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Pronation:Busting Some Myths with Disruptive Technology

Discussion in 'Biomechanics, Sports and Foot orthoses' started by drsha, May 11, 2012.

  1. At last. What you are saying here is that the categories that you "type" the foot to are meaningless in this situation and moreover that it doesn't change the prescription. So in this situation functional foot typing is pointless :drinks

    In terms of the "PERM", how many degrees from vertical, either inverted or everted would change the prescription?

    And at the risk of it getting lost I'll ask again: can you define "a more centered position"? Is this with the "PERM" vertical?


    Dennis, by definition biomechanics is applied physics. End of Story.

    You were doing so well...
    but there you go again: "just making s**t up". You haven't demonstrated that yet. I'm sure that if you stopped making completely unsubstantiated comments like that people might begin to take you more seriously. Good luck with your "biomechanics summit" BTW.
     
  2. drsha

    drsha Banned

    1. with regard to the frontal plane of the rearfoot, yes.

    2. Simon: Personal digs with personal digs you chad.
    I would say that my understanding of mechanics biomechanics is better than most and not as good as yours and that you lack understanding in applying biomechanics and architecture clinically. So IMHO you are a better scientist than I and I am a better podiatrist than you.
    Why can't we leave this stuff out?

    Your example relates to powerful motorized machines against an inanimate object and not the hands of a clinician practiced in biomechnics examining a patient.
    The test applies a momentary force that is small and quick.

    Did you hear the one about the gorilla that was tauted as an amazing golfer and thousands paid to see him play.
    He lined up his tee shot and hit the ball 435 feet dead center down the fairway, 3 feet from the cup.
    He then lined up his putt and hit the ball 435 feet dead center down the fairway.
    Let's be real here.

    5. I see very poor clinical applications to this diagram so I will pass

    Dennis
     
  3. So you are attempting to hold the rearfoot in vertical during static stance. Hmmmm heard that one before.
    Is it because you can't Dennis? Do you actually know what "chad" means? You might want to check yourself from time to time. Anyway, since you have no way of knowing what my clinical skills and ability to apply my knowledge of the interaction of structure and forces within clinical biomechanics are like in a clinical setting, you clearly have no idea whether or not I am a better clinician than you. So once again you are patently just making s**t up. Next...

    No Dennis, it was your example not mine; remember? However, the same principles apply to a boat pushing against a dock, a foot against an orthosis, or a hand against a foot. Deformation will be dependent upon the load applied (go study that graph)

    And that is why you fail. Never mind Dennis. It's been swell talking to you again and great to have you finally admit that functional foot typing is pointless, at least in certain situations. :drinks Go ahead, make my day, attempt to answer this one: In terms of the "PERM", how many degrees from vertical, either inverted or everted would change the prescription? "Gotcha", end of story...
     
  4. Simon:

    I don't know why you and Eric still bother replying to him. I gave up months ago even trying to have an intelligent conversation with him....it is useless and a hopeless waste of time.
     
  5. Seriously? Because It the sentence makes no sense whatsoever. A moment can be clockwise or counterclockwise, pronatory or supinatory. But the sentence "apply a PERM moment to the cast" is a meaningless one because A, PERM is a position not a direction and B: You can't apply a moment to a cast unless its fixed to a pivot.

    You understand? one can move a clock hand clockwise or counterclockwise by applying clockwise or counterclockwise moments but one cannot apply a noon moment to a clock hand because noon, like PERM, is a position, not a direction. And one cannot apply a noon moment to a brick. Thats the level of irrationality contained in that sentence.

    So I was hoping you'd answer that question to show that you were talking about a real concept rather than just using words you don't understand in an order that looks a bit like something you recognize in order to try to put a stain of scientific validity on some very vague ramblings. Giving you an opportunity actually. Way to use it.

    That you cannot explain the meaning of what you said is ample evidence, were any needed, that you do not understand the terms you're using. Vague terminology suits you ill Dennis, because it gives only vague impressions. Precise terminology suits you worse because when you fail to understand it it is palpably obvious that you don't.

    So I was hoping you'd explain in order to show that you had a better grasp of biomechanics than that bizarre sentence suggests.

    The possibility of subconscious self harm cannot be ruled out. Perhaps we're punishing ourselves.
     
  6. efuller

    efuller MVP

    This is why I discuss Dennis' posts. He's implying that physics doesn't apply to the human foot. He's implying you can do biomechanics without the mechanics. This is an outrage and should be called out whenever it happens. It's anti science.

    I know I'm not going to get Dennis to understand (or admit to) the weaknesses of his own paradigm. A lot of the time his posts don't make enough sense that they need to be answered. Occasionally they do. It's the students that come to web site that I'm concerned about. A lot of students accepted neutral position theory without questioning it or seeing its flaws. This discussion can help students question what they are taught.

    Eric
     
  7. Eric:

    Good point. I see now why you continue to engage someone who doesn't seem to have the capacity or desire to acknowledge scientific reason. Please carry on....I simply don't have the patience for him.:drinks
     
  8. drsha

    drsha Banned

    I understand your query now Robert.

    I'll preface the answer by stating two things:
    1. Clinically, the words that you or I use to describe an entity does not alter how we treat it unless there is innovation or IMHO, a destructive technology.
    Arguing the semantics is an exercise in debate not in care.

    2. Debating the merits or the lack thereof of the french language, its grammatical flaws, its idiomatic nuances and its areas where its words can be misunderstood, when you are not interested in ever learning or speaking french is a waste of all of those involved.

    In my career, Sureck's Atrophy, Reflex Sympathetic Dystrophy, Causalgia and Chronic Regional Pain Syndrome have gone and come but I treat them all with "Chemical Sympathectomies of Marvin Steinberg DPM".

    Your point seems to be that if you prove my terminology or some part of my work less than perfect (which BTW, some of yours is less than perfect as well, maybe more than mine IMHO) then you disprove everything my work is about.

    I don't know if that's a straw man or an irrelevant humor fallacy argument, I just know Foot Centering provides a paradigm for DPM's to provide care for the same foot and postural sufferers we have seen for 100 years. What you (collectively) are doing has some underhanded, selfish and biased intentions IMHO.

    Now to your query:
    When you are foot typing a subject, you apply an inversion force (a SERM moment) until resistance is met (rigid resistance) and records the position of the STJ as inverted or everted (the SERM Position).
    From that position the examiner applies an eversion force (a PERM moment) until resistance is met (rigid resistance) and records the position of the STJ as inverted, vertical or everted (The PERM Position).


    The aim of all this is to eventually get the rearfoot to be centered and balanced on the frontal plane as close to vertical as possible when treating, B/L because for different reasons, when it comes to SERM Position, too inverted or too everted a position, at any age will lead to pathological biomechanical consequences.

    If I am correct here, does that mean that the rest of my S*** is correct, using Simon's logic and vile chad language? Of course not.

    So, am I correct in my applications of Phyizzics here Robert?

    Dennis

    To explain using your example, if the clock hand was on one o'clock (a position) and I pushed it clockwise past all the other number to stop it at 12 o'clock (a position) I accomplished it by applying a "move it from one to 12 force" (a moment).

    can I have my gold star now professor?
     
  9. Super.

    No, arguing the semantics is an exercise in communication. And since you are unlikely to come to my clinic and treat my patients, or I to yours, the extent to which we can help each other with care is limited by how effectively we can communicate.

    But we're not in france. We're on podiatry arena. Where we, in common with all good published work and university education, use appropriate, accurate and clearly defined terminology. If I say "clockwise moment" to simon, Robin or Ed, they know what I mean. If I write "clockwise moment", anyone can pick up a textbook and read what I mean. Thats what standard terminology gives us, a common language.

    Yes, but if one googles any one of those terms, one finds the others mentioned.

    :hammer:

    No, its not. You're seeing an personal attack where none exists. What I'm saying is that if your terminology is ambiguous, inaccurate or just plain made up then you cannot hope to effectively communicate your work! I can talk about medevial history with great verve and some knowledge, but if I went to swasiland and tried it I'd be wasting everybodys time. That would not mean what I was saying was wrong, just that I could not communicate it!

    If you were right it would be a straw man. Actually more correctly it would be a Denying the Antecedent fallacy. But we digress.

    Yes. The question is, is it a BETTER paradigm than the ones we're variously using at the moment.

    Speaking for myself, nah.

    You said apply a perm moment to the cast, not the foot.

    All this is to get the reafoot as close to vertical as possible. Right. Thats actually coherent. Although theres a lot more to talk about there...

    Not really.

    Why not just say you're applying a clockwise moment / moments? Thats a lot simpler and cleared then a "move it from one to 12 force".

    Whatever the merits of trying to "get the rerfoot to vertical", and there's a lot there which needs unwrapping BTW, this thread seems to be about terminolgy. And as I said before, you have a real problem here. If you are selling (figuratively speaking) a model, you have to be able to describe it clearly and coherently to the people to whom you are presenting it. Otherwise its a little akin to me turning up to a sales pitch in Germany, presenting it VERY LOUDLY in English, then getting narky with them for not liking my product. Your OP, and much of what comes after, is hard to answer because the way you describe it is not logically consistent. Almost every sentence needs unwrapping and repackaging. For EG.

    When you are foot typing a subject, fine so far you apply an inversion force Inversiona and supination are two different things, but ok(a SERM moment), probably supination force / moments) until resistance is met (rigid resistance) Rigid resistance is not the same as until resistance is met, do you mean "to end range"? Also "rigid resistance" never really happens in the STJ, the limiting ligaments will give increasing resistance to the point they rupture and records the position of the STJ Do you mean the rearfoot? as inverted or everted Relative to to what? Vertical? Leg?(the SERM Position)

    Whilst people may form opinions about the validity of a theory by the coherence of its description, that is strictly speaking a fallacy. However what is not is that to pass intelligent comment or judgement of a theory it must be communicated in a clear and unambiguous way. And with respect, you have a real problem doing that. I'm no master at this, but I'd phrase the above sentance as follows. I'm assuming that since you talk about vertical this is a WB test.

    Foot typing

    A bisection line of the posterior aspect of the calcaneum is drawn on the foot. The patient is asked to stand in paralell stance. The tester manually everts the calcaneum to end range and records whether the bisection line is Everted beyond vertical, vertical or inverted to vertical. This is recorded as the PERM The rearfoot is then manually inverted to end range and again, the position of the bisection is observed as inverted, vertical or Everted. This is recorded as the serm

    I've left of what these positions are annotated as but you get the idea. Inverting the calc is inverting the calc, not applying a serm moment to the sub talar joint. You've got moments, postions, directions, sub talar joint / rearfoot and inversion / supination all jumbeled up together and used interchangable. Makes it really hard to follow.
     
  10. drsha

    drsha Banned

    very insightful.

    I will try to use Arena Terminology on The Arena as much as I can.

    One comment in foot typing, the patient is in open chain not stance.

    Dennis
     
  11. Thankyou.

    If you're using open chain then you need to redefine vertical. What's your reference line? Centre of the leg? Achillies tendon? That would be a starting point.

    While I'm on a roll, another suggestion. If you're going to invent a term for a new concept which does not yet exist, don't use a term which already does. Take your rearfoot with a perm which is still inverted. That you call a rigid rearfoot right? But rigid already means something else so by using it you make people who want to use your work unlearn the previous meaning (as in fixed and immovable) and apply a new one (not fixed, but won't evert beyond vertical). And you confuse the hell out of people who've not learned your meaning. If you called it IRF (inverted rearfoot range) then people only have to learn the new terminology rather than redefining the old. IRF would mean a rearfoot with a range of motion between vertical and inverted. Then flat, which is not really a term one can apply to a calcaneum, would become an ERF, etc.

    Would make more sense to me... If you've invented a new dish made of a butterfly chicken breast wrapped around a venison sausage served with a red wine reduction, don't call it egg and chips. You'll have people confused and complaining that their egg and chips are nothing like egg and chips. They might even throw stuff at you for not knowing what egg and chips were. As such they might not even taste your chickosausiwine. Which might be a real shame if your chickosausiwine is actually rather good...
     
  12. drsha

    drsha Banned

    If my feeling towards N=1 biomechanics was "a good orthotic prescribing podiatrist guesses rightish more times than they guess wrongish. But it's not a hard science, it's still guessing and every patient is a case study, n=1 which I totlally agree with, until the evidence surfaces to change that the statement into one giving us more control, I would want to gather all the information I could, from every direction I could so as to improve upon my guesses.

    I would want to add to my Newtonian knowledge, architectural knowledge, posiitonal knowledge, shell casting, prescribing and fabricating knowledge.
    I would want to research the comments being made by other successful "guessers" that possibly I am overloaded in one area and underloaded in others.

    I think that would make for a better practitioner.

    I think I fit that bill better than you as you are wasting time try to find others pointless and meaningless and I am looking for the best in all.

    As to 1 degree inverted, vertical, one degree everted making my paradigm pointless, if feet went from 1 degree inverted to one degree everted, we would have no need for biomechanics. Things get worse as they diverge further. I would say after 2 degrees either way from vertical (barring comorbidities.
    For one degree inv/vert/evert a zero post is appropriate. What do you use?

    What would be your Kirby skive for your 1 degree inverted, vertical, everted.

    The fact is that you cannot name one biomechanical paradigm that is not pointless (your term) in your selected range.
    SALRE/Root?Tissue Stress

    You are just as pointless as me so what are you proving?

    Why single me out.

    That's POINTLESS.
     
  13. efuller

    efuller MVP

    Pathological biomechanical consequences. There's a term everyone can understand, but it's too vague to do experiments on to verify.
    What pathological biomechanical consequences result from SERM that is too inverted or everted? Why do you think that these consequences are related to SERM?

    Eric
     
  14. Dennis, that's why we use research to inform our practice and in the absence of research we employ techniques which are: 1) Theoretical coherent, 2) Biological plausible, and 3) Consistent with the available evidence. Moreover, it's why we don't just make s**t up. In addition to Newton you should study the work of the other physicists who developed our understanding of mechanics and thus, biomechanics- Hooke, Cauchy, Young to name but a few.


    I think that you have failed to construct a sentence here. Never mind. Your ad hominem fallacy tells me everything I need to know.

    I use a tissue stress approach as I know that one or two degrees cannot be measured accurately or repeatably either within clinicians or between them. You still don't get it do you, Dennis? It doesn't matter whether your delineation between foot-types and thus foot orthotic designs is at vertical or at two degrees inverted or any other degree inverted or everted, the same problems that I have demonstrated previously, with your help, still apply.
    It depends on what the presenting problem is Dennis. I might use a 4 degree varus rearfoot post, I might use a 20 degree medial heel skive, I might use a 4 degree valgus rearfoot post, I might use a 15 degree lateral heel skive; I might use anything in-between; I might use a neutral cast, I might use an inverted cast; i might use an everted cast; I might use no arch fill; I might use a bit of arch fill; I might use lots of arch fill; I might pour the cast inverted, everted, or vertical. I might use polyprop. for the shell; I might use eva, polyethylene, high density plastazoate, composites or laminations; I might use a standard rearfoot post, I might use no rearfoot post, I might use modified rearfoot post designs etc etc etc But what I don't do, is base my entire orthotic prescription, nor even the rearfoot posting angle based on whether the rearfoot is inverted, vertical or everted when an unquantified pronatory force is applied to it.

    You make the assumption that your PERM measurement and the others predict pathology, yet you have absolutely no evidence whatsoever other than your own anecdote to support that. And your technique could result in someone with chronic lateral ankle instability receiving a varus posted orthosis. The trouble with your anecdote is that it is frequently NOT: 1) Theoretical coherent, 2) Biological plausible, nor 3) Consistent with the available evidence. Viz. it's frequently just s**t you've made up. This is Eric's point above.

    Do you think I was born yesterday, Dennis? That you can manipulate me in debate? Come on. I've spent the last couple of days taking you to the point were you demonstrated that your own foot-typing technique was pointless. Who do you think was leading who on here? I have not said that all biomechanical paradigms are pointless- show me where I have said this? And when you fail, retract your ridiculous straw-man argument. What I said and demonstrated with your help, is that in certain situations it was pointless applying your functional foot-typing system since regardless of the "type" assigned, the feet would receive the same device. A tissue stress approach is certainly not pointless, since the whole point of the paradigm is to reduce the stress upon an injured tissue, to enable it to heal. This paradigm applies an approach which is: 1) Theoretical coherent, 2) Biological plausible, and 3) Consistent with the available evidence.

    More ad hominem.
    You have not been singled out. You are nothing special. But I am with Eric on this:

    Dennis, your "technology" isn't "disruptive", it's just weak and poorly thought out.
     
  15. drsha

    drsha Banned

    Yawn
    Dennis
     
  16. drsha

    drsha Banned

    Let's see who has been leading whom Simon.

    1. You state that in your biomechanics EBP you do two things
    A. "we use research to inform our practice
    and
    B. "in the absence of research we employ techniques which are: 1) Theoretical coherent, 2) Biological plausible, and 3) Consistent with the available evidence

    Newton's Laws, which you claim to be beholding to is proven in the research over and over again
    and needs no plan B.
    The Arena faithful has, using a Newton's Laws and high level evidence smoke screen to mask its snake oil paradigm of SALRE and Tissue Stress has not produced any Newtonian type, high level evidence backing up its camouflaged claims.

    Again, to use your low class terminology (not that you made the statement, Isn't that Simple Simon!),
    IMHO, The evidence that you have for your work is S**T!
    Your scientific claims are made up.

    2. Total S**T

    3. You either LIE or you have never actually visited my work when you state: "It doesn't matter whether your delineation between foot-types and thus foot orthotic designs is at vertical or at two degrees inverted or any other degree inverted or everted"
    when all I have agreed to and you have proven is that at 1 degree inverted, vertical and 1 degree everted, the Wellness Biomechanics prescription starting template
    calls for a level rearfoot.

    4. Simon, this is the one that really gets me.
    16 spelling mistakes, many poorly defined and ambiguous words and terms that come from things that were just made up or are poorly or none evidenced.
    You state:
    I might use a 4 degree varus rearfoot post, I might use a 20 degree medial heel skive, I might use a 4 degree valgus rearfoot post, I might use a 15 degree lateral heel skive; I might use anything in-between; I might use a neutral cast, I might use an inverted cast; i might use an everted cast; I might use no arch fill; I might use a bit of arch fill; I might use lots of arch fill; I might pour the cast inverted, everted, or vertical. I might use polyprop. for the shell; I might use eva, polyethylene, high density plastazoate, composites or laminations; I might use a standard rearfoot post, I might use no rearfoot post, I might use modified rearfoot post designs etc etc etc But what I don't do, is base my entire orthotic prescription, nor even the rearfoot posting angle based on whether the rearfoot is inverted, vertical or everted when an unquantified pronatory force is applied to it.

    So in understandable terms and to use Fullers prompt, in a few sentences or paragraphs, please explain how you decide which of these many applicable biomechanical treatment options you use on any given case?
    To me, it sounds like you could use a starting paradigm But no innovation or creativity in your armamentarium, not you.

    You LIE again or have never visited my work
    when you state that I admitted that I base my entire orthotic prescription on whether the rearfoot is inverted, vertical or everted as you state:
    "What I don't do, is base my entire orthotic prescription on whether the rearfoot is inverted, vertical or everted when an unquantified pronatory force is applied to it. as you admit"

    5. You make the assumption that your PERM measurement and the others predict pathology, yet you have absolutely no evidence whatsoever other than your own anecdote to support that.
    True.
    I only have successful EBP that is based on anecdotes that are:
    1) Theoretically coherent, 2) Biologically plausible, and 3) Consistent with the available evidence

    6. Its Simple Simon, as stated above in 1., I am using your demeaning and vulgar words in responses here in order to debate but unlike you, I have great admiration for your work and those of many others. I have given out almost 200 "thanks" and acknowledged the education I have received directly from you and others on The Arena. I quote your names and have referenced your works in mine.

    I never stated your work to be pointless or S**T I merely find parts of it limited (or is that rigid) and suggest that they are in need of revisiting.

    I Never Said You Made This Statement. End of Story!

    7. In order to get to even state that any of my work was pointless you had to boil it down to subjects with 1 inv, vert, 1 evert in order to say that I suggested the same Rx, a Zero RF Post for all
    FAIL!

    What different kind of prescriptions do you write for the frontal plane correction of the rearfoot for these very patients?
    Markedly Different? End of Story!

    8. You state:
    "A tissue stress approach is certainly not pointless, since the whole point of the paradigm is to reduce the stress upon an injured tissue, to enable it to heal"
    True

    I state:
    Functional Foot Typing is not pointless as it profiles all feet into subgroups that can then be treated and researched in a more custom manner, by type, as they tend to share more common characteristics then when all feet are treated and researched as a whole.
    True or False?

    Dennis
     
  17. phil

    phil Active Member

    False.
     
  18. drsha

    drsha Banned

    yawn

    Dennis
     
  19. phil

    phil Active Member

    Dennis,

    Might be time for you to go and have a little nap. You're yawning a lot. Go gather your strength and come back to fight the battle of who could care less another day?

    Sincerely,

    Phil
     
  20. drsha

    drsha Banned

    yawn

    Dennis
     
  21. blinda

    blinda MVP

    Dennis,

    If you`re bored now, why not use this time to make a reply to my questions raised here?

    Please?
     
  22. drsha

    drsha Banned

    Robert:

    In saying that you have visited my work on Foot Typing, I refer you to the posting of September 2008 where Newsbot published my patent application of 2006.
    In the middle of the post it states:

    The Rearfoot SERM position refers to the position the Rearfoot Joint assumes in open chain, i.e., when not weighted on the ground, with reference to a bisection of the lower one third of the leg after applying a strong inversion force upon the Calcaneus until it can no longer move. This is performed by inverting the foot so that it can no longer move, followed by determining whether the position is inverted or everted. If the Rearfoot Joint is tilted toward the medial arch, the Rearfoot SERM position is inverted. If the Rearfoot Joint is tilted toward the lateral arch, the Rearfoot SERM position is everted

    [0030]The Rearfoot PERM position refers to the position that the Subtalar Joint assumes in open chain with reference to a bisection of the lower one third of the leg after applying a strong eversion force upon the Calcaneous until it can no longer move. This is done by everting the foot until it can no longer move, followed by determining whether the position is inverted, vertical or everted. If the Subtalar Joint is tilted toward the medial column, the Rearfoot PERM position is inverted. If the Subtalar Joint is vertical to the ground, the Rearfoot PERM is perpendicular. And if the Subtalar Joint is tilted toward the medial arch, the Rearfoot PERM position is everted.

    As the foot typing that you have been associating with me examines the patient standing in parallel stance"" and my science uses an open chain evaluation that has closed chain implications, I can start to understand why, from the beginning, you have been less then kind when reviewing it.

    Robert:
    Perhaps you could source the foot typing method that you have been referencing for these 3.5 years?

    I tried to examine a patient yesterday and was stymied as to who could have proposed such an ignorant, useless, pointless system to be considered here on The Arena.
    I for one would rather like to echo your sentiments once we find the person responsible for this foot typing method that you based your opinions on.

    and in addition, I invite you to examine-visit-test functional foot typing using the current available material in its entirety and start fresh raising questions to me either privately or publicly as you go.

    Newspaper Headline:
    There's A Woman Giving Birth In America Every 14 Minutes: If We Can Find Her, We Can Solve The Current Population Problem


    Dennis
     
  23. David Smith

    David Smith Well-Known Member

    Hope I'm not pre empting Robert here but:

    Dennis, what then is the difference between finding the perm and serm and to measuring the range of motion of the STJ in degrees relative to the rear shank bisection? E.G. STJ RoM = 25dgs inversion and 8dgs eversion or 30dgs inversion 0dgs eversion etc etc. Except of course that the latter is far more informative and precise!!
    The former is easier to categorise of course (if we ignore the difficulty of defining boundary limits as per Simon S explained earlier) and as we know easier is better IF YOU'RE A HALF WIT!:craig:

    While your kids are happy with Jumbo Leggo to make a rough approximation of a jet plane, ours are quite at home with Advanced 3D Scale Modeling kits with precision made parts.:bash:

    Regards Dave
     
  24. drsha

    drsha Banned

    I see your point.

    Mine is to simply easier to categorize as you state.

    The practitioners become more precise as they practice.

    As I've stated all along, mine is a starting platform with its "more precise " method but any "more precise" method can be pasted in.

    Dennis
     
  25. drsha

    drsha Banned

    I see your point.

    Mine is to simply easier to categorize as you state.

    The practitioners become more precise as they practice foot centering as with any other interpersonally adaptable method.

    As I've stated all along, mine is a starting platform for biomechanics with its "more precise " method recommended in foot centering but any "more precise" method can be pasted in.

    Dennis

    the only disappointment for me is that these same questions could and should have been raised three+ years ago instead of focusing on the imperfectons and weaknesses of my work (and others).
     
  26. Sorry. Missed the last one.

    Yeah, As David said my issues with FFT have never been whether it was WB or non WB. The Non WB adds another potential for error, but thats not the biggest deal in the world. Vertical is an established constant (my Iphone finds it nicely) wheras the bisection of a leg is an inaccurate business at best.

    Not my biggest problem with the model by any means.
     
  27. efuller

    efuller MVP


    from October 7, 2008
    I'll admit that I did not specifically criticize the use of the heel bisection, but I did talk about measurement accuracy. We didn't even need to talk about how hard you push will change the measurement, determining the heel bisection is an even bigger problem. Of course, being able to repeat the measurements is still useless if they do not change the treatment.

    Eric
     
  28. efuller

    efuller MVP

    One of the nice thing about tissue stress is that you don't always need a high level of accuracy. If you diagnose a problem that is related to a high pronation moment from the ground, you can then attempt to decrease the pronation moment from the ground. The advantage of tissue stress is that it provides a logical approach to the method of treatment.
     
  29. Determining heel bisection is a snip compared to determining the bisection of the lower 1/3 of the leg! But we're back into the minutiae. There are bigger issues here. Lets pretend we live in a world where such tests are believable.

    This sentence

    Fascinates me. Enough truth to be interesting, enough generalisation to be frustrating, a dash of tautology, A bit of terminology which needs translating, the core of FFT (it seems) and a lot in common with a few other paradigms, both overt and the guilty ones we all have ingrained, contradictory and yet... interesting.

    I'd rather talk about that than measurment error. We know heel bisections are poo, leg bisections doubly so. Thats not really in dispute is it? Anyone?
     
  30. drsha

    drsha Banned

    If you don't need accuracy, why are you asking me to be accurate?

    Let's leave it as I don't always need to be accurate either.

    Dennis
     
  31. efuller

    efuller MVP

    Dennis, most of my criticisms were not about your accuracy, although it is a problem because a change in treatment is supposed to be based on them. So, using your method you do need to be accurate. Most of my criticisms were more about your logic. That's the part of my post that you cut. Tissue stress provides a logical process for altering your treatment based on your diagnosis and or physical exam measurements. What's the logic on basing a treatment on SERM? Any treatment? How do you alter your orthotics for one foot type as opposed to another?

    Eric
     
  32. When you have to be accurate to the nearest Identify-the-knackered-structure the measurements are less important. When 3 or 4 degrees will change the prescription in a measurement with a composite tester error of 6 or 10 its much more so.
     
  33. David Wedemeyer

    David Wedemeyer Well-Known Member

    Anyone else feel it's just plain rude to keep a lady hanging like this after she took the time to craft such well thought out questions?:eek:
     
  34. drsha

    drsha Banned

    that would make some sense to me if you had ever visited my work.

    What's the difference between open chain and closed?

    Dennis
     
  35. drsha

    drsha Banned

    Not interesting enough to visit my work Robert!
     
  36. David Smith

    David Smith Well-Known Member

    Dennis

    I think many of us and certainly I have visited your work extensively, I have read and reread everything you have published and made public because I thought at first maybe you have something. BUT! there is nothing more than a dumbing down of Root, renaming some of the definitions that you choose to use in FFT and instead of starting from Sub Talar Neutral your reference is rearfoot bisection vertical, where vertical means parallel to the posterior tibial or shank longitudinal bisection.

    Instead of ranges of motion of the rearfoot and forefoot you have replaced that with PERM and SERM. The difference between the two is like having an itinerary for a bus journey and one tells the direction of travel from start to destination and all the towns between, the the distances and times to each one, the other only says we go we stop somewhere we arrive somewhere, sometime.

    Plus you add a range of acronyms like TIP (The Inclined Posture)and FEJA (Functional Equinovarus of the Joints of the Ankle) and all neatly tied of in a bag called FLEB (Functional Lower Extremity Biomechanics). None of the functions that these acronyms encompass are anything new, rather just well known functions renamed.

    This is the full extent of you new biomechanics paradigm that you claim is so radically different from Root but is really just Root for Dummies who can't be bothered to learn Root. Ultimately its so Dumbed that it just plain wrong.

    It is so dumbed down that it can be fully explained on 4 pages as it is here is this book http://books.google.co.uk/books?id=...m serm&pg=PA384#v=onepage&q=perm serm&f=false Principles of Diabetes Mellitus by Lenord Poretsky

    or here http://www.podiatrytoday.com/article/7628?page=2 in Podiatry Today


    Dave
     
  37. Sigh. I visited it. I didn't find much to like. Did I become an expert in it? No, why would I? I know very little about crystal healing for much the same reasons. You probably know very little about the practice of trepanning, but enough to know you don't fancy it. I visited Slough once. Didn't much like it. Couldn't tell you the name of the street I visited, but I can tell you it wasn't very nice.

    You have the most extraordinary way of advertising your model Dennis. You post prolifically on it (I'm being polite here) perhaps a little more than your audience wants to hear. Then, when asked questions about it, you get pouty that people are not more intimately familier with it already! I'm confused, I really am. If you don't want to answer questions about your model, why ARE you actually here? To tell people to go read it for themselves? Does it really take so many words to do that?

    :deadhorse:
     
  38. drsha

    drsha Banned

    David:
    1.You are so entitled to have your opinion of my work after reading and re-reading it. I get it.

    Some who visit it say that it is more understandable and teachable than Root. I guess they are the "Dummies" that you refer to.

    Some of them are MD's, patients and ancillary and adjacent professionals who have tried to understand Root and SALRE and Tissue Stress applications and can't. Some are podiatrosts, many are podiatry students in America.

    They feel there is a need for new acronyms and definitions. Something they can understand and build on.

    Biomechanics is a misspelling on word (and on The Arena). Prefacing it with Functional Lower Extremity makes biomechanics more understandable from lets say the biomechanics of the tennis swing.

    The text you quote where biomechanics was "Dummied Down" is a medical text used at many major teaching universities, fellowships and residencies internationally. It is on its second printing and has been referenced many, many times.
    Dr. Poretsky changes 16 of the chapters authors for the second printing and kept me on as The Diabetic Foot author.

    Who else on the biomechanics map can claim such an accomplishment?

    I continue to thank The Arena as part of my educational process and whether you believe it or not, I sell tissue stress every day that I practice, lecture or publish.

    You're too busy being angry to see that.

    Dennis
     
  39. drsha

    drsha Banned

    I guess its because you believed SERM-PERM testing to be performed closed chain when it is not that makes me believe that your visit was mostly imagined and certainly not tested.

    It's kind of like testing out a car and driving it in reverse gear to go forward.

    After that test drive, you might honestly say:
    "I visited it. I didn't find much to like. Did I become an expert in it? No, why would I? I know very little about crystal healing for much the same reasons. You probably know very little about the practice of trepanning, but enough to know you don't fancy it. I visited Slough once. Didn't much like it. Couldn't tell you the name of the street I visited, but I can tell you it wasn't very nice".

    Dennis

    Take 10 patients and foot type them then opine.
     
  40. David Smith

    David Smith Well-Known Member

    Dennis

    When Robert went to Slough and didn't like it, he didn't dislike it for itself but because he had been to much better places. Like your system, Its a bit rubbish when compared to anything or anywhere else. But if that's where you live and have grown up I am sure that there are many fine things to say about Slough just as you do about FLEB or Neoteric Biomechanics (not a misnomer here is it:bang:) or FFT or Foot Centring or wellness biomechanics (not another misnomer :bang:) how many more names do you have for your system that you sell for $400 dollars value plus some felt pads that appear to do the same as your orthoses. FFT so good you named it 6 times at least. They only named New York twice and that beats the pants off Slough.
    Imagine if Slough named themselves 3 times and called all their roads boulevards and 42nd street and the local recreation ground, central park. Might sound impressive but when you took the time and spent the money to go there, imagine how disappointed you'de when it was nothing like NY. You would just have to tell your friends it all just a sham.

    Dave
     
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