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MASS Position Orthoses = Modified Whitman Braces??

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kevin Kirby, Dec 6, 2008.

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    MASS Position Orthoses = Modified Whitman Braces???

    Are the orthoses that Ed Glaser's orthosis company produces using "MASS" position foam-bed casting truly "revolutionary" and "new" as he would like us to believe? My contention is that these high-arched orthosis designs have been around for nearly a century and largely fell out of favor over 40 years ago due to their painful "arch-gouging" effects.

    In order to support my contention, I have photocopied a page (#180) out of a 69 year old textbook (Schuster, Otto N: Foot Orthopaedics (2nd edition). J.B. Lyon Company, Albany, NY, 1939) which shows a "modified Whitman Brace" foot orthosis from 1939 that is nearly identical in design in the medial arch to the Sole Supports orthosis that Ed Glaser claims are so "revolutionary". I'll let you be the judge of whether Ed Glaser's contention that his reintroduction of a high arched orthoses done with his foam bed "MASS" casting technique is truly "revolutionary", or is just another rehash of a century-year-old idea that fell out of favor due to patients complaining of excessive arch pain with these types of orthoses.

    Attached Files:

    Last edited: Dec 6, 2008
  2. VernWalther

    VernWalther Member

    Who gives a rats behind whether or not it’s new or revolutionary if it works? I’m most concerned with the best way to help my clients’ over-pronated feet function to their best potential and minimize deforming forces to correct and PREVENT debilitating musculo-skeletal problems.

    I’m kinda new at this, so bear with me. I’ve been a C.Ped. for 3 yrs and own a Foot Solutions store. We sell a full spectrum of over the counter inserts and cast customs using Amfit cad-cam as well as Sole Supports (CBAS @ FS). The discussions on this board are educational, challenging, enlightening and often entertaining. Thank you everyone from this occasional “lurker”.

    I think it might be more complicated than whether Whitman’s and Ed Glaser’s MASS position pictures match. Whitman's photos appear crudely rigid. Did Whitman use the same gait referenced casting technique as Glaser to achieve his orthotic shape or just push the arch higher? Perhaps Ed rediscovered or reclaimed MASS from the trash bin of failed designs. Whitman, circa 1939, (70 yrs ago) probably nailed it as far as observing the dynamic range of pronation/supination motion of the foot to begin with the end in mind, i.e., full supination. However, the fundamental problem with high-arched orthosis designs from yester-year, from my understanding, were that the orthotic materials used in concert with the design varied from steel to wood to hard leather. No wonder it was abandoned due to their painful "arch-gouging" effects. The bottom line is it never caught on because you can’t introduce a static force to comfortably control a dynamic range of motion on soft tissues and expect compliance. Wasn't "neutral" and its variations more or less a compromise given the limitation of materials available in the 70s? And still is.

    Try this thought experiment.

    Forget everything you’ve ever been taught about orthotic designs and materials. Start with a completely fresh prospective.
    (This is the most challenging part of the experiment.)

    Now, observe the graph of the "normal" gait cycle from heel strike to toe-off. The first obvious observation is that the graph is a continuous, dynamic sine wave. In normal walking gait, the load phase of each foot occurs in approximately 1/2 second. You hit the bottom range of pronation in the first 0.1 sec and gradually re-supinate for 0.4 seconds, give or take, and much quicker when running. Repeat 10-15,000 times a day or 2,000 times per mile.

    So how would you best manage the downward force to control pronation from the moment of heel strike?
    Where would you position the initial arch height to begin controlling pronation?
    What shock dampening materials would you use under the foot?
    How do you factor body weight and downward forces applied?
    How would you assure that the foot achieves full re-supination through toe-off and propulsion?
    Static and dynamic are a poor mix.

    While “MASS” as a casting position may or may not be revolutionary, I think the Sole Supports calibrated, flexible, full-contact design does the best job of any orthoses I’ve worked with in matching the downward force of body weight and gravity to decelerate pronation through it’s “normal” end point and then flex back up to apply assistance force evenly pressured under the arch to achieve a fully re-supinated foot at forefoot loading and toe-off.
  3. DaVinci

    DaVinci Well-Known Member

    I think we all can agree on this one thing!
  4. Admin2

    Admin2 Administrator Staff Member

  5. Lawrence Bevan

    Lawrence Bevan Active Member

    I agree in that the concept of the 2 devices is largely the same. "Save the arch and save the world". The main difference would probably be the flexibility of the materials.

    Ed's "revolutionary" approach is the clever packaging of the concept into an easily graspable idea and turn-key apporach to casting and prescribing. For all his denigrators I would have to congratulate him on his business sense.
  6. Vern:

    Welcome to Podiatry Arena and thanks for posting. I personally don't have a problem with high arched orthoses, when they are indicated clinically, since I have been making them for 23 years, long before Ed Glaser created his "MASS" position casting technique. I do have a problem, however, with saying that all patients should be casted in this "MASS" position that creates a Modified Whitman Brace type medial arch contour. I also have a problem with Ed Glaser's contention that patients require a high arched orthosis that doesn't have a rearfoot post in order to have a "truly functional orthosis". This is simply ludicrous.

    I have numerous patients who have come to me with Sole Supports orthoses from the one podiatrist that uses the company here in Sacramento complaining of one or more of the following problems:

    1. The medial arch is so high that their medial arch is more painful than what their original problem was (the medial fibers of the central component of the plantar aponeurosis is the most commonly injured structure by Sole Support orthoses).

    2. They develop supination instability due to the increased subtalar joint (STJ) supination moment which causes an increased rate of inversion ankle sprains.

    3. They develop painful tendinitis of either the peroneus brevis or peroneus longus muscles due to the increased STJ supination moment.

    4. They develop an painful compression-overload syndrome of the lateral column/lateral digits due to the excessive STJ supination moments created.

    The doctor that uses these Sole Support orthoses has been probably taught by Sole Supports that every patient needs MASS casting. Therefore, he continues to use these ill-conceived orthoses for all his patients not realizing that he is hurting these people. Vern, this is the main problem I have with this company's marketing technique. They have taken a century-old orthosis idea, repackaged it with a slick marketing campaign, advertised heavily to the podiatric/chiropractic/pedorthic community, have paid seminars around the country to do infomercials on how their orthoses are the "only true functional orthosis", and tried to say that their ideas are new and "revolutionary" with no regard to the many poor patients who must suffer from these painful orthosis designs from the clinicians that fall for their advertising pitches.

    I am sure that these types of high-arched orthosis designs work for some people since, like I said earlier, I have been using high-arched orthosis designs occasionally on patients that need them. However, to travel around the country pontificating that these orthoses are needed by all patients, are revolutionary, and are much better than any orthosis lab's orthoses, is nothing more than advertising hype and a disservice to the ethical clinicians that do truly want the best orthoses for their patients.
    Last edited: Dec 6, 2008
  7. Vern:

    Just thought I would show you an example of the painful orthoses that I see in my office that are produced by, what you call a "gait referenced casting technique" with a "calibrated, flexible, full-contact design" that "does the best job of any orthoses I've worked with".

    The patient that brought in these high-arched orthoses to me is a male, in his late 30's, that has a mild cavus foot with sacroilitis on his right side. He was told by his podiatrist, that uses Sole Supports "gait referenced casting technique" that are "calibrated, full-contact design" orthoses, that he needed foot orthoses to cure his back pain. The patient wore this first pair for about 3 days before he nearly was crippled with a severe increase in hip and foot pain. I wrote down exactly, in the patient's words, what he told me about these "gait referenced casting technique" and "calibrated, full-contact design" orthoses:

    "The orthotics felt like a tennis ball under my foot. They made my hip pain worse. I wanted to cut off my little toes after wearing them for a few days since the orthotics made me feel like I was walking on my little toes."

    He went back to his podiatrist, who adjusted them once, with no relief in pain, then ordered a second set of "gait referenced casting technique" and "calibrated, full-contact design" orthoses that, again, only made the pain worse. Unfortunately, since his insurance didn't cover orthoses, he was out $450.00 in cash for having a couple pairs of devices that he not only couldn't wear, but which nearly made it so he couldn't walk at all.

    When I saw him, he also had a pair of much lower arched Amfit orthoses that I adjusted to add a valgus rearfoot and forefoot wedge to, that within two weeks, made his foot, hip and low back completely resolve. His expense in seeing me on a cash basis for three office visits was less than half of what the other podiatrist charged him for the pair of these cruel "gait referenced casting technique" and "calibrated, full-contact design" orthoses that nearly disabled him. He was more than glad to donate his $450.00 pair of pain-producing foot orthoses to me when he found out that I was going to use them to educate other clinicians in my national and international lectures and on the internet about why ethical practitioners should never make foot orthoses like these for patients.

    Vern, are these the types of orthoses that you also make for your patients?? Where did you do your training on custom foot orthosis therapy?

    Attached Files:

  8. joejared

    joejared Active Member

    The arch is obviously and painfully proximal of where it should be, even for a cavus foot. 2 of my customers are fairly aggressive in terms of arch height, but usually when I see them they are also accompanied with a first metatarsal cutout. If mobility is to be restricted in the midtarsal joints something else has to give to restore a normal gait.
  9. :D

    What does rigid look like?

    Hey vern. Welcome to the pleasuredome. I agree that the "calibrated resistance" bit of Eds sole solutions was probably not in the original design. However the concept of a mega high arch obviously has been around for a bit. Come to think of it I tend to cast in a pretty high position and with no arch fill when i make UCBLs. It is irritating when somebody claims as their own, techniques which have been around since the dawn of time.

    And that is a swine of an orthotic! One wonders how that can happen if the foot was cast in mass which, after all, is one of the more repeatable techniques. Where was the error here, in casting? In prescription? In manufacture?

    Again, welcome:drinks

  10. Robert, how do you calibrate resistance in the real world? I'm very interested in the effects of orthosis stiffness and have even done a bit of research in this area. I'm keen to learn how it's done, since even using FEM I'm struggling to design an orthosis that will perform the same under different loading conditions as the deformations observed are usually non-linear, particularly with foams and laminates.
    Last edited: Dec 6, 2008
  11. Pretty picture. There is a time and a place, but not in chronic lateral ankle instability. I think the mass devices do look like a Whitman, also the name escapes me tonight, but basically I have an antique text that talks about inverting the rearfoot and everting the forefoot to "provide maximal arch support from devices" I'll find the ref. on monday for those that are interested.
    Last edited: Dec 7, 2008
  12. David Wedemeyer

    David Wedemeyer Well-Known Member

    Vern's post confirmed a lingering question that I have had about the CBAS insert. I felt that they were manufactured by Sole Supports after encountering a number of them in my office.

    I have two questions for Ed please:

    1. Why did SS's rebrand them for the retail pedorthic outlets?

    2. Who evaluates, diagnoses, determines medical necessity and prescribes the CBAS inserts dispensed by the Foot Solutions pedorthists?
  13. I'll tell you where the error was. This podiatrist doesn't know enough about biomechanics to realize when he sat through a podiatrist-lab owner infomercial with this podiatrist-lab owner pontificating that all the ills of the foot are caused by excessive pronation and also that his company's orthoses are "gait-referenced", "calibrated", "full contact design", "revolutionary", and "the only true functional orthosis"......he actually believed him.

    Then this podiatrist went on to giving every patient that he felt needed "less pronation" some foam-bed casted Modified Whitman Brace orthosis, even those patients with a mild cavus foot that had symptoms related to excessive subtalar joint (STJ) supination moments. Now, because the orthosis caused increased external STJ supination moment, when the patient's foot actually required increased external STJ pronation moment, his symptoms got worse until he could barely walk.

    It wasn't until I gave him a foot orthosis that didn't contact his medial arch and pushed harder laterally to the STJ axis, with my valgus rearfoot and forefoot wedging added to his EVA Amfit orthosis he also provided to me to work with, that the patient got better. Of course neither Ed Glaser or the podiatrist that watched Ed's infomercial would know how to do this since neither of them grasp the concepts in my paper on how ground reaction forces that act on the plantar foot affect the kinetics across the subtalar joint axis and how they may then be altered by orthosis modifications to improve the kinetics of not only the subtalar joint but of the whole lower extremity (Kirby KA: Subtalar joint axis location and rotational equilibrium theory of foot function. JAPMA, 91:465-488, 2001).

    That, Robert, was the error.
    Last edited: Dec 8, 2008
  14. Steve The Footman

    Steve The Footman Active Member

    It sounds like Ed's practitioners at least are only focused on the single axis model of pronation/eversion.:dizzy:

    What I object to is the marketing hype that turns podiatry into a charlatan profession. Making unsubstantiated claims for fixing all ills with one simple technique is the same as snake oil sales or naturopathy.

    Just come out and say it is just a placebo effect that you are aiming for. But stop making claims for any scientific justification for what you do.
  15. Don Bursch

    Don Bursch Member

    It would be a mistake to assume all high-arched orthotics are alike, just as it would be to say all low-arch, posted orthotics are the same or that Kirby skive orthotics are just a standard custom with a bigger rearfoot post. How was the foot cast for the Whitman? I doubt that was the same as our MASS casting technique. How rigid was the Whitman made? We say you have to factor in body weight and foot flexibility to come up with the right blend of flex/rigid for a given foot. I doubt that was a consideration with the Whitman. Also, google whitman orthotic images and you see quite a wide variation in arch heights and a more consistent emphasis on high medial and lateral flanges. We don't do high flanges as that would make an orthotic way too rigid. We get the best 'contain' of a foot by capturing the full 3D complexity of the plantar vault.

    As far as Kirby's example case of the cavus foot, it sounds like a case of too much shell rigidity for that patient. I would be interested in the name of the patient so I can see what was done to modify the orthotics. Most of the cavus feet we treat successfully have plantar foot pressure issues that respond well to full contact and less force per unit area. I don't know enough about what was causing his sacroiliitis to comment on how appropriate using one of our orthotics in the case was. Was there an LLD? What manual therapy or other treatments were used to calm down the inflammation? It may be the modified amfits you used provided some needed shock absorption or cushion for his right side. Perhaps any extra shock absorption, even a sorbothane insert, would have been as helpful.

    In any respect, one case proves nothing about the overall efficacy of any treatment approach. Regardless of the tool, the practitioner must still make good decisions about the appropriate use of any tool in the toolbox for any particular case. So this example may be saying more about that original provider than Sole Supports. And we are generally most appropriate for the majority of patients with too much tarsal mobility.

    Obviously, if all we did was hurt people we wouldn't be in business or an RMA average of 0.3%. Or . . .maybe we have simply tapped into that massive potential masochist market out there:eek:

    There seems to be a tacitly held assumption by many of the veteran posters here that the bigger the toobox, the more special-case the modification, the less predictable the orthotic design, the more 'expert' one is. While experience and special-case problem-solving skills are very important, it would be a mistake to say that guruistic complexity is always the best solution. I agree with Leonardo DaVinci that:

    "Simplicity is the ultimate sophistication."

    MASS position technique and orthotic design attempts to provide a comprehensive and reliable approach to the common biomechanical fault of most feet: too much tarsal mobility with inadequate re-supination. We also have had widespread success with more rigid feet due to the full contact design. So we feel confident that a MASS position orthosis, assuming good casting and orthotic design skills and appropriate patient selection, should be able to significantly help about 80 - 90% of the pt population. There are of course very unusual cases with complicated orthopedic involvement of the entire lower extremity, or post-trauma cases with altered anatomy that need some unusual problem solving. Some of our certified providers are up to that challenge using Sole Supports; most probably are not. We cover the limitations of our approach when we do training. We are a central fabrication lab with all the limitations of that. We realize that some cases will need expert attention. We even have a list of some expert pedorthists, most notably in the mountains of Colorado, who love our our basic theoretical approach and modify it for the special needs patient.
  16. Thanks for the marketing pitch for your lab, Don. You know you wouldn't need to be running interference for the owner of the lab you work for if he would simply say that Sole Supports orthoses may be good for some patients and not good for others, that high-arched, foam-bed casted orthoses may not be good for all patients and may cause problems and pain. If you would only add the patient I presented that couldn't hardly walk with your orthoses to your testimonial page of the Sole Supports website, then I wouldn't bother you anymore. You can go ahead and use the quote that I provided earlier on your testimonials page:

    "The orthotics felt like a tennis ball under my foot. They made my hip pain worse. I wanted to cut off my little toes after wearing them for a few days since the orthotics made me feel like I was walking on my little toes." ..:rolleyes:
  17. joejared

    joejared Active Member

    From what I saw of those photos, I would have thought a professional should be consulted twice prior to making a device with an arch peak that far proximal. The thickness of the device, and while granted, it was only a photo that was presented, seemed about average.

    I'm not sure if MASS is the method I'm thinking of, and it would be interesting to see a paper on it, but if it involves supinating the patients foot and taking a plaster or biofoam mold of the foot, my first question would be whether or not, if it is for use in an automated lab, the software is capable of supination/pronation and if that same software takes into account the longitudinal movement of the midtarsal joints in the process of supination/pronation. Perhaps this method is compensating for an inherent weakness in a system?

    With adequate marketing, anyone can get their first time customer. Whether or not they come back for more will depend on product quality and service. Given the life cycle of orthotics, it's probably difficult to obtain statistics for return customers, but not impossible.

    Even this number concerns me. For every 5 patients that walk through the door, one of them wont be helped. That means, at minimum, I've got a batters chance of being one of those patients. Does anyone here have statistics on what would be an acceptable failure rate?
    Last edited: Dec 8, 2008
  18. David Wedemeyer

    David Wedemeyer Well-Known Member

    The SS team uses the catch phrase "Guruism" in far too many posts for it to be a coincidence. This "Us vs. Them" mentality and denunciation of established and accepted physical facts regarding foot function and clinical practices is tiresome and insulting. I propose that it is you who have erroneously anointed the new Messiah of orthotics and are blindly following a paradigm steeped in artifice and manipulation of fact. More on that later.

    Again I ask the questions:

    1. Why did SS's rebrand them for the retail pedorthic outlets?

    2. Who evaluates, diagnoses, determines medical necessity and prescribes the CBAS inserts dispensed by the Foot Solutions pedorthists?

    Don you have to be aware that the retail pedorthic outlets persistently negate referrals to doctors and comprehensive examination (which they are not trained in nor licensed to perform) and instead "evaluate" and "suggest" devices based not on medical necessity but on the sale.

    Who writes the script for your CBAS inserts provided by these retail chains Don?

    How can you on one hand claim to have a patient specific device based on all of this fancy biomechanical sleight-of-hand appropriate for doctors to prescribe and on the other hand rebrand the same device for retail pedorthists and claim the same medical and ethical values for this apparent marketing scheme?

    Does anyone else see this as a conflict based in avarice?
  19. EdGlaser

    EdGlaser Active Member

    Re: MASS Position Orthoses = Modified Whitman Braces???

    I am embarrassed for you, that you would even post this nonsense. If you cannot distinguish a Whitman plate from a Sole Supports then you are either incompetent or trying to make some inane point. I think that one would have a harder time distinguishing a Root orthoses from a SALRE orthotic, if such a thing even exists. Maybe you are just trying to take the heat off of yourself and put me on the defensive. Challenging SALRE must be putting a strain on you.

    With very sparse exception, everything that you teach in your newsletters, is a rehashing of the same crap that I was taught in podiatry school, and we attended the same years. The only quasi-new thing that you bring to the table is you found a way to put a bigger rearfoot post in an orthotic without causing an change in posture or function. What is your next miracle, oh great one, are you going to make a blind man deaf?

    Google "Whitman foot orthotic" on the images setting. You will see numerous images of what orthotic labs are selling as Whitman plates, TODAY (not 70 yrs ago). Maybe after reviewing these images you will gain a clue as to what a Whitman plate is. The Whitman plate was not about arch height, it was about a huge medial and lateral flange that made the orthotic into a rigid brace. That is why Whitman did not describe the MASS position, never mentioned calibration, nor soft tissue compression.

    MASS position is not simply a higher arch, it is a more functional posture. I know this is a strange concept for you.....the cast matters.

    Unlike SALRE orthotics whose geometry is a low flat smooth invented generic shape unrelated to the cast other than size.

    So, Why do you cast anyway? All the correction is in the mods.

    All you really need is a single measurement to make a SALRE orthotic. Measure from the back of the heel to the center point of the first metatarsal head. The rest is a generic shape that has a "bag of tricks" to dampen terminal tissue stresses, mostly through soft tissue compression at the end of pronation, when the arch finally falls onto the tilted pancake. So what is casting for.... is it just a sales pitch for the patient, smoke and mirrors, does it make you look to the patient like you are doing something medical?

    Maybe Walmart has it right. According to you, Simon, David, Robert and the other lapdogs, all you need is a generic low flat curve of plastic. in standard shoe sizes, and then a pressure plate reading to tell you where ground reactive force is happening and any computer can easily spit out the mods to mask symptoms without affecting function. Very doable. In fact it is done. So being the ethical practitioner you are, it behooves you to refer all of your orthotic patients to Walmart where they can get the same thing, only more accurately done, for less than $50.00. Outside of the improvement, I do not think that they would notice the difference.

    BTW, I never said that I held a degree in Engineering, If I did, don't you think that I would put ME after my DPM. I changed major from Biology to Engineering in my sophomore year because I was interested in learning the subject. My friends were mostly engineering majors and I found their work more challenging than what I was learning in Biology. I had a full academic scholarship to undergrad which ran out after four years. It would have taken me 5.5 to complete a double major in Biology and Engineering. Looking back, I wish I had gone on to complete my ME. I then worked two years as an assistant engineer with a mechanical engineering group and found that I did not want to pursue a career in mechanical engineering. I have to say that I learned more in my year in the field than I ever did in the classroom. I decided to go back to school to become a Podiatrist, which was my first choice of careers. I saved my money and went back to school to cram in a bunch of Biology courses to complete my biological sciences degree so that I could apply for Podiatry school. Once that major was completed, I went back to work in the Engineering field, designing and inspecting pipe hangers in the Reactor Piping division of a nuclear power plant under construction....in order to save up some of the money I needed to move to NY city and go to Podiatry School. I love telling my life story.....feel free to ask. It is however irrelevant to any discussion on this site.
    Do me a favor. From now on, to help you get past this credential crap, why don't you just assume that I have NONE. Make believe that I am a high school drop out, if you want. How does that change whether I am right or not about foot orthotics and foot biomechanics? There's a great movie called, "Lorenzo's Oil" about a banker and housewife who found the cure a rare neurologic disease that their son suffered from. True story. If I recall, the MD's with the credentials delayed the availability of that cure using your pompous baseless argument.

    If your whole argument is to discredit me, because you cannot find fault with MASS position theory, then your argument is, as always, ad hominem, weak and ludicrous. This particular thread however stands out because you combine it with this "straw man argument" that supposes that you are incapable of differentiating between Sole Supports and Whitman plates.

    I really hope that people reading this can identify enormous key differences between the two. It is amazing to me that your supporters cannot see the differences. This is taking blind follower sheeple to a whole new level. Maybe you should call your theory: Faith based orthotics....and physics doesn't apply to you because you walk on water.

    You and David H are true geniuses. You figured it out. I took a failed technology from 70 yrs ago, renamed it and used hypnosis to mesmerize my customers and clients 6000 times per month. I just can't decide if its my super-human charisma or my good looks that is attracting so many doctors to my theory and product month after month, telling others about it, putting on lectures for colleagues in their region. Part of my diabolical scheme is that those hypnotized patients come back in to rave about their successes, ordering second, third and fourth pairs. Maybe its just my credentials or the bunny suit.


    PS: This was one of the funniest posts of yours I ever read. Have you considered comedy as a profession?
  20. EdGlaser

    EdGlaser Active Member

    Actually David, I met Don when he brought his wife in for a minor surgical procedure in my office. Later, I called Don to offer an in-service on orthotics to him and his fellow physical therapists at Vanderbilt University, where he was head of Outpatient PT for 8 yrs. He became convinced that I was right after a long string of successful outcomes with our technology. He left Vandy to work for Nissan, where he invited me in again to speak. He kept meticulous records of many patients and because he was at their workplace, he had excellent followup. Don has many years of clinical experience with our product.

    I think that if you wanted to find a blind follower.... check the mirror.

    Customer request.

    It is within the scope of practice, in most states, for cPeds to cast and dispense custom orthotics. Where it is not within their scope of practice, some states require a prescription. They often get scripts from MD's, PT's, DPM's, DC's etc.

    That is NOT our policy nor the policy of Foot Solutions. They make extraordinary efforts, as a corporation, to make it crystal clear that they are not doctors and cannot diagnose. Their customers sign two places on their intake forms stating plainly that they are not doctors and cannot diagnose.

    Making broad generalities about the motivation of individual franchise owners is about as scientific as the SALRE theroy. I applaud your consistency. My experience however is that most pedorthists are doing the best job that they know how to offer the best service they can. They want repeat business and referrals.

    Besides, you have nothing to worry about. You believe that the are just dispensing a 70 yr old, outdated, failed technology because you and Kevin are incapable of distinguishing Sole Supports from the Whitman plate. And who is the expert?

    Those professions mentioned above, when necessary.

    It is because we are ethical that we could never offer any medical professional, for whom it is within their scope of practice to use foot orthotics, any less than the very best we have to offer. This is not a marketing scheme. They are a customer and we are a vendor. I did not invent pedorthics. Several podiatry colleges in the US host cPed training. You, David, claim to be a cPed. How can you put those letters after your name and then denigrate your own profession. You didn't learn foot biomechanics in Chiropractic college so you are basing your conclusions on your cPed training and what you glean from this site, dominated by the Kirby fan club. Sorry, the Ed Glaser fan club just broke up.....the guy died.

    We recently called six of the largest labs in America. All six PFOLA members said that they would be happy to open an account for a DPM, cPed, DC, PT, ATc, MD or any other profession that uses foot orthotics. Most Good Feet stores do not even have cPeds.....we don't sell to them. Before they started with us, Foot Solutions has, since their inception, offered custom orthotics from PFOLA member AMFIT which were done based on Neutral Position Theory ala Root or Kirby. In fact they used force plates as well....the I Step system. Not all stores are allowed to use CBAS. They must have a cPed in store, take a more comprehensive certification course with us followed by refresher courses delivered regionally and starting in Jan. they will be getting live and recorded webinars twice per month.
  21. Re: MASS Position Orthoses = Modified Whitman Braces???


    If you never said that you hold a degree in Mechanical Engineering, then why have you told so many people that you are a Mechanical Engineer????






    http://www.podiatrists.org/enewsroom/news/news2007/thefoot/Such Power.pdf
    Last edited: Dec 9, 2008
  22. EdGlaser

    EdGlaser Active Member

    Can you please provide me with the URL for the Sole Supports testimonials page. I can't find it.

    I did find one for Doug Ritchie's brace. http://www.richiebrace.com/testimonials.htm

    I remember a few years ago you called any site that contained testimonials unethical and unprofessional. Does that apply to Doug too? Funny, I couldn't find one negative testimonial on Doug's page.

    How about PFOLA member Amfit: http://banner.amfitsystem.com/#case_studies

    At one time we did have testimonials on our site. No more. Sorry, we cannot post your testimonial.

    It is funny how you denounce testimonials as non-scientific anecdotal evidence yet your study of one patient is pure brilliant scientific conclusive research evidence. At least you are consistent with your level of science. One patient comes in complaining of break in pain and you skirt the biomechanical issues and opt of a tilted foam cushion. You are really gellin' now.

  23. EdGlaser

    EdGlaser Active Member

    Re: MASS Position Orthoses = Modified Whitman Braces???

    You will notice that not one of these quotes is from me.
    Am I running for president? Are you Carl Rove?

    Reporters take notes and write stories, customers make mistakes on their websites about my credentials. Fortunately, I do not have to depend on my credentials to somehow make me right. Your theory does however need to hide behind such flimsy evidence and ad hominem arguments. I have to say that your evidence here is as scientific as your theory. You have certainly found a few places where people misquoted me.....After twelve and a half years of teaching, I am surprised that someone hasn't said that I was the King of England or at least a Duke.

    When are you going to actually argue biomechanics and leave all this childish name calling to the kindergarden playground? You'll recognize it....the one with the 2D see saw. I don't have time for this silliness. I have a lecture this weekend and a lot of real work to do. I will be back sometime next week.

    Thank you for the Laughs,
  24. Ed:

    Too bad you don't even know what is on your own website.:D


    Last edited: Dec 9, 2008
  25. EdGlaser

    EdGlaser Active Member

    The customer here is the doctor. They are reporting their success with our technology and using it for year after year on thousands of their patients. You are right. If we were producing an orthotic that is universally painful and consistently fails, then we would never have the repeat business that we enjoy. We do have data on second and multiple pair orders. I might share those statistics next week.

    We do not currently have exact data on success rates in the field. Don was making a conservative estimate. When real numbers become available, I will post them. Until then, arguing about Don's guess is silly.

    I have to go now....see ya'll next week. Have fun at the next fan club meeting.

    Ed Glaser
    King of England
    Elvis Presley's Identical Twin Brother
    Catsup Advisory Board Member
    President of the Duct Tape Council
    Big fan of Garrison Keillor
    Colonel in TN State Militia
    Page in TN House of Representatives
    Official Arkansas Traveler
  26. EdGlaser

    EdGlaser Active Member

    Hey I appreciate the kind words by all of these testimonials. Try to click on any of the buttons on that site. They don't work. Frankly, I have no idea why that url still brings you anywhere.

    Go to www.solesupports.com and find your way to that page. You cannot because it was part of our old website which has changed radically.

    Our newest website is even far more exciting and should be up soon. As I said, we used to have this on our site....it is no longer active. Why don't all these people report the consistent horrible pain that you describe. I guess my hypnosis is working.

  27. joejared

    joejared Active Member

    The face of pfola is changing, and I do hope others will chime in on that, but in keeping with the thread police, there is an active thread on that topic. I've seen istep data, and tried to make its data usable inspite of my own intuition that it wouldn't work for my software. I don't support it . The only application for their data that I see that is viable, just barely, is to size the patients foot and possibly to intuitively gauge the arch peak position, but not automatically, because there is no arch data and because of the spacing between pressure points. Interpolate all you want to, and extrapolate all you want to, but it's still not a 3D representation of the patient's foot.
    Do you believe a pressure mapping system is a viable resource to provide a patient with a prescription orthotic? I don't.

    The Amfit data seems like it would be usable, as long as each sensor for each pin has an analog output that could be read and actually relates to altitude. I'm inclined to have more confidence in it, but no customer has asked me to support it. As to the reputation of Amfit and their software, I have no working knowledge of their system so I can't speak as to their quality, but I do like their pin cushion idea, even though it appears to be limited to semi-weight bearing acquisition.

    Politics however of larger labs are just that. I don't care how large a company is. I care that the end user, the patient gets a product that works for them and is what it's advertized to be.
    Last edited: Dec 9, 2008
  28. EdGlaser

    EdGlaser Active Member

    I want to congratulate you heartily. I am very interested in your original work on foot scanning devices and software. This is the future of foot biomechanics. Pop and foam box will be left behind by the inventor of a foot scanner that is accurate and repeatable and places the foot in any desired position that the operator wishes. The same machine could make SALRE and MASS orthotics with simple changes in foot posture.

  29. I hesitate to even stick my hand into this blender of personal abuse. But i will. Can we please keep the ad hominems to a minimum guys?

    Ed refers often to a SALRE device.

    I was unaware that SALRE generated a specific branded device or even a type of device. I was under the impression that SALRE is simply a model to aid our understanding of foot function. Not the straw man of a crude perception of a rigid foot rotating about a see saw but as a model of a specific element of a specific joint which can be useful clinically and the principles of which can be extrapolated to other joints.

    The Medial heel (kirby) skive is one modification to spring from this model but hardly qualifies something as a "SALRE device" any more than a higher arch, blake inverted etc etc.

    I use SAL as a part of my assessment. It tells me something of how the foot functions and what types of orthotic / modification might work better than others. I don't know of a SALRE device! Am i missing a whole prescription protocol here?

    I know of the Root casting and prescription protocol. I know of the MASS casting and prescription protocol. I am loosely aware of the Tissue Stress protocol (although i missed the summer school and only got the notes which is never the same :mad:). I am unaware of a casting and prescribing protocol for SALRE.

    Does one exist? Because if not then one cannot compare the two. Catagory error.

    It might be helpful to clarify this to shift the debate onto more fertile ground for CIVILIZED discussion.


    PS. I've not ignored your question re calibrating resistance Simon. But i fear it would be lost here! One for another thread perhaps.
  30. Robert, the tissue stress approach is one that I have employed in my clinical practice for many, many years. SALRE goes some way to explaining the biomechanics that may lead to increased tissue stress and ultimately to pathology and provides suggestions for mechanisms of reducing tissue stress. As do elements of other theories of foot function. I made this point to Kevin, Howard and others during a Q and A at a summer school some time ago when the speakers were assembled to debate and defend their theories. I basically said that their theories really just helped to describe the mechanics of tissue stress and that ultimately tissue stress theory was "the way forward". Everyone seemed to agree.

    In some ways it is a shame that Kevin chose to name his theory SALRE, and to focus on the STJ in the publication of this theory that appeared in JAPMA since those unable to extrapolate the ideas presented therein cannot see further than the subtalar joint, when in actuality the concepts it described can be applied to all joints (for those without the ability to read between the lines- read the lines in Kirby's books where he explaines the mechanics of increased tissue stress at other joints). The mechanics of tissue stress theory are really described by the works of Kirby and Fuller and Dananberg, Root et al..

    If we really wanted to push the point of a SALRE orthosis (which we don't), we could say that any orthosis that altered moments acting about the subtalar joint axis is a SALRE orthosis. Hence a MASS device is a SALRE device. But since what we are really talking about are tissue stress orthoses, any orthosis that reduces stress in the target tissue, is a tissue stress orthosis. I hope you can see that this is ultimately fruitless and classification for classification's sake.

    I'll come back to calibration another time.
  31. admin

    admin Administrator Staff Member

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