Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Overpronation, The Truth

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Dieter Fellner, Nov 26, 2010.

  1. Griff

    Griff Moderator

    Craig,

    I am one of Haile's biggest armchair fans and have followed his career quite closely. Other than his recent report of a knee issue whilst running the NYC marathon (and let us not forget he is nearly 38 years old and has run at the highest level for 18 years) I am not aware of any injury problems throughout his entire career - unless you know differently?

    Infact out of the 13 marathons he has entered (winning 9 and breaking the WR twice in the process) I can only remember him not finishing one other, and that was London in 2007. A fact a good friend of mine who ran a 2:38 that day never lets me forget, as he 'overtook' Haile at mile 18... a story he has been dining out on ever since
     
  2. CraigT

    CraigT Well-Known Member

    Not sure if we are on the same page... The situation I have seen is that the heel loading occurs on the medial side of the heel counter. The heel may appear inverted or vertical on the shoe, but at the moment of actual heel contact, the upper is driven medially and essentially there is no support from the shoe. It is accentuated in a racing flat. I thought Kevin described it very well earlier. Sometimes you see the opposite where a grossly pronated foot (sorry for the terminology... but you know what I mean) which has a heel that is so everted that it sits on the lateral border of the heel counter and you end up with lateral midsole compression. But if you believe the dogma, lateral wear should mean 'supinated'.
    I could not say with certainty that this is happening here, but it should be considered. What I find interesting that if this running pattern is typical of Geb, then I thought he would be renowned for it- it is the first time I have seen footage like this... anyone else? He is perhaps the greatest ever and there is lots of video.

    I was only referring to the fact that he does have an injury at the moment. I have read he has a history of achilles problems- I believe he may have damaged it originally at the Sydney Olympics, and may even have had surgery. I can't say if they are all related, and it is all armchair speculation. I am not suggesting that he is injury prone or has chronic problems though...
    This means he doesn't start a marathon unless he is good shape and injury free. It doesn't mean he doesn't get injuries...
    Don't get me wrong- I am a huge fan of his. His longevity is one of the amazing things about him for sure.

    If he presented to me with a chronic injury problem, I would try to ascertain if there is a potential cause and effect relationship with respect to his biomechanics (broadly speaking). I would explain my thoughts, then let him decide if we try anything. I don't think it is anything different to treating any other patient apart from the fact that when you are clocking up 100 miles a week in training then small things can be big things
    Fraid not... the African guys I have seen were all Kenyan Qataris. Would love to see Geb's feet if only for professional interest...
     
  3. Dieter Fellner

    Dieter Fellner Well-Known Member

    Thanks for the interpretation. I followed Kevin's postulate. This explains it by way of visualizing a transverse plan slippage of the heel on ground contact unresisted by the heel counter, from a shoe so butchered as to reduce mass and keep it nice and light but at the expense of motion control. (btw do you regard this as generally a useful design feature?) And I can appreciate the fact there is a good deal of hypothesizing contained within all of that. I attempted a little research online to reveal some of the mysteries of the contemporary running shoe design (since my plimsoll days) that goes on at Adidas, but I drew a blank. Maybe it's a closely guarded commercial secret. Some people do that!

    But this bit, about a grossly everting heel sitting on the lateral border of the heel. I have difficulty visualizing it. Unless the lateral border of the heel, (and presumably the foot follows) gets a ride up along the lateral heel counter? But it would then virtually pop out of the shoe. No, I am missing the point, right? Also, I don't get it how this leads to lateral mid-sole compression; but I would love to be educated!
     
  4. I think an even more interesting thing in watching Haile running from behind, at probably slightly faster than a 5:00 minute mile pace, is that he is heel-striking, even at this relatively fast speed. Doesn't the Church of Barefoot Running preach that heel-striking runners are slower?!:bang::boxing:
     
  5. Dieter Fellner

    Dieter Fellner Well-Known Member

    Can't argue nor reason with beliefs bordering on religious conviction - it's a question of faith. I'm sure the counter is along the lines of "just think how much faster if only he ran barefoot" or some such soliloquy ... :wacko:
     
  6. I guess that Haile was cured of his "32 degrees of overpronation" during his world record 2:04:26 marathon performance at the 2007 Berlin Marathon. ;)

    http://video.yahoo.com/watch/2473680
     
  7. CraigT

    CraigT Well-Known Member

    I have seen this also with regular shoes, but it is certainly more obvious in racing flats and the like- regular running shoes may only show this as a long term wear pattern. I call it the 'pseudo pronator'.
    Not sure what you are referring to- butchering the shoe or motion control?
    I think they are both useful designs if used in the correct context. Racing flats for racing/ speed training which should be also suitable for the athlete. Motion control doesn't generally control motion, but usually gives a good foundation for support if this is required.
    The 'pseudo supinator' wear pattern. The individual will have a very everted calcaneus, flat MLA and abducted forefoot- you would never consider them a supinator, although the wear pattern on their shoe displays lateral midsole compression.
    The shape of the foot means that rather than the heel sitting centrally on the midsole and the pronatory forces everting the upper on the midsole, the heel is everted within the shoe and sits laterally where it is contact. If this is lateral enough to sit against the heel counter, then it can be deformed and you see lateral midsole compression at the heel.
    I had an athlete through recently who displayed this and now I am wishing I took photos...
     
  8. Dieter Fellner

    Dieter Fellner Well-Known Member

    Dr.Kirby indicated the loss of structural integrity between heel counter and shoe is a design option to reduce the weight of the shoe. Is this the only consideration or does it have a functional purpose from the perspective of the foot in motion. Or is it simply that it is assumed that most people run with pressure on the mid-foot and forefoot and it is possible to abandon any rear foot stability requirement from the shoe. The company attempts to direct customers to shoe choice based on a global profile of the 'pronating' or 'rigid' foot. I guess this added component, assuming it is engineered and with a noble purpose, will be too subtle a distinction?


    Ok, I think I got the visual, pretty much along the lines of my confabulation. But wait, this was an amateur/semi-pro or professional runner?! How did he run, in a wheelchair? That's flippant of me, but this foot type, on the face of it <<not>> ideal for running. Did you fix him or change him or make him better? :D
     
  9. Dieter:

    I think you are assuming that these running shoes are all designed with only biomechanics in mind. Remember, that the marketing people in shoe companies sometimes change shoe design to make them look "sexier", be lighter or have useless components. But, in general, racing flats lack much of any support, since the focus tends to be on reducing mass in these shoes.

    By the way, racing flats were the first "minimalist shoes", 40 years before the term was invented by the Church of Barefoot Running.
     
  10. CraigT

    CraigT Well-Known Member

    He is a footballer who is from a strong italian first division side- not a runner. I have never seen a top distance runner with feet like this!
    As for 'fixing' him- he had a pretty major issue with his knee which may have been somewhat related to his feet (will never know), but the damage was beyond what conservative care could help. He has had surgery.
    He is happy with his orthoses and I believe he wear them at least for all training activities. He had previous low grade arch pain, which he said is now gone.
    He had some of the worst feet with regard to biomechanics I have seen in an athlete- I was very surprised that he had not previously had any type of orthosis.
     
  11. musmed

    musmed Active Member

    Dear Kevin
    how can you see the calcaneus?
    I just looked at my feet and only saw skin.

    How about this for a thought.
    How can the plantar calcaneus move medially when logic says there is a lateral movement occuring.
    May I suggest this is what is happening and what you are seeing is the fat pad getting out of the road and thus creates this illusion on a medial shift of the calcaneus as you described?
    The fat pad has to go somewhere, why not there.
    I feel comfortable with that idea.
    Any other ideas out there?
    Regards
    musmed
    Paul Conneely
     
  12. Dieter Fellner

    Dieter Fellner Well-Known Member

    No, I don't think a running shoe is designed only with biomechanics in mind, not at all. That would be naive of me. Far from it in fact. People buy with their eyes as much as, and sometimes more, than for their feet. There is no reason to assume the running elite is that different.

    But, I do know the sports shoe design and retailing giants spend good money on R&D, and this includes the functional aspects of shoe design. Especially if such a shoe is to adorn the winged feet of a running superstar. Although I doubt the shoe was specifically designed for Haile. Runners will choose a shoe based on their individual preference and experience.

    It would be <reasonable> but not necessarily factual, to think a little functional thought for design is part of the R&D package. But Adidas, if they do that, do not seem anxious to advertise this fact, so maybe not so much ..... maybe an Adidas R&D scientist will read this and comment.
     
  13. Paul:

    If you were from Krypton, as I am, then you would have that ability.:rolleyes:
     
  14. musmed

    musmed Active Member

    boy arn't you lucky. CAn you see through anything or everything?
    I am certain it will pass the Cochrane review.
    You still have not answered my poser.
    Regards
    Paul Conneely
     
  15. CraigT

    CraigT Well-Known Member

    Not sure we are talking about the same thing Paul- I believe Kevin is saying medial shift of the calcaneus on the midsole of the shoe.
    Perhaps you could explain the lateral movement you are talking about, because I don't see the logic...
     
  16. musmed

    musmed Active Member

    Dear Craig
    Hi unfortunately have lost me. If the calcaneus moves on a sole of a shoe it must do it every where else, n'est pas?

    The logic is simple
    stretch the spring ligament, where is the only place the calcaneus can go?
    collapse laterally possibly.

    I hope to show all a movie that shows the calcaneus does not move.
    I will ahve a go now
    one is a pdf
    the other is an avi. The avi file is set to look at the left foot not the right.
    hope it works.
    I have many of these files produced by using a CT scanner and extremely expensive software.
    Trust you are not melting over there.
    Regards
    Paul Conneely
    www.musmed.com.au

    the system blocked the .avi with a security token problem whatever that means. i have sent an email to podiarty arena admin to get it cleared up.\
    If not work i will try something else.
     

    Attached Files:

  17. CraigT

    CraigT Well-Known Member

    Talking about different things.... we are not talking about the calcaneus moving independently, simply the calcaneus shifting in the shoe medially at the point of contact. It could well be the fat pad, but in this context it is irrelevant- perhaps better just to say 'the heel'.
     
  18. musmed

    musmed Active Member

    Craig
    You are kidding I hope.
    Why does the pat pad move?
    Nothing in nature occurs because it had nothing better to do.

    This is precisely why the fat pad moves so as to leave the calcaneus in neutral.

    as the old car commercial used to say, 'please reconsider'.
    regards
    Paul Conneely

    please do not forget about:
    1.calcaneus- fat pad
    2. fat pad- skin
    3. skin-ground (shoe or whatever)
    they are all joints in a primitive sense
    They all reduce friction
    They all spread forces as applied from above down and down above
    they all leave the bones alone as they should
    bones only compress and twist and bend
    if they do anything else they lose their oritntation withtin the soma (body)

    They all play a role
     
  19. CraigT

    CraigT Well-Known Member

    Like I said- we are not talking about the same thing... I am not going to go through it again.
     
  20. musmed

    musmed Active Member

    Dear Mr Spooner
    Thanks for these referrals.
    I will read them with interest.
    As in Dunedin when ths sun shines you go for a walk. I'm off. I hope it lasts long enough

    Regards
    Paul Conneely
     
  21. musmed

    musmed Active Member

     
  22. musmed

    musmed Active Member

    Dear Mr Spooner
    I ahve read these papers you listed.
    I was concerned with the MRE paper (first one)
    They called the fat pad a soft tissue ???? To cut it off it take between 4 and 5 scalpel blades.
    I had to smile when they said the fat pad and breast tissue have the same tensile forces. Really???

    MRE was designed to look at muscle diseases and has progressed but I wonder how accutate it is when dealing with such a tough object as the fat pad. Compared to most other tissues it would be definitely harder to make it vibrate and thus get accurate data that this method relies upon.

    The images show fat pad movement which makes sense as I say the calcaneus does not move only the fat pad. Thus the calcaneus is in neutral. I ahve about 50 similar videos. All is explained on the special page I set up.

    I posted the .avi flies on my website www.musmed.com.au as I cannot put them on podiatry arena.
    These films show the calcaneus does not move.
    Have a look and let me know of your thoughts.
    Raining in Dunedin so I will go home to the aussie floods.
    Regards
    Paul Conneely
     
  23. Mr Con-neely,
    For change a just sense make little do you. Pads fat in-vivo examined were. Off cut study this not in were. Pad bony tissue heel you consider soft tissue or? Demonstrated did reliability they? Images calcaneus same they were shear applied when? Supposed educated be to you. After advert got you out of way, you showing shear and MRI heel applied to? Arsed couldn't be look beyond self-promotion to shame-less page first:rolleyes: Either I'm turning into Yoda, or I'm taking the piss, decide you. Arsed with you can't be, I.


    Fu-king cooking in Plymouth; great little Chinese restaurant I know.
     
  24. musmed

    musmed Active Member

    Dear Mr Sponer
    It must be sunday and you have missed church or something!
    Was you attempting to be clever or just mastering spoonerisms?
    It has already been done
    could you tell me how to post an .avi file on this site
    Thanks for your feedback.
    I notice you are now allowed to examine to the knee.
    Overhere we can examine anything that affects locomotion.
    Regards
    Paul Conneely
    www.musmed.com.au
     
  25. Mr Con-nearly, grow a dick.
     
  26. Dieter Fellner

    Dieter Fellner Well-Known Member

    Paul, phenomenal images, very nice!

    Very static also. Does it explain Haile's video? I don't buy it. I have seen fat displacement but I have never seen it to that extent. I can buy into the mechanical sliding lateral heel displacement, up to a point but I'm not convinced this is all there is to it. Perhaps it is a combination that includes pronounced heel eversion together with the shoe artifact.

    As for heel fat and breast fat - I recently completed 9 months dissection and explored both and did not find any tremendous differences on gross inspection. Perhaps there are biomechanical studies that say differently.

    All the same, nice images!
     
  27. musmed

    musmed Active Member

    Dear Dietar
    Thank you for your comments.
    It is impossible to make dynamic images with a CT 64 slice machine so the static is the best I can do.
    My aim was to see what exactly happens in marked OP feet as these are in this .avi file.
    I feel certain what the slight lateral shift of the calcaneus is a secondary thing due the lengthened spring ligaments.
    We stood people with normal feet on slight everted slopes and got similar images but not when we are standing on a level surface.

    I'd love to do more but radiation must be taken into consideration when we do any of our imaging.

    I will return to the video you quoted and see if i can tie them in.
    Thanks once again
    Regards
    Paul Conneely
     
  28. Yeah, that'll be the problem then.... Actually they are nice avi's, Just a shame they are static and demonstrate nothing with regard to this thread. Which is unusual because Mr Con-nearly's postings are usually spot-on. :rolleyes:

    Sleet? It's coming like a male porn star on zinc tablets here in Plymouth.
     
  29. Dieter Fellner

    Dieter Fellner Well-Known Member


    Okkkkkkk ...... so I took a closer look at the clinic picture and the CT. Now, the images are from different subjects, right? Take a look at the shape of the wires..... don't look right
     

    Attached Files:

  30. Remind anyone of the marigold therapy reduces hallux valgus study? Sharp work Dieter. Moreover, get your subject to stand in a different position for the photograph versus the ct scan and there you go... Like I said... Mr Con-nearly. But not quite.
     
  31. musmed

    musmed Active Member

    Dear me
    the poor porn star

    Pray tell how you do dynamic MRI's. I know there are a few portable MRI's that can just see lumbar spine motion. Owing to their very low Telsa values of about 0.5 to 0.7 the clarity is poor.

    I fell these images are useful in this case as they show that overpornation is purely a midfoot problem not a calcaneal one.

    The fact that they are static is that as I mentioned before, you cannot CT dynamically yet.

    Maybe with 3D ultrasound currently available in the future's software we may be able to perform dynamic imaging but as the demand would be on a research level I will not hold my breath waiting.

    I hope you can give the poor bugger a warm blanket or two.

    Regards
    Paul Conneely
    www.musmed.com.au
     
  32. Dieter Fellner

    Dieter Fellner Well-Known Member

    Paul: the point is, IMHO, as attractive as they are, the images don't prove one thing nor another and less so when you select non matching subjects. Since you put forward the idea this adds prove to your hypothesis, it is ipso facto, not so.
    Still nice images!
    ps what is your professional background?
     
  33. Simon, trying to make something out of nothing, you are. Yeesssssss.;)

    http://www.yodaspeak.co.uk/index.php
     
  34. manmantis

    manmantis Active Member

    Having attended one of your lectures Paul, I can only imagine that the static images shown here are about as useful at proving nothing at all as your static images of feet sliding off orthotics under load.

    How was it Paul? My memory might be a little sketchy here, but I seem to recall you describing the load position being obtained by getting the patient to pull themselves down onto the orthotics using straps attached to some sort of pressure-plate.

    Exactly the same as real-life, dynamic, in-shoe function then.

    Cheers,

    Julian
     
  35. I'm not going to get into this thread. But you should know that this post caused me to spray my computer with mince pie crumbs! :D Bad enough that Ian does this to me, now you start as well! This wins my vote for quote of the year! "Arsed with you can't be, I." Classic.

    On a side note I've been trying for ages to track down the letter in Pod now identifying "marigold-gate". Anyone remember who wrote it and / or when?
     
  36. I think it was Tim Kilmartin, but may have been Trevor Prior.
     
  37. musmed

    musmed Active Member

    Dear Julian
    Yes you are corrent. They are pulling at one bodyweight according to the electronic scales used.

    I cannot understand the difference between standing foot pressures and doing the same on an inclined smith's machine.
    Although we only tested 2 souls using a force plate in standing and lying supine undewr load the results were almost identical.

    Does your hands and wrists change shape when doing pushups vs. chin ups?
    Anyway
    If you all disagree with my images
    pleas let me know a method of improving them and I will try and make such a contraption and image it.
    Regards
    Paul Conneely
     
  38. Why? Why not just look at the bone pin studies that have looked at calcaneal motion in-vivo and the cadaver simulation studies? Because these show frontal plane rotation of the calcaneus, which disproves your theory- right?

    If you really want to use your toy, have subjects stand in the following positions: maximally supinated, relaxed stance and maximally pronated. Guess what you'll see in relation to frontal plane calcaneal position... it changes- right?
     
  39. musmed

    musmed Active Member

    Dear Simon

    The toy...tut tut some times I wonder if this podiatry arena is becoming the boys club for the chosen few.

    Thank you for your suggestions I will see how i go.

    Now what you t6old me I already know. You only mention one plain the frontal what about the others.
    My image show the calcaneus in standing, this is what they are shows the calcaneus is not moving as demonstrated in all schools of podiatry by drawing a 'texta' or what ever down the middle of the achilles in a kneeling pwerson and then having them walk on a treadmill so as to flog a pair of orthotics.
    That is what they show.

    Other images show from our series of 10 (all overpronated feet) is that the maximum motion of the calcaneus is 6.8 degrees. This is measured usingt this software.
    Basically the calcaneus is set directly behind the middle of the camera, (this is software generated), widest part of the calcaneus in standing position is found and the position of the medail and lateral talar dome is used as the angle producers.

    I defy anyone to visually see a calcaneus covered with skin move 6.8 degrees.
    I not often a 3-5 degree motion 9 of various parts) is mentioneed all the time in postings.

    Hope you found your friend in the ice and snow

    Regards
    Paul Conneely
    I ahve to go and mow the lawn
     
Loading...

Share This Page