will continue with this one as there has been no response from Ed in recent days.

    Laboratory Positive Cast Modifications (PCM's) and ORF Correcting:

    Orthotic labs that have historically catered to Podiatrists, have the ability, by prescription or personal whim, to modify the positive casts generated from negatives or to alter the presciption modifications.

    The discussion with reference to adding plaster as "arch fill" in order to make devices more acceptable and dispensable (reduce returns) would be a classical example (The FootHelpers Lab default is No Arch Fill or as Dr. Glaser states: Full Contact).

    If I am understanding it correctly, Sole Support Lab offers no PCM's or ORF's whether they be ordered from the source or conducted by the lab without being prescribed.

    Once a MASS Cast is taken (or recieved), the rest of the process does not concern itself with how the cast was taken, its accuracy or who took the cast and does not allow prescription PCM's or ORF's.
    No lifts, wedges, posts, skives, ray cutouts, lesion balances or epigenetic influences allowed in The Mass Box, to my knowledge.
    MASS Casting and its foot posture, as a single entity, resolves, treats, cures, prevents and improves performance in all cases, for all casters (once Certified).

    How dare Ed intimate that his work is more researched and mine more opinionated?
    Does he think that a Dr. Dockery or Laporta testimonial outweighs those on my websites or any others?

    What about LLD, neuromuscular diseases, deformed feet, poorly functioning musculotendonous units, Charcot Feet, weightbearing masses, postural deformity and weakness, performance issues and most of all degenerative or metabolic entities?
    No need to correct or modify the shells in any of these on a case to case basis by the examiner or lab?

    If MASS addresses all of these examples, by using a universal casting technique as Dr. Glaser intimates in his reductionist verses, podiatrically, for me, that would be some "FEET".

    At The FootHelpers Lab, we accept all PCM's anf ORF's, foot type-specific, as per the orders and tastes of our clients and their patients needs, integratively, holistically and expansionist.

    Sadly, a few DPM's and all but a small handful of PT's in addition to all AT's, Chiro's and C.peds, to date, have not been capable of completing our Rx Form to our satisfaction to begin working with us.
    They are excluded to work with Centrings and advised to upgrade their foundation, casting and prescribing skill and clinical experience. They have been asked to stop claiming otherwise because of our patent restrictions.

    Podiatry lives atop of The Future of Biomechanics in Wellness Biomechanics. FFT Needs a DPM or equatably prepared professional (some of whom live on The Arena, I'm sure) and MASS clearly does not.

    Dr Sha
  37. These Stateside infomercials are beginning to feel like a nasty rectal discharge - a purveyor of something nauseatingly unpleasant behind a thinly disguised coherent effluent. Wouldn't a full-page advert in the NY Times be more fruitful Dennis?
  38. drsha

    drsha Banned

    I appreciate the time that The Arena Police has extended me on this thread allowing it to debate MASS vs. Wellness Biomechanics as to opionionated weaknesses and strengths.

    In respectful return, I will end my portion of this debate (which unfortunately has turned one sided anyway with Ed not finding the words to reply) as Dr. Russell has started the watchdog bullying which we all know eventually escalates to threats of violence unless heeded.

    It remains interesting to me how comfortably and righteously blinded and biased The Arena remains when it comes to its tolerance of the infomercials of Kirby, Payne, Spooner, et al as they sell their books, articles, appearances, boot camps, philosophies, etc that although they remain educational, valuable and stabilizing and worth a look, at the end of my day, remain nasty rectal discharge (Dr. Russell's kind words) for me.

    Dr Sha
  39. That is one way of looking at it I suppose. However the aforementioned do provide insightful, coherent debate and argument, politely and professionally to the general good of their colleagues and their patients. And another observation, none of them strike me as mad, insane or deluded. Therein lies the difference.

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