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Semi Weight Bearing?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by PodKor, Oct 26, 2006.

  1. Arthur Fass DPM

    Arthur Fass DPM Welcome New Poster

    I would like to give a testimonial about sole support orthoses. I had a severe plantar fascial injury 2 years ago which prevented me from running and caused almost constant pain on ambulation. I had standard Root orthoses and was constantly trying to get my 1st ray more plantarflexed with modifications. My 1st ray into the arch was painful on propulsion. Nothing worked well until I took Ed Glaser's course and had him cast me for sole support devices. The change to my foot was unbelievable with much greater push from my 1st ray and I can return to running and all sports pain free. I have had similar results with patients
     
  2. Arthur:

    By any chance, did someone from Sole Supports ask you to contribute to this forum? Glad to hear your foot is feeling better.
     
  3. achilles

    achilles Active Member

    Dear Ed,
    First may I say regardless of you're opinions, I have to admire your enthusiasm. ;) However, a less antagonistic approach may yield a far more receptive response to your posts??
    In regard to your casting techniques, I am particularly interested in how you control the paediatric foot whilst weightbearing.
    In my experience, box casting is difficult due to the weight of the child and inherent foot flexibility. Couple this with a medially devaited STjt axis and preventing abduction of the forefoot when loading is extremely difficult when compressing the foot against the box foam. Due to the smaller architecture of the child foot, I have found the foam creates a ground force reaction that persistently alters the foot position and usually causes the forefoot to 'slide' off the casting foam.
    I have cast thousands of childs feet and have found that the only way to maintain foot position, in a child, during casting is to stabilise the calcaneum and navicular when loading the forefoot.
    I am interested in how you solve this problem during 'box casting'
    regards
    Tony
     
  4. Atlas

    Atlas Well-Known Member

    Tony...Ed.

    How do the additions compare between foam box and your standard additions for POP?

    What about the concept of 'subtractions' ?


    Ron
     
  5. EdGlaser

    EdGlaser Active Member

    Tony,

    I apologize. Since I first posted on this site with a very different approach, the vast majority of what I have heard from Kirby and his harem have been personal attacks on my business, motives, marketing, education, reading, writing etc. etc. etc. In America this is the strategy of the Republican Party. If you don’t like the message…..attack the messenger. Simon attacks anything new, a sign of insecurity, unless he or Kirby invented it. So, I have spent more time correcting outright lies about me and my company than I have giving the whole story about my theories and technology. Yet….they continue on this fruitless path.
    The only reason I try to correct the lies is because I do not want anyone to think that they are true just because I ignored them. In spite of that I always try to contribute my point of view on the actual topic mixed in with defending myself from the personal attacks. I only mean to be antagonistic to those that would muddy the waters with lies and personal attacks to distract from the real issues of delivering better patient care.
    I do not include Eric in this group even though he often disagrees with me because I judge people by their intention and I have met Eric and know that his intention is truly to seek the truth. In that case criticism is more than welcome….it helps me modify my theories and constantly improve my technology. I think that if you met me, you would find me quite humble and non-threatening.

     
  6. Peter

    Peter Well-Known Member

    Ed Wrote

    "the vast majority of what I have heard from Kirby and his harem have been personal attacks on my business, motives, marketing, education, reading, writing etc. etc. etc. In America this is the strategy of the Republican Party. If you don’t like the message…..attack the messenger. Simon attacks anything new, a sign of insecurity, unless he or Kirby invented it."


    We in Britain call this approach "scepticism", and sceptics, which I am pleased to call myself, feel that we add to research by asking the questions that need to be answered.

    I have met Drs Kirby, Fuller and Spooner. I consider all of them sceptics, and well conditioned researchers, who speak from experience, and validate their clinical approach, with research.

    If they attack your marketing, then you shouldn't be using this forum for marketing, should you now!
     
  7. EdGlaser

    EdGlaser Active Member

    Market This

    Peter,
    Unfortunately when you come up with something new and are the only one doing it; then presenting it, defining it, explaining it, are all perceived as marketing it. I believe in what I do. I am enthusiastic. My approach makes good biomechanical sense and our phenomenal growth, which is accelerating, is a testament to the success we routinely have on patients for whom standard approaches have repeatedly failed, like Dr. Fass or Dr. Barrett or Dr. Dockery and so many others. When I have such an advancement in technology, the unethical thing to do would be to keep it quiet. I offer it to every practitioner who wants to try it. Do I want to see every patient that needs an orthotic in Sole Supports? You BET I DO!!! Why would I want any patient to have less than the best? Who deserves sub-standard treatment? Who goes to the doctor to get half better?

    What science is there to determine the exact amount of arch fill? The exact amount to post or wedge? Why is a cast taken off weight bearing with 15 degree average variability forefoot to rear-foot acceptable by anyone? Why would anyone in their right mind, knowing that the foot should heel strike in supination allow the foot to drop all the way to neutral before beginning to think about correcting it and then cast correct it further? Sorry, but much of what is done today, even by the gurus on this site, is BS. It is the bare minimum to cover symptoms which any prefab can do.....how much research do you need before you accept that?
    I think differently. I think it is the doctors responsibility, if they are treating the foundation of the kinetic chain to take that opportunity to give every patient the greatest amount of correction that they can tolerate with their anatomy. Doing less is a sin of omission. You just want to mask symptoms....bathe them in cortisone. You want to fix things, reposition the foot into greater supination.

    Don said it best to me today. The simplicity of what we do is: The arch has fallen....we raise it back. Its so simple and obvious that the gurus are afraid of it. Most intelligent docs want to try it....not just see a few of someone else's failures and declare themselves and expert on the technology. Someone who uses our product is actually diagnosing the problem, prescribing our product, designing it, casting our way and dispensing it correctly with appropriate stretching etc. Kevin hasn't done that. He is just an old school guru who is upset that I have come up with something that supplants his entire career based on Root teachings with one very minor variation. One great biomechanist with whom I spent some time made this comment on Kevin's work; "Kirby is a one note symphony."

    Then, when backed in a corner Kevin makes misleading statements to the effect that he invented our product or has tried similar approaches. Guess again....I am insulted that he would equate the "minimally" arch filled, uncallibrated, off weight bearing cast (therefore poorly repeatable), tilted pancakes he uses with a Sole Support. Sure and a Yugo is a Rolls Royce.

    I will not apologize for my business success either. On the other hand, if you are not financially successful with the biomechanics you are practicing, then you should definitely re-examine what you are doing. If you are successful, making money at it, then you are as commercial as me or anyone else that makes their living treating feet biomechanically. Incidentally, I don't think Root was very successful in practice, Weed either. Why was their business not growing like mine? They also lectured. They had credentials, wrote papers, two books, etc., etc., etc.... If you believe in what you do, you should want as many peoble to benefit from it as possible. As one of the docs I talked to today, for whom our product has improved his personal health and his practice said to me, "Frankly, I don't care if your theory is right or wrong....the proof is in the pudding....and Sole Supports work far better than anything I have ever used before." Making a profit is not a sin, denouncing good technological advances for the sake of your own ego is. Skepticism and criticism is fine, personal attacks that are not relevant to the theory presented only detract from anyone seeing the point. Is Kirby not marketing himself on this forum as the ultimate guru who knows all, invented everything from the internet to pants (including of course Sole Supports), who has come up with the ultimate approach to biomechanics that is solid unquestionable science....Horse manure.

    My theories must be pretty solid if the greatest criticism that can be levied against them is: you are marketing and self-promoting because you know that you are the only one who produces this product and it makes damn good sense to most everyone that looks at it. Thank you for that. If the science behind foot orthoses was solid.....we would not have this forum because no discussion would be necessary because they would work every time. Even we cannot claim that about our product. There is much to be learned. Do you know any other lab that is doing as much research as us? I don't.

    Believe me....we get negligable business from this site. I have much bigger and better marketing opportunities that are real and work and are expanding our company faster than we ever dreamed. Marketing here, where most of the participants do not even have the opportunity to try our product is certainly a waste of time.....I only participate because it is amusing, sometimes stimulating, and usually thought provoking. I also am enjoying reading some of the articles referenced here.

    Many would have preferred that I never got on this site or challenged the status quo here so we all could go on in blissful ignorance believing the SARLE theory or the Tissue stress model or the Wedging and Posting model. All have limited merrits....but fail to go far enough to make a significant positive effect on the gait cycle. I appologize to anyone I have upset. Keep doing what you are doing and just attribute all of my theories to marketing ......that should keep you happy.

    My only regret is that in the time I spent answering yet another personal attack, I could have finished my description of the Gib test, a simple test that is of great benefit to practitioners in assesing the forefoot flexibility of their patients. I have way too much real work to do over the next ten days to spend any more valuable time here....see you when I get back from my next three city tour....mid Nov.

    Goodnight and Sweet Dreams,
    Ed :)
     
  8. Peter

    Peter Well-Known Member

    Ed,

    I suspect the disparaging comments from the forum regulars here on Pod. Arena are probably due to the marketing aspect of your posts, like the way you put your web-site at the foot of many of your postings.

    The forum appears unique in that it allows serious and not-so-serious debate on issues pertaining to pathomechanical dysfunction.

    I recall some of the many ding-dongs between Messrs Kirby and Dananberg on the Mailbase a few years ago ( halcyon days), and despite conflicting opinion, they managed to keep their debate impersonal, and without attaching a bias towards a particular "one device cures all" orthotic device.

    Debate away, its been a long time since a topic has been so keenly contested.

    BTW, are sole supports (free plug there) any different to the 6 or 7 off-the-shelf arch supports of semi-rigid material that I can think of off the top of my head without bothering to think, here in the UK?

    Kind Regards,

    Peter
     
  9. Marketing, sniping and clinical arrogance

    And so the circle turns again and we end up with Mr Glaser Throwing his toys out the pram and leaving. It would be really great if ALL of us could discuss the science without degenerating to this every few weeks! A few points:-


    Sorry, since when has

    Been something new?! Or indeed unique?

    I think this displays the fundamental difference of opinion. I don't believe
    rather that we have outgrown it. I for one do NOT believe it is that simple.

    The argument is not unakin to the movement in medicine more generally that as a backlash against overscientific medicine people are increasingly returning to "holistic" and "alternative" remedies. There is an immensely irritating advert in the UK at the moment for a brand of frozen food containing no additives in which a grizzled old fisherman reflects with a nostalgic tear in his eye that in the 19th century they used only ice, natures preservative.

    YEAH AND THEY ALSO DIED OF CHOLERA IN THEIR THOUSANDS!!!!!

    It's not that we cannot grasp the MASS concept, rather that we have left the days of "flat feet => arch support" behind. I think you are reinventing the wheel!

    Yes you've got him bang to rights there. Kevin kirby is indeed the only one who thinks he knows it all and has come up with the ultimate approach to biomechanics. Fortunately Ed your humility and willingness to examine the views of others set an example to us all! Nobody could accuse YOU of thinking YOU have come up with the ultimate approach to biomechanics as can be clearly seen from your posts.

    (modesty is so becoming)

    Shame on you Kevin. :mad: SHAME ON US ALL for thinking anyone but HRH ED has any answers or valid ideas at all The last 20 years of research have clearly been a waste of everybodies time! Kevin you did'nt need to design any of the elegant and consistant models of motion you spent all that time on! You could have just gone bowling and waited for the His grand transendance Mr Glaser to give us all the answers. :rolleyes:

    Oh yes and

    Erm... some?

    Makes a change for Ed to drop below radar because he's busy. Ran out of holiday locations? :eek:

    Warmest kindest and fondest regards

    Robert
     
  10. Ed modestly wrote:
    Yet in a previous thread when I asked him to make public one of his "advancements in technology" so that it could be tested by the independent research community he said:

    Hmmmmm. Seems Ed's ethics are a bit turn on and offable.
     
  11. efuller

    efuller MVP

    This one criticism that I have had of your theories. If a little bit is good, more must be better. This is where the outcome studies are needed to show what you do is better. The meausre is not economic success, nor is it position of the joints, it's resolution of symptoms.

    I've heard that criticism. I disagree with it. What Kevin has done is help put the mechanics in podiatric biomechanics. Very few before him applied mechanical principles to podiatric problems. Those who think that Kevin's work is just the medial heel skive do not know, or do not understand his whole work. It appears that you are unaware of his work as well when you say that his entire career is based on Root teachings. He has taken from Root what works and has been critical of what does not make sense to him.

    Ed, the above quote is an example of the reason why people are attacking you. You just can't insult someone and expect them to sit there and take it. How do you know that Kevin puts pancakes in peoples shoes?

    Ed, in our previous conversations you have not understood my criticisms, so I just gave up. I'll try one more time. Give me a mechanical analysis of why increased pressure on the soft tissue arch will raise the arch or plantarflex the first metatarsal. Use the whole foot in the free body diagram.

    Ed, you have also been critical of those who use the Root paradigm. There are many aspects to the Root paradigm. One of the aspects of the Root paradigm is that supination of the subtalar joint will reduce symptoms because the foot is more stable. Ed, in your paradigm you take Root's idea and run with it. Your idea is not new. You may have a different reason for saying that supination is good, but you are saying, as Root did, that supination is good. This leads to the other criticism. You describe how in a supinated position the foot is more ...? Kevin and I have been saying the same thing. I called this idea the joist effect years ago. (A 2x8 is more rigid when laid on the 2" surface as opposed to the 8" surface.) However, I question whether the one to three degrees of inversion of the calcaneus you might see when comparing barefoot standing to standing on an orthosis will be enough to create the joist effect. How many degrees inverted does your device put the average foot? How many degrees of inversion do you need to get better allignment of the talo calcaneal joint?

    Respectfully,

    Eric Fuller
     
  12. David Smith

    David Smith Well-Known Member

    Eric

    Hear Hear! well put. I would agree with everything you say.
    I would like to add
    and not inducing additional pathology and symptoms.

    Kevin Kirby, his books and teachings (with the help of www.) has been a great motivation to many podiatrists in terms of looking at biomechanics as an engineering science. It was his insight which encouraged me to go on to take a masters in applied biomechanics. I thought with my engineering background that I understood the principles of mechanics (Newtonian) but my knowledge has increased by the nth degree now.
    Applying engineering science to the mechanics of the body is IMO the only way that we can reliably research, analyse, record and repeat the results and outcomes we see or expect.

    I think Ed would have been better to have come on the scene saying look I have developed a unique way of calibrating the stiffness of an orthosis material to the forces applied by the foot and by using a full contact method it can improve mechanics and outcomes in some circumstances.

    Instead he came out saying he had invented the Holy Grail of orthoses (one design cures all) and you can all forget everything you ever knew or taught about FFO intervention. Just believe me.

    Even if this were true, which is unlikely, it would have met will strong opposition and did.

    I also gave up because I noticed that Ed's ability to answer any questions in terms of engineering biomechanics was severely limited, which for me does not instill confidence.

    All the best Dave Smith
     
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