Should Podiatrists Think More Like Engineers?

An abundance of user-friendly sources are available online through Orthopedics Hyperguide, Sermo, Medscape, ePocrates, with remarkably easy to comprehend general physics calculations. These refresher lectures, CME courses, are at no cost and essential to anyone providing care to these patients.

ATTN: Kevin Kirby

Both Dennis Kiper and Dennis Shavelson made comments regarding my article in Podiatry Today on "Should Podiatrists Think More Like Engineers". Those of you who have opinions on this matter regarding whether podiatrists would benefit from "thinking more like engineers", or not, may consider commenting on this subject on the Podiatry Today magazine website since I believe this is a critical step forward for the international podiatric profession.

Yes, come and discuss your concepts of engineering. You can talk and “act” and think like an engineer all you want, and if you can discuss the science basis of your technology, that would be welcome. A medical product that's been around for over 60 years with such poor performance standards, compared to generic products and compared to other medical technologies over the same period of time is, “a critical step forward for the international podiatric profession.”--Kirby


The level of success achieved with traditional orthotics is not what it should be, because it lacks science basis, it isn't precise, let alone accurate enough for the times, it isn't “easily” repeatable by other learned doctors or labs, it isn't comfortable most of the time, therefore non-compliance. When wearing the product, ambulating should be the benefit, The Rx isn't quantitative therefore the inability to improving the Rx as the biomechanical optimal position changes over years

In the early 1960’s, Dr. Merton Root introduced his concept of foot biomechanics . He believed an orthotic should “compensate for abnormal motion while allowing the foot to move in an unrestricted and natural way.”

He was absolutely correct!

What happened, was the development of an orthotic/technology, which attempted to control (instead of assisting or guiding) the foot by holding it in a “semi-fixed” position through the gait cycle. Unfortunately, this technology caused “the foot to move in a restricted and
de-stabilized way”. This also contributed to making it difficult and uncomfortable to wear in many shoes. Since there is little give in this technology, other painful conditions can and do result in the knee, hip and or low back.

So Kevin and all your followers, let's have a healthy engineering and biomechanical discussion. After all, if we can improve the way things work, everybody benefits.

 

We could talk about subtalar joint neutral instead...

What can you say about that?

 

Aloha,

Sure.

But how will that save lives and limbs?

Took some pretty bright engineers to develope these materials.

How about we start using them to protect more feet?

https://www.youtube.com/watch?v=4Aprrlqd-TU

Mahalo,
Steve

 

Oh dear. Dennis you are stuck in time old bean. If you were a TV you'd have a cathode ray tube. If you were a video playback system you'd be a top loading Betamax. In a previous post I invited you to read some literature from the last decade. It appears you didn't fancy it. C'mon - give it a go and while you are at it treat yourself to a 50" flat screen plasma TV and a Blu-Ray DVD player.

Dennis, are you trying to show us all just how poor your understanding of the mechanical effects of foot orthoses are? (Mission accomplished sir!) Hang on a minute, maybe instead you are constructing a man of straw to erroneously generate a niche and help facilitate sales of your particular product?? You sly old dog - you nearly had me there...

 

Ian,

You poor sap, I was reading the literature when you were still suckling on your mother's teats. Correct statements never go out of time.

You are so engorged with sales around here. Who's selling?? I don't see the mention of any product names or web sites. I personally sell to the public like most of you here. I don't receive or offer any sales pitches to my colleagues, so who's selling? On the other hand, I was invited to talk about some of my statements on my web site. I didn't come here and propagate any talk of my product.

I have been talking about technology, you and the rest of your clan have been avoiding it.

“Dennis, are you trying to show us all just how poor your understanding of the mechanical effects of foot orthoses are? “

The reason you say this is because you don't understand the mechanics of a traditional orthotic. If you think you do, why don't you enlighten me with those mechanics and I'll be happy to point out deficiencies.

 

No, Dennis, you are wrong. You have a website offering to sell the the public "orthoses" which are nothing more than a plastic bag filled with fluid...all without ever seeing, or examining, or doing gait evaluations of these patients for $399.00!

There is no one on this website that does what you do. The technology you talk about is all in your mind, there is no research evidence for it. Show me the research that shows that a plastic bag of fluid placed inside a patients shoe works better than traditional orthoses.

Also, Dennis, please provide references which support these claims from your website:

Dennis, provide all of us following along just one shred of research evidence from a peer-reviewed scientific journal that supports any of the claims you make above or any of the claims you make on your www.DrKiper.com website. I won't hold my breath.

 

I don't doubt you were squire. The issue here is it is reasonably clear that was the last time you bothered reading any literature.

And you assume they were correct because......?

Here's one for ya from Rear Admiral Grace Hopper: The most dangerous phrase in the language is "We've always done it this way."

See Kevin's post. We all know your agenda.

 

Here's a better idea: why don't you tell us all about your understanding of the mechanics of "traditional" foot orthoses, then (and only then) tell us about the mechanics of the fluid filled insoles that you are selling. Then, my colleagues and I (many of whom are invited to lecture on the mechanics of foot orthoses around the globe) will be more than happy to point out the inadequacies in your current understanding. It seems to me thus far that you know very little regarding foot orthoses research; prove me wrong. Or go flog your wares elsewhere because no-one here is buying.

BTW, it's not the length of time you've been reading that counts; it's what you've been reading. Dick and Jane probably doesn't make you well read nor erudite whether you read it last week or when it was published back in the 1930's. It strikes me, and I'm sorry to say it seems to be predominantly the American podiatrists in the main, that many who come on here to discuss foot orthoses just haven't kept up to date and are unable to discern good text from weak text. Either that, or they are just lazy readers. http://www.youtube.com/watch?v=uflsjU95lRM&feature=kp

 

I guess you are more used to the hard-sell tactics in the States than we are here in Europe; to me it just seems crass. I guess we have this all to look forward to here. Shame, since you have some of the best podiatric biomechanics minds in the world over there. It's just a case of sorting the flotsam and the jetsam from that which is useful and meaningful. The hard-sell is just not my bag.

http://www.muzu.tv/lloyd-cole-and-the-commotions/my-bag-music-video/252954/

BTW, you missed Ed off of your list.

 

There is no one on this website that does what you do. The technology you talk about is all in your mind, there is no research evidence for it --Kirby

So what, if no one else is doing what I do. Does that mean I'm the evil warlock here? No Kevin, you're wrong. The reason no one else is doing what I'm doing, is you (all) don't know how to do it, at the very least you don't know how I do it. I've been doing it for around 26 years without needing research to inform me that the technology makes “sense”. I recognized that the moment I saw the first water orthotic (right idea, wrong medium).

Years of private practice, now as an experienced clinician and surgeon, I am able to asses a biomechanical problem (I'd be surprised if none of you have ever spoken by phone with a patient who shared their bio-mechanical problem and only because you couldn't treat them from afar you told them to come into the office ...and please don't bicker with the possibility that it was only a consult). Because of the nature of the fluid and its properties I don't need to see them.
I only need to asses their muscle response... And you've got that figured as “smooth as silk snake oil.

I am able to fit them and adjust the Rx to pronate or supinate (including self-post) the foot to an optimal position AKA STJ Neutral (at midstance) The hydro-dynamics of the planes of motion at the tarsus and biomechanics will move accordingly. It's nothing more than a silicone dynamic orthotic. It is what it is.

It's your own paradigm that podiatric telemedicine can't be done (have you not heard the term “telemedicine”). For Pete's sake, they're doing surgery over the internet. So don't tell me I'm stuck back in time, your group is so far back, for all I know you think the earth is still flat.

Fluid technology and hydro-dynamics are well documented in the literature, not in my mind alone.
Simon Spooner thought my article was “weak”, but wasn't specific. I thought my clinical assessment of the fluid mechanics and bio-mechanics was pretty specific, pretty much something only a podiatrist or other foot specialist could even understand, using my best description of the anatomy in motion and what I scientifically understood through all my years of training. After all, I did state this was my clinical assessment. If it was weak, how so?

You keep asking for the research, that you know isn't there, because you're closed minded and may have conflicts of interest. “Let's Think Like An Engineer”, well you need to do that in order to figure out why and why not your technology works less than 50% of the time +/- 1%. It's way to inconsistent regardless of the “exact” percentile. So many inconsistencies from one practitioner to another, (where's your science in that?) and first and foremost--RESULTS. Instead you try to think about lever arm forces of the “very important” muscles and structural forces of the components, hoping to find one more edge to slant your results.

I haven't been selling you anything. I got suckered in by one of your group and then mocked for a credible and verifiable “technology”. Where you're looking to “think like an engineer”, my engineering is already completed based on principles of physics applied to fluid technology. No more, no less.

When you tell me “how poor your understanding of the mechanical effects of foot orthoses are? “ Are you kidding? I “obviously” don't understand principles of science applied to your technology but do know the “effects” of your mechanics.

Absolutely ROTTEN in my estimation. But that could be my fault, maybe I don't understand your science. I'm all ears.

A time tested, verifiable and credible scientifically, and quantitative product with a verifiable patient response. So, the clinical research is missing. I'm not responsible for research. This is not my product. I didn't invent it. I'm simply a prescriber who met Dr Krinsky back in the 80's. So the rest of this story isn't necessary.

So, when you invite open and free podiatric discussion possibly for the betterment of mankind, and you prefer to stick your heads in the sand. By that I mean, if you really did read the article in Pod Today and really understand the “blend of fluid mechanics and bio-mechanics” and prefer not to question the scientific information other than the way its related to the general public, then fine, keep your heads down and your arses up. And stay irresponsible to the public at large.

You want to see research arrange a clinical trial at the school. How long has it been since custom orthotics with the latest and greatest technology has fared up against something new or different?

 

Aloha,

Before some of you hem and haw too much about who moved your cheese perhaps you could watch these educational videos about becoming more like composite engineers.

https://www.youtube.com/watch?v=IeST0vfDuhw

https://www.youtube.com/watch?v=lHnVU4zTcTE

https://www.youtube.com/watch?v=tZhH2B-EI1I

Say Cheese,,,
https://www.youtube.com/watch?v=91YxXk3fmw8

Just thinking like and engineer,
Steve

 

and I'll be happy to point out deficiencies.
Here's a better idea: why don't you tell us all about your understanding of the mechanics of "traditional" foot orthoses, then (and only then) tell us about the mechanics of the fluid filled insoles that you are selling.

I already did: http://www.podiatrytoday.com/closer-look-principles-fluid-dynamics-they-relate-orthoses

but Simon, you didn't understand it the first time, you're going to try again?

 

That it was and the references were cherry-picked. What else do you want me to say? That it is a very low quality publication in a very low quality "journal"? Would it have even made it into a better quality journal, for example JFAR? No, it wouldn't. If you want me to pick it apart publically I'd be more than happy to do that for you. I'll tell you what, re-post it here and I should be delighted to view it with the eye of a professional reviewer. Meanwhile, maybe you coud go some way to telling us all about the mechanics of foot orthoses... yet, I doubt it. You don't have the pre-requisite knowledge, Dennis. Funny:drinks And this guy's just a card: This message is hidden because Dr. Steven King is on your ignore list. Yep. i listened to his telephone show the other day, funny as... I'll pick up on some specific points when I'm bored another day- something about impulses hmmmm.

 

BTW, Simon

You are constantly saying the statement "I'm selling..." and even though I didn't know you took it that way, you've already stated "you're not buying"--OK we've got that established, now can we talk?

 

Yep, tell me all you know about the mechanics of "traditional foot orthoses"...

BTW, do you have a vested interest in the sale of fluid filled foot orthoses? Yes will suffice. So don't whine about being a salesman, it's your job. The fact that I think that you've long since sold your soul to Satan is neither here nor there. "if you're into marketing..Kill yourself"- Hicks. And there's no need to use big, bold text, I'll still only read it.

 

Nope, that's you talking weakly about fluid filled foot orthoses in an opinion piece in a magazine, not about the mechanics of "traditional" foot orthoses as was requested- try again. Like I said, I'll talk about sacks of silicone when we've discussed the mechanics of "traditional" foot orthoses- not before. Anyone might think you snuck in that link as a marketing ploy, Dennis- you cunning little marketeer you. I understood it perfectly though, Dennis- I saw the cherry picking and lack of contemporary references in full. Root, midtarsal joint "locking", no data of any worth; what's not to laugh at?

 

That it was and the references were cherry-picked. What else do you want me to say? That it is a very low quality publication in a very low quality "journal"? Would it have even made it into a better quality journal, for example JFAR? No, it wouldn't. If you want me to pick it apart publically I'd be more than happy to do that for you. I'll tell you what, re-post it here and I should be delighted to view it with the eye of a professional reviewer. Meanwhile, maybe you coud go some way to telling us all about the mechanics of foot orthoses... yet, I doubt it. You don't have the pre-requisite knowledge Denis. Funn


BTW, it's not the length of time you've been reading that counts; it's what you've been reading, I would think that , that quality applies to your sense of discrimination of journals?? Good information wherever you get it is good information! I selected that journal, because I am a podiatrist, writing an article for podiatrists. Apparently, I'm not the snob you are.

references were cherry-picked, you must be referring to:
William A. Taylor, PhD, Emeritus Professor of Physics, Department of Physics and Astronomy, California State University, Los Angeles.

Yes, my patient, with whom I discussed principles of physics with for the article. He confirmed for me the “equilibrium state of stability” at midstance, by the fluid mechanics of the silicone. He actually corrected my initial statement to him that the position of the foot reached a “state of equilibrium”--he corrected it and explained it reached an “equilibrium state”. Now, while I understood his correction, I'm not a physicist, but if any of you were to present the facts as I gave to Dr Taylor to any physicist in the world, you will get the same answer.

Dr Taylor also confirmed for me what I thought about the momentary prolongation of the fluid effect, and “equilibrium state of stability” at heel off. In comparison (as you requested) at heel off with a traditional orthotic, destabilization (at the forefoot) occurs at that moment and followed by the momentum and forward motion of the foot.

What you fail (or in this case) refuse to understand is that difference in stability and instability at toe off for the two technologies is paramount in the accuracy and total biomechanical repercussions of the gait cycle.

I've really covered this in the article, I've provided the link, so pick it apart as you will if you can, publicly. If you can open my eyes, ...well, don't want to make promises.

So, that “cherry picked reference” made the rest of the article invalid? You mean the anatomy, the descriptions, the motion, the momentum, the biomechanical loading—THAT DOESN'T COUNT?--Made absolutely no sense to you? Couldn't see the flow of a viscous fluid as described?
Or were you unable to comprehend the anatomical description of the motion of the foot with and w/o orthotics??

You said you lecture on this, perhaps you're just not used to such descriptive bio-mechanical motion.

BTW—I do have the prerequisite knowledge you speak of, you don't have the post-requisite knowledge I have. All you can do is insult me, the technology I use (that's all in my mind) and twist sentences from my web site to your purposes. That's funny.

 

I'll read this post when you've provided one containing your understanding of the mechanics of "traditional" foot orthoses, not before Dennis.

BTW, it's not the references you included, it's the ones you didn't.

I'll take that as a compliment. Anyone who knows me for the working class boy that I am, black country accent and all, will fall about laughing at that one. I am, clearly, considerably better read than what yow am, despite me dragging up. Lol.

Obviously this is just "voodoo economics" on their part:
"She's the dollars
She's my protection
Yeah she's a promise
In the year of election
Oh sister, I can't let you go
Like a preacher stealing hearts
At a traveling show
For love or money money money
Money money money money money
Money money money
And the fever, getting higher
Desire, desire, desire, desire
Desire, desire" U2- Desire

http://www.youtube.com/watch?v=KQCShKW-nfA

 

Aloha,

Simon you honor me and entertain me.

Thank you for listening to the conversation that Dr. Bret Robotsky and I had on Meet the Masters. located here

http://www.podiatricsuccess.com/speakers/year2014

If i may sell some product here on Podiatry Arena i would say that i have learned alot from Dr. Robotsky and his many masters on this program. So tune in and listen up!

Funny though he has not had any engineers on his show yet.

Dennis when you finallly get put on the coveted Ignor List from Kevin or Simon please consider joining The Podiatric Renagades. We cannot vouch for your science but we do serve a great crab dip at our meetings.

A Hui Hou,
Steve

 

This message is hidden because Dr. Steven King is on your ignore list.

Who cares? Probably something about carbon fibre and a pithy tag line. I don't even see his, Dennis, so consider yourself at home.

 

I'll read this post when you've provided one containing your understanding of the mechanics of "traditional" foot orthoses, not before Dennis.



Who is asking you to read, what you already read, and didn't understand the first time.


Your no teacher to me. I don't expect you to validate this. You've already done that for me with the arguments and statements you've made.

BTW, it's not the references you included, it's the ones you didn't

Oh really,. Only you can decide what's the right references to use?? is that really right? You decided for everyone here that my article was weak based on your determination of references that were missing?

Sorry you didn't find something good about it.

The research concluded in total support of the statements and concepts I've made, you've not disproved or picked apart one of them.

 

Dennis:

One question which I asked earlier needs to be answered before we can start to take you as anything more than an internet salesman of fluid-filled plastic bags that go into shoes that you somehow "prescribe" without ever making a proper diagnosis, without performing a proper examination or without considering the three dimensional structure of their feet.

Is there any research on your "Silicone Dynamic Orthotics" that has been published in a peer-reviewed scientific journal?

A simple yes or no would suffice. If yes, please provide the reference(s).

 

You keep asking for the research, that you know isn't there, because you're closed minded and may have conflicts of interest. “Let's Think Like An Engineer”, well you need to do that in order to figure out why and why not your technology works less than 50% of the time +/- 1%. It's way to inconsistent regardless of the “exact” percentile. So many inconsistencies from one practitioner to another, (where's your science in that?) and first and foremost--RESULTS. Instead you try to think about lever arm forces of the “very important” muscles and structural forces of the components, hoping to find one more edge to slant your results.

 

I just remembered one:

1. Quesada PM, Sawyer FD, Simon SR. Temporal and gel volume and effects on plantar pressure relief with use of silicone gel-filled insoles. Presented at the 21st Annual Meeting of the American Society of Biomechanics. Clemson University, South Carolina, September 24-27, 1997.

 

Dennis:

This is not a paper that has been published in a peer-reviewed journal. It is a lecture at a biomechanics meeting. For your information, these are a little different from each other in regards to evidence based research criteria.

However, a lecture from someone other than the seller of a product is something, and it probably has much more scientific fact in it then any of the conjecture and hyperbole you use on your website, www.drkiper.com, to sell your silicone-filled bags of plastic to the unsuspecting public for $399.00.

 

Dennis:

So, from your own words I will answer the question for you.

Is there any research on your "Silicone Dynamic Orthotics" that has been published in a peer-reviewed scientific journal?

Answer: No.

Now, Dennis., you've got a lot of work to do to convince us your silicone-filled bags of plastic you sell on your website for $399.00 to the unsuspecting public are better than the traditional orthosis designs that have numerous research studies showing they work quite well at relieving the pain of certain conditions, altering the kinetics and altering the kinematics of gait.

I suggest it may be more healthy for you to stop living in the past in your little fantasy world that you are some sort of "biomechanics expert" and start reading the more recent scientific literature which clearly shows, contrary to your bluster, that foot orthoses are not only therapeutically effective, but also alter the biomechanics of gait.

Traditional Foot Orthoses = 46
Dennis Kiper's Silicone-Filled Bags of Plastic = 0

Eggold JF: Orthotics in the prevention of runner’s overuse injuries. Phys. Sports Med., 9:181-185, 1981.

D’Ambrosia RD: Orthotic devices in running injuries. Clin. Sports Med., 4:611-618, 1985.

Dugan RC, D’Ambrosia RD: The effect of orthotics on the treatment of selected running injuries. Foot Ankle, 6:313, 1986.

Gross ML, Davlin LB, Evanski PM: Effectiveness of orthotic shoe inserts in the long distance runner. Am. J. Sports Med., 19:409-412, 1991.

Saxena A, Haddad J: The effect of foot orthoses on patellofemoral pain syndrome. 93:264-271, 2003.

Donatelli R, Hurlbert C, Conaway D, St. Pierre R: Biomechanical foot orthotics: A retrospective study. J Ortho Sp Phys Ther, 10:205-212, 1988.

Moraros J, Hodge W: Orthotic survey: Preliminary results. JAPMA, 83:139-148, 1993.

Walter JH, Ng G, Stoitz JJ: A patient satisfaction survey on prescription custom-molded foot orthoses. JAPMA, 94:363-367, 2004

Kusomoto A, Suzuki T, Yoshida H, Kwon J: Intervention study to improve quality of life and health problems of community-living elderly women in Japan by shoe fitting and custom-made insoles. Gerontology, 22:110-118, 2007.

Finestone A, Giladi M, Elad H, et al: Prevention of stress fractures using custom biomechanical shoe orthoses. Clin Orth Rel Research, 360:182-190, 1999.

Simkin A, Leichter I, Giladi M, et al: Combined effect of foot arch structure and an orthotic device on stress fractures. Foot Ankle, 10:25-29, 1989.

Eng JJ, Pierrynowski MR: Evaluation of soft foot orthotics in the treatment of patellofemoral pain syndrome. Phys Therapy, 73:62-70, 1993.

Thompson JA, Jennings MB, Hodge W: Orthotic therapy in the management of osteoarthritis. JAPMA, 82:136-139, 1992.

Marks R, Penton L. Are foot orthotics efficacious for treating painful medial compartment knee osteoarthritis? A review of the literature. Int J Clin Practice, 58:49-57, 2004.

Gross MT, Byers JM, Krafft JL, et al: The impact of custom semirigid foot orthotics on pain and disability for individuals with plantar fasciitis. J Ortho Sp Phys Ther, 32:149-157, 2002.

Slattery M, Tinley P: The efficacy of functional foot orthoses in the control of pain and ankle joint disintegration in hemophilia. JAPMA, 91:240-244, 2001.

Chalmers AC, Busby C, Goyert J, et al: Metatarsalgia and rheumatoid arthritis-a randomized, single blind, sequential trial comparing two types of foot orthoses and supportive shoes. J Rheum, 27:1643-1647, 2000.

Woodburn J, Barker S, Helliwell PS: A randomized controlled trial of foot orthoses in rheumatoid arthritis. J Rheum, 29:1377-1383, 2002.

Mejjad O, Vittecoq O, Pouplin S et al: Foot orthotics decrease pain but do not improve gait in rheumatoid arthritis patients. Joint Bone Spine, 71:542-545, 2004.

Powell M, Seid M, Szer IA: Efficacy of custom foot orthotics in improving pain and functional status in children with juvenile idiopathic arthritis: A randomized trial. J Rheum, 32:943-950, 2005.

Bates BT, Osternig LR, Mason B, James LS: Foot orthotic devices to modify selected aspects of lower extremity mechanics. Am J Sp Med, 7:328-31, 1979.

Smith LS, Clarke TE, Hamill CL, Santopietro F: The effects of soft and semi-rigid orthoses upon rearfoot movement in running. JAPMA, 76:227-232, 1986.

Novick A, Kelley DL: Position and movement changes of the foot with orthotic intervention during loading response of gait. J Ortho Sp Phys Ther, 11:301-312, 1990.

McCulloch MU, Brunt D, Linden DV: The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. J Ortho Sp Phys Ther, 17:2-10, 1993.

Butler RJ, McClay-Davis IS, Laughton CM, Hughes M. Dual-function foot orthosis: Effect on shock and control of rearfoot motion. Foot Ankle Intl, 24:410-414, 2003.

Laughton CA, McClay-Davis IS, Hamill J: Effect of strike pattern and orthotic intervention on tibial shock during running. J Appl Biomech, 19:153-16, 2003.

Mundermann A, Nigg BM, Humble RN, Stefanyshyn DJ. Foot orthoses affect lower extremity kinematics and kinetics during running. Clin Biomech, 18:254-262, 2003.

Williams DS, McClay-Davis I, Baitch SP: Effect of inverted orthoses on lower extremity mechanics in runners. Med. Sci. Sports Exerc. 35:2060-2068, 2003.

MacLean CL, Hamill J: Short and long-term influence of a custom foot orthotic intervention on lower extremity dynamics in injured runners. Annual ISB Meeting, Cleveland, September 2005.

Eng JJ, Pierrynowski MR: The effect of soft foot orthotics on three-dimensional lower-limb kinematics during walking and running. Phys Therapy, 74:836-844, 1994.

Nawoczenski DA, Cook TM, Saltzman CL: The effect of foot orthotics on three-dimensional kinematics of the leg and rearfoot during running. J Ortho Sp Phys Ther, 21:317-327, 1995.

Stackhouse CL, Davis IM, Hamill J: Orthotic intervention in forefoot and rearfoot strike running patterns. Clin Biomech, 19:64-70, 2004.

Nester CJ, Hutchins S, Bowker P: Effect of foot orthoses on rearfoot complex kinematics during walking gait. Foot Ankle Intl, 22:133-139, 2001.

Nester CJ, Van Der Linden ML, Bowker P: Effect of foot orthoses on the kinematics and kinetics of normal walking gait. Gait Posture, 17:180-187, 2003.

Woodburn J, Helliwell PS, Barker S: Changes in 3D joint kinematics support the continuous use of orthoses in the management of painful rearfoot deformity in rheumatoid arthritis. J Rheum, 30:2356-2364, 2003.

Nawoczenski DA, Ludewig PM: Electromyographic effects of foot orthotics on selected lower extremity muscles during running. Arch Phys Med Rehab, 80:540-544, 1999.

Tomaro J, Burdett RG: The effects of foot orthotics on the EMG activity of selected leg muscles during gait. J Ortho Sp Phys Ther, 18:532-536, 1993.

Mundermann A, Wakeling JM, Nigg BM, et al: Foot orthoses affect frequency components of muscle activity in the lower extremity. Gait and Posture, 23:295-302, 2006.

Mundermann A, Nigg BM, Humble RN, Stefanyshyn DJ: Orthotic comfort is related to kinematics, kinetics, and EMG in recreational runners. Med Sci Sports Exercise, 35:1710-1719, 2003.

Guskiewicz KM, Perrin DH: Effects of orthotics on postural sway following inversion ankle sprain. J Orthop Sp Phys Ther, 23:326-331, 1996.

Hertel J, Denegar CR, Buckley WE, et al: Effect of rearfoot orthotics on postural control in healthy subjects. J Sport Rehabil, 10:36-47, 2001.

Rome K, Brown CL: Randomized clinical trial into the impact of rigid foot orthoses on balance parameters in excessively pronated feet. Clin Rehab, 18:624-630, 2004.

Burns J, Crosbie J, Ouvrier R, Hunt A: Effective orthotic therapy for the painful cavus foot. JAPMA, 96:205-211, 2006.

Postema K, Burm PE, Zande ME, Limbeek J: Primary metatarsalgia: the influence of a custom moulded insole and a rockerbar on plantar pressure. Prosthet Orthot Int, 22:35-44, 1998.

Li CY, Imaishi K, Shiba N, et al: Biomechanical evaluation of foot pressure and loading force during gait in rheumatoid arthritic patients with and without foot orthoses. Kurume Med J, 47:211-217, 2000.

Raspovic A, Newcombe L, Lloyd J, Dalton E: Effect of customized insoles on vertical plantar pressures in sites of previous neuropathic ulceration in the diabetic foot. The Foot, 10:133-138, 2000.

 

How does an orthotic hold the foot in a semi-flexed podition? Statements like the above make me wonder how much you know about mechanics. This is why people are asking you what is your understading of the mechanics of orthotics. Yes, the Root theorists may have said thngs like that, but they were wrong. The understanding of the mechanics of orthotics has moved on.

"move in a restricted and destabilized way" Dennis is this what you believe about how orthotics work? What is your definition of stability? One definition of instability would inlude standing on a bag of silicon gel. I've stood on one of these and have felt the instability.

Eric

 

Aloha,

Extrodinaray Claims Require Extrodinary Proof.

I am sorry for you Dennis you are being torn apart by mechanical sharks.

Just have a little solice in the fact that a guru to Kevin and Simon has already written a chapter (chapter 4 on Inserts and Orthotics) in his latest engineering minded and tested book, "Biomechanics of Sports Shoes" that summizes that they cannot support their claims to make the greatest and cheesiest orthoses as well... Oh well...

So where does that leave us?

More Science!

Here is link in omage to our silent yet ever vigulant vericator of values, Craig...

https://www.youtube.com/watch?v=NgZjgP9G7r0

A hui hou,
Claim Maker Steve (The Fastest-Lightest-Safest Shoes on the Planets...)

Good thing a marathons have soo many miles to test "Theories" on.

 

Opps,

Like a good scientist i could not verify that the word vericator was in our english language. It is always toughest and most proper to prove yourself wrong...

A hui hou,
Steve


VARICATE

In which Scrabble dictionary does VARICATE exist?


Scrabble (US/Canada)
No

Scrabble (UK)
No

Official Scrabble (OSPD)
No

WordFeud
No

Words with friends
No

Hanging with friends
No

Letterpress
No

Lexulous (US)
No





Definitions of VARICATE in dictionaries:


No definitions found

 

Dang Phenetics,,, and broken spell checker

Mo Proper English!

VIGULANT

In which Scrabble dictionary does VIGULANT exist?


Scrabble (US/Canada)
No

Scrabble (UK)
No

Official Scrabble (OSPD)
No

WordFeud
No

Words with friends
No

Hanging with friends
No

Letterpress
No
Lexulous (US)
No
Definitions of VIGULANT in dictionaries:
No definitions found

Arrgg !!
http://en.wikipedia.org/wiki/Phenetics

 

Aloha,

Perhaps we could use phenetics to help us engineer and class our diverse but all foot touching orthoses?

"in fieldwork one needs to be able to separate one taxon from another. Classifying diverse groups of closely related organisms that differ by very subtle differences is difficult using a cladistic approach. Phenetics provides numerical tools for examining overall patterns of variation, allowing researchers to identify discrete groups that can be classified"

Like a mouse in a maze you never now when or where the cheese will appear.

A Hui Homage,
Steve

 

Aloha,

Look who has an enor-mouse pile of cheese...

http://www.sportsonesource.com/news... 1, Modell's, Evolv, Rider Sandals, Aerosoles...

https://www.youtube.com/watch?v=QIXhgBE5Swo

A Hui Hou,
Steve

 

Craig, Admin, anyone?

Whilst I can`t read the not-so-subtle pitch of the king of salesmanship (and have no desire to do so as he is also on my ignore list)....do we really have to tolerate what is now prolific spamming of the arena?

Bel

 

Dear Dennis and Steven,

I would like to thank you for taking my ignore list virginity.

The thread is much easier to read now.

Nick

 

At least we're still getting some good comments following my article over on the Podiatry Today website:

http://www.podiatrytoday.com/should-podiatrists-think-more-engineers

I really would like to see Ian Griffiths, Eric Fuller and Dave Smith contributing their views on the Podiatry Today website also since I know they have strong opinions regarding this subject.:drinks

 

Dr. Kiper:
Does your opinion that "traditional technology used today is in my opinion inadequate and faulty" have anything to do with you marketing your "Silicone Dynamic Orthotic" on the Internet at http://www.drkiper.com/ ?

---Not at all, I've never marketed to you and don't even see how by posting my site that's going to make any financial difference for me.?? I market to the public, yes... I was trying to get you to look at the technology. I figured it out, what about all the science and biomechanics of the foot do you not see on top of a bag of fluid? You mean it doesn't make any sense to you?? (regardless of the iteration?)
I think I already know the incredulous answer! The fact is I didn't promote here, you promoted me for me. I was only trying to expose the technology. It was a clusterF*** at best

On this website, you claim "The Silicone Dynamic Orthotic is the next generation prescription in arch support —". You further claim on your web site: "It is the mechanical action that separates the Silicone Dynamic Orthotic from any orthotic. It matches the way the foot walks."

You further claim on your web site: "Most orthotics operate in a “fixed" position (a static fulcrum) which does not allow the foot to move naturally. If it’s a traditional "flexible" support, the arch moves up and down, while the foot is moving forward. This does not prevent the front of the foot from becoming unstable."
Your web site comes complete with mail order instructions for your "Silicone Dynamic Orthotic" for $399.00.

I am curious. How do you know that "traditional technology used today is in my opinion inadequate and faulty" when, in fact, numerous research papers have clearly shown that custom foot orthoses, using the Root model, are very effective at treating a large number of foot and lower extremity pathologies?


Since I stopped using traditional orthotics, I still maintained contact with everyone who still was. I saw and heard the conversations and problems then, and I see and hear the same problems 40 years later. Now with the internet, runner's sites, blogs and sites that cater to biomechanical problems. There is more discussion of dissatisfaction by the pts. than satisfaction when it comes to traditional custom orthitcs. There are successes of course, many orthoses come close to a “proper” biomechanical fit. BUT, not close enough in most cases to make it not work well enough or well at all. How about an imbalance in the orthotic causing a biomechanical problem somewhere in the chain. Then there's the follow up as the Rx (optimal position) changes. Inadequate and faulty.

You adjust your orthoses with angles and posts I adjust mine with grams and mgs.

There are individual stories of patients who went thru multiple pairs and could only find a modicum of satisfaction, or in many instances as you already know, some stopped wearing altogether.--so that's the inadequate part. (over my career I've had all the same pts as you and their stories are many times even worse because of the biomechaincal stress that they're in.)
I've spoken with companies of generic orthotics and the information they provided from PT, orthopedic, osteopathic, chiropractic and podiatry profession as well. It's not as good as it should be, because the faulty part is what I've already written in the article and previous posts here.

How many clinical trials have been done where generic orthotics either matched or exceeded satisfaction from traditional custom orthotics in the trial? I might not have seen or heard about any new trials? Enlighten me.

So without even knowing the results, I would say, if the newer results were even better by 50% over the last trials, I would say that is still inadequate compared to fluid technology results.

 

Dennis:

This is not a paper that has been published in a peer-reviewed journal. It is a lecture at a biomechanics meeting. For your information, these are a little different from each other in regards to evidence based research criteria.

AWWWWWWWWW, and I thought we were finally going to be friends

 

Eric,

How does an orthotic hold the foot in a semi-flexed podition? Statements like the above make me wonder how much you know about mechanics.

I have never claimed traditional orthotics hold the foot in a “ semi-flexed podition” I guess you're right, I'm too far behind the rest of the class to even understand a semi-flexed podition”--WHAAAAAT?

Of course you may wonder what I know about mechanics, I know what you know, the difference is that you're not familiar with what I've realized using a different science based technology. The fluid technology is predicated on principles of physics. You've never worked with an orthotic like that!

As for your trying them 25 years ago, Marty introduced this in the wrong way in my opinion. There is so much more one needs to know and guide the pt thru, just like traditional orthotics. So, unfortunately your single experience was bad, but I continued with the technology after Marty” death, and your experience would be different today.

 

Kevin,

I suggest it may be more healthy for you to stop living in the past in your little fantasy world that you are some sort of "biomechanics expert" and start reading the more recent scientific literature which clearly shows, contrary to your bluster, that foot orthoses are not only therapeutically effective, but also alter the biomechanics of gait.


There you go again Kevin, calling me some sort of “biomechanics expert”--I never put myself out that way. I simply discussed the reason so many traditional orthotics “fail” and why fluid technology is so accurate. I've also posted a challenge to your technology, we both know you and Schere will never let that happen.

Because you are so wrapped around and vested in traditional technology how could anyone expect you to understand (especially without all the research to tell you, this is good or not good). Many good ideas come from “out of the box thinking”, someone else here states on their signature--”if we all thought the same, there would be no progress”--RIGHT ON!

You and the others keep telling me to read the current literature, WHY would I want to read a bunch of comic books and call that “current”

 

Because we, that is the audience which you are trying to win over, would very much like to evaluate your product in light of evidenced based research?