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Should Podiatrists Think More Like Engineers?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kevin Kirby, Mar 27, 2014.

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  1. Dennis Kiper

    Dennis Kiper Well-Known Member

    My article did use supporting evidenced based research.
     
  2. Not really, the literature was cherry-picked (i.e. biased) and not particularly well employed. For example:

    "The fluid support effect on foot function suggests that stability at the midtarsal joint complex is primary and stability at the subtalar joint complex is secondary. Once the midtarsal joint is fully loaded and stable, rearfoot pronation is already limited. This concept has support in a 2008 study about invasive in vivo measurement of rear-, mid- and forefoot motion during walking.3 The study showed that “the movement at the talonavicular joint was greater than at the talocalcaneal joint and motion between the medial cuneiform and navicular was greater than expected.”"

    The study in question was: Lundgren P, Nester C, Liu A, Arndt A, Jones R, Stacoff A, Wolf P, Lundberg A.
: Invasive in vivo measurement of rear-, mid- and forefoot motion during walking. Gait Posture. 2008; 28(1):93-100. How exactly does this paper support your contention that "The fluid support effect on foot function suggests that stability at the midtarsal joint complex is primary and stability at the subtalar joint complex is secondary"?


    Here's another example:
    Dennis said: "There is no need for cupping the heel to aid in the control of rearfoot motion. Additionally, McPoil and Cornwall did not support rearfoot posting to control pronatory forces in a study comparing a posted orthosis and non-posted orthosis."

    Here's the study referenced to support the contention that "there is no need for cupping the heel..."
    J Am Podiatr Med Assoc. 2000 Jan;90(1):2-11.
    The effect of foot orthoses on transverse tibial rotation during walking.
    McPoil TG1, Cornwall MW.


    Abstract
    The purpose of this study was to determine the effectiveness of two types of foot orthoses in controlling the magnitude and rate of internal tibial rotation, measured by the tibial pointer device, during walking. Ten subjects between the ages of 23 and 43 years volunteered to participate in the study. Prior to data collection, each subject was issued two types of foot orthoses: a pair of rigid, plastic orthoses with posting in either the forefoot or the rearfoot, and a pair of soft, accommodative, premolded orthoses with no posting. All subjects wore standardized footwear. Following a controlled break-in period for both footwear and orthoses, each subject was asked to walk at a self-selected speed over a 12-m walkway while the movement of internal tibial rotation was recorded with a video camera during five trials. The results indicated that both the rigid plastic and the accommodative foot orthoses significantly reduced the magnitude and the rate of internal tibial rotation. No significant difference was noted between the soft and rigid foot orthoses conditions.

    The more astute of you will have noticed that both types of device employed by Mcpoil had a heel cup. So the statement that: "There is no need for cupping the heel to aid in the control of rearfoot motion" is completely unsupported by reference here and is simply Dennis's opinion.

    Let's take a closer look at Dennis's statement of what the study was supposed to have shown: "did not support rearfoot posting to control pronatory forces". The literature regarding tibio-talar coupling notwithstanding, the study was a kinematic study measuring transverse plane tibial rotation; it did not even measure pronatory forces nor rearfoot motion.

    Now, are there any studies in the literature which have shown the kinetic or even kinematic effects of foot orthoses rearfoot posts? Of course there are, yet they were not included by Dennis since they didn't meet with his agenda- right, Dennis? At best this shows him to be naive of the literature, at worst it shows him as intentionally deceptive; which one was it, Dennis?

    Like I said, the opinion piece Dennis wrote for the magazine was generally weak and showed selection bias in the referencing. I'll come back to some of the other weaknesses as time and interest allow.
     
  3. David Wedemeyer

    David Wedemeyer Well-Known Member

    Dennis how have you been? Thank you for acknowledging the Wright quote on my profile, it makes a lot of sense doesn't it? The reverse is also true; when your ideas are so fatuous and illogical that nearly no one agrees with them, it is simply time to abandon them. :empathy:

    Dennis and I go back a ways everyone, actually having met at PFOLA 2008 in San Diego. Dennis made me one of his SDO insoles and it was as expected, a fluid filled bladder with top cover. Being one of the few people (if there are any more on PA) who actually have worn his insole I can speak from experience that it didn't perform well.

    On the other hand, the things I have learned from prominent DPM's such as Dr. Kirby did in fact lead me to design an orthotic that resolved my own foot complaints. It appears to work for the patients referred to me weekly by a number of local foot and ankle specialists as well. Go figure..

    Best Regards,
     
  4. Dennis:

    All your bravado and bombast combined with your utter lack of understanding of basic biomechanics concepts and how to properly reference research and write good scientific articles makes you a very easy target. A phrase that comes to mind: "easier than shooting fish in a barrel". Can't say I've had this much fun on Podiatry Arena for a while. Please keep it up, I find it quite entertaining.

    However, we are really not giving your odd behavior proper notice. I suggest we move our discussion to a thread titled "Dr. Dennis Kiper and Silicone Dynamic Orthotics: Effective Therapy or Snake Oil??".

    I think that thread will attract a lot of attention on the Google search engines when people go searching on the internet about your $399.00 silicone fluid-filled plastic bags that you call "orthotics". I think the public really needs to know about you and your product and what they really are!

    How about it, Dennis. Are you game?
     
  5. How do you take into consideration the relationship between temperature, pressure and volume within a liquid when prescribing your insoles to individuals whom you have never seen nor met and are simply selling for extortionate amounts across the t'interweb?
     
  6. Dennis Kiper

    Dennis Kiper Well-Known Member

    The litersture was cherry-picked (i.e. biased) and not particularly well employed.

    Simon's opinion that the following was not well employed:

    "The fluid support effect on foot function suggests that stability at the midtarsal joint complex is primary and stability at the subtalar joint complex is secondary. Once the midtarsal joint is fully loaded and stable, rearfoot pronation is already limited. This concept has support in a 2008 study about invasive in vivo measurement of rear-, mid- and forefoot motion during walking.3 The study showed that “the movement at the talonavicular joint was greater than at the talocalcaneal joint and motion between the medial cuneiform and navicular was greater than expected.”"


    Explanation as to why Simon doesn't understand this: The ROM is greater (that means MORE-Simon) at the TNJ than the STJ therefore: the MTJ needs to be addressed first. Otherwise you're going to have your scientific STJ axis pointing into the blue yonder on an unstable structure (putting it politely)

    Fluid is displaced forward at heel contact and biomechanically loading-dynamically. --moving towards midstance.
    At midstance , any ROM of the TNJ still available would allow destabilization of the MTJ . If, as I stated, the MTJ is stable and fully loaded first (Simon—I'm saying here that if there's no more pronation motion available), then the STJ motion is already limited –get it!(it's in its “optimal biomechanical position”, meaning, the STJ is stable also.)--IF, there was more motion at the STJ than TNJ then this would not be correct. The stability at the STJ would be primary—BUT SIMON, that's not the way it is—there's more motion at the TNJ than STJ.

    In fact there are 4 areas of dynamic, biomechanical loading with fluid technology, with “static” technology you have only one biomechanical “loading” moment, occurring at midstance.

    To reiterate: load and stabilize the MTJ first—than the STJ is “already limited , fully loaded , and stable”at midstance. (FOR THOSE THAT ASKED ME TO DESCRIBE THE MECHANICS OF A TRADITIONAL ORTHOTIC) In a traditional orthotic, there's not much happening in terms of biomechanical loading (for your edification I have quoted a section of my own article--

    At heel contact, pronation control is static under the MTJ complex throughout midstance phase until forefoot contact. Then, the forward progression of the plantar surface of the foot momentarily halts (do you get this Simon?), as GRF of the forefoot increases and decelerates against the ground. Now, the transference of the forward momentum and sagittal force on the foot coupled with the weight bearing and pronatory forces of the MTJ complex against the position and surface of the orthosis at the end of midstance, allows for forefoot pronation, through the casted orthotic position.) This results in--DESTABILIZATION (I explain this in the article as well)


    "motion between the medial cuneiform and navicular was greater than expected.”" This just confirms
    why the TNJ has a greater ROM than the STJ. (And if you don't understand that—don't bother me)


    There is no need for cupping the heel to aid in the control of rearfoot motion. --Yes, this is my opinion

    based on the further text of that reference: “Additionally, rearfoot posting to control pronatory forces is not supported by McPoll and Cornwall comparing a posted orthosis and non-posted orthosis “

    AND if you understand that stabilizing the MTJ is primary and the STJ secondarily, then you too would see why there is no need for cupping OR posting the rear foot.

    STJ theory is BUNK!
     
  7. Dennis Kiper

    Dennis Kiper Well-Known Member

    How do you take into consideration the relationship between temperature, pressure and volume within a liquid when prescribing your insoles to individuals whom you have never seen nor met and are simply selling for extortionate amounts across the t'interweb?

    I offer a 6 month money back guarantee, up front so that the pt understands I'm confident in my approach.
     
  8. Still fighting the good fight Professor Kirby;)
     
  9. Someone explain to Dennis that jonts of the foot don't all rotate at the same velocity. So a joint may reach it maximal position in one direction quicker than a joint which has a lesser magnitude of excursion simply because the joint with the larger maximal excursion is moving more rapidly. Then someone show the kinematic graphs from the bone pin study to Dennis so that he can show us where exactly during the contact phase the bones of the mid-tarsus are "stable" (I already did that in a different thread and he couldn't). Tell him that joints which are not rotating don't have rotational axes. His "axes sticking up in the air" is the funniest thing I've read from someone that is supposed to understand biomechanics in ages. As Eric said, we've moved on considerably from Merton's view of foot function. I'll come back to rest tomorrow as it's Friday night and I need a bite to eat and a beer. Really Dennis, you need to think before you write.
     
  10. blinda

    blinda MVP

    As if by magic....:welcome: back....please, please use whatever bits of 2 by 4 it takes to demonstrate moments about any given axis.....at least it'll provide a starting point? Give the fellow a chance, eh?
     
  11. Dennis Kiper

    Dennis Kiper Well-Known Member

    . His "axes sticking up in the air" is the funniest thing I've read from someone that is supposed to understand biomechanics in ages.

    There you go, no argument to the points I was asked to address. A complete lack of understanding of bio-dynamics. Even though you said you would "pick it apart" for me.

    That's what it's been from the beginning, you couldn't address the real issues you asked me to, so instead "twist": something else around.
     
  12. Where the funk have you been? Not even a note from your parents to excuse you? "Robert can't play on Podiatry Arena because he's got a verruca" Forgot your kit? Nothing.
     
  13. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,

    Ian G,, Dude, Seriously ??

    The first response i get after noting that there is an elephant in the room you ask to have me removed from the room ?



    Let me quote from the Book of Benno, Chapter 4.Foot inserts did not produce consistent effects for the foot eversion and internal tibilal rotaion.

    Thus, there were no "accommodation effects" to the orthotic interventions in terms of kinematics, kinetics, and muscle activity.

    The custom-molded orthotics tested in this study did NOT significantly affect ankle jount eversion.

    The inserts/orthotics increased muscle activity in most cases.

    The inserts/orthotics increased resultant knee joint moments in most cases.

    The effects of inserts on the path of the COP were in most cases not consistant, and in many cases were actually opposite to what was expected.

    The tested insert intermentions did not affect the ankle and knee joint moments that are responsible for actual motion.

    The selected interventions did not affect the ankle and knee joint moments that are more associated with dynamic stability.

    None of the tested insert interventions could be used consistantly to reduce knee joint moments.

    Indentical insert interventions con produce substantially different results for different subjects.

    Orthotics may sometimes be too restrictive, reducing natural foot movement too much. ** Denis this one may help with your fluid theory **

    The tested shoe inserts produced no consistant changes in foot eversion and tibial rotation.

    The subject-specific effects of the inserts on foot eversion and tibial rotation were small.

    Orthotics (and for that purpose (foam) shoes) do not substantially and/or consistently affect the kinematics of the skeleton.

    The reported reduction in foot eversion and/or tibial rotation with inserts or orthotics was significant but small (2-3 degrees) in some reports and not significant in others for measurements taken with skin and shoe mounted markers.

    Changes in Skeletal movement due to shoes or shoe inserts seem to be small and inconsistant.

    Based on the availible information, one may question the concept that a major function of orthotics or inserts is to align the skeleton.

    There is weak evidence that selected orthotics improve the injury situation of runners and athletes in general.

    There is limited functional knowledge about the specific mechanisms that an orthotic or insert provides to limit excessive loading of specific structures. ** My favorite **

    It is interesting to note that the sme orhtotic of insert interventions are proposed for substantially different problems and injuries.

    Orthotics/inserts that reduce the functional demand on a muscle or muscle group may be assosciated with the deterioration of the muscle strength and functionality.

    Orthotics/inserts can be constructed to increase the activity of defined muscle groups, making them stronger and more funcitonal.

    The potiential effects for inserts and orthotics are in the possibility to change muscle activity. * My Hope *

    Strong support through an insert or orthotic, if consistantly used, may have negitive effects on the muscles involved. These muscles may no longer be needed, may lose their stregth, and may deteriorate as a result. ** Good news for folks already stricken with MD **


    Now i suggest that you yahoo's that are mounting a frontal attack on Dennis take up your "science and engineering hopes/theories" with Dr. Benno Nigg at his retirement party for his successfull and helpful career at the International Running Symposium this summer in Calgary...

    Sign up here;
    http://www.calgaryrunningsymposium2014.com/


    For students of podiatry, pedorthics and biomechanics i would suggest you BUY BENNO's BOOK ! And read the whole thing,,, please. and come to Calgary to get it signed by this world renouned researcher engineer and scientist.
    http://lowerextremityreview.com/market-mechanics/niggs-book-on-sport-shoes-debuts


    If you want to think like an engineer...

    A Hui Hou,
    Steve

    My Own little world of one...
    https://www.youtube.com/watch?v=M9Yasgzjc0w
     
  14. Dennis, where would you like me to begin? Your previous post shows such poor understanding that I do not truly know where to begin. Your whole premise seems to be based upon stability during dynamic function as a "good" thing. Yet you are unable to show: a) when the bones and joints of the foot are stable during dynamic function b) why such stability should be a good thing C) that your insoles somehow create this "desired" stability. You employed a study which actually demonstrates the opposite and in fact demonstrates that the midfoot is never stable during the contact period of gait to evidence your conjecture. What more do you want me to say? If you want to kid yourself that you are somehow responding to my criticsm, then that's fine, but you're not kidding anyone that means anything to me. I really don't care whether you sell any of your insoles ever again. Do I think I've missed out on a great new cure? No. Do I think you are a gifted biomechanist that could teach me something new? No. Have I got better things to do with my time than discuss your hang-ups? Yes. Good luck Dennis, you're a real player. But I don't "play chess with chickens".
     
  15. Oh you know. Things and stuff. I was washing my hair. :D

    Not much seems to have changed here, although I see some new names.
     
  16. blinda

    blinda MVP

    Hey, Whatever else goes on in this thread, don't dis vp....k?
     
  17. Strangely, sharing the same forename as the last one.:rolleyes:
     
  18. J.R. Dobbs

    J.R. Dobbs Active Member

    And here for those that don't yet own the book are some photographs of the orthotics Benno based his conclusions on. See if they look like the kind of foot orthotics you would prescribe before reading too much into Benno's conclusions. Just wait until the guys from Planet X get back then you'll see the future of foot insoles.
     

    Attached Files:

  19. Dennis Kiper

    Dennis Kiper Well-Known Member

    Orthotics may sometimes be too restrictive, reducing natural foot movement too much. *


    There is weak evidence that selected orthotics improve the injury situation of runners and athletes in general.



    Where do these statements come from—please

    The first one at the top is what I was saying when I quoted what Root had defined as a proper orthotic.
    I've already addressed this in several posts as well.

    The 2nd statement confirms what I've said repeatedly, that over all results from traditional orthotics are poor. Performance expectations are poor when you don't have a “precision” fit that offers the foot stability in its dynamic movement.
     
  20. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,

    Dennis could you please help me?

    I am finding it difficult to see how your fluid dynamic gel is significantly different than Kevin's elastomeric impression materials (EVA, PU) he uses in the midsoles of his prescriptive devices. i.e. the shoes he puts his "corrective" orthotics on.

    You guys aren't from Indostan are you?
    https://www.youtube.com/watch?v=iBqgr5xZLz0

    A Hui Hou,
    Steve
     
  21. Dennis Kiper

    Dennis Kiper Well-Known Member


    Simon

    Dennis, where would you like me to begin? Your previous post shows such poor understanding that I do not truly know where to begin. Your whole premise seems to be based upon stability during dynamic function as a "good" thing. Yet you are unable to show: a) when the bones and joints of the foot are stable during dynamic function b) why such stability should be a good thing C) that your insoles somehow create this "desired" stability. You employed a study which actually demonstrates the opposite and in fact demonstrates that the midfoot is never stable during the contact period of gait to evidence your conjecture. What more do you want me to say? If you want to kid yourself that you are somehow responding to my criticsm, then that's fine, but you're not kidding anyone that means anything to me. I really don't care whether you sell any of your insoles ever again. Do I think I've missed out on a great new cure? No. Do I think you are a gifted biomechanist that could teach me something new? No. Have I got better things to do with my time than discuss your hang-ups? Yes. Good luck Dennis, you're a real player. But I don't "play chess with chickens".


    You're a liar and full of hot air.

    you are unable to show: a) when the bones and joints of the foot are stable during dynamic function b) why such stability should be a good thing

    You couldn't say something more stupid and lacking knowledge.

    You employed a study which actually demonstrates the opposite and in fact demonstrates that the midfoot is never stable during the contact period of gait

    Another stupid remark, when talking about fluid technology. What you say is true for traditional technology

    It's you who doesn't respond, you're unable to deal with principles of physics applied to fluid technology. --Where's your “picking me apart” text. I don't feel you've said anything detrimental to my article. Where's your brilliant observations of fluid movement as described. Listen, do everyone a favor and just tell the truth, you just don't get it!

    “Who? What? When? Why? Where? How? Yeah? And? So? What? (Hey, where did my wife go?)

    "My mission drive is to open up my eyes, 'cause the wicked lies and all the sh!te you say. “

    "Science is the antidote to the poison of enthusiasm and superstition." --Too bad you've got the STJ axis, stuck so far up your anus.--Where's your brilliant observations of fluid movement as described. Listen, do everyone a favor and just tell the truth, you just don't get it!

    But I don't "play chess with chickens". Maybe you should try--you might win a cluck or two.
     
  22. Dennis Kiper

    Dennis Kiper Well-Known Member

    Aloha,

    Dennis could you please help me?

    I am finding it difficult to see how your fluid dynamic gel is significantly different than Kevin's elastomeric impression materials (EVA, PU) he uses in the midsoles of his prescriptive devices. i.e. the shoes he puts his "corrective" orthotics on.


    Materials you described only "cushion" the intense forces--not a bad thing, but fluid "cushions" naturally, thru biomechanical loading.
     
  23. David Wedemeyer

    David Wedemeyer Well-Known Member

    This is so entertaining
     

    Attached Files:

  24. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,

    Dennis,

    Read Benno's Book ! Chapter 4

    My favorite chapter is chapter 7 on work and energy, but discussion on that engineering topic has been a dead end every time i try to discuss that here in the Arena...

    A Hui Hou,
    Steve

    I would be happy to swap technologies and walk a mile in your shoes if you let me.
    Dance along Simon if you feel the jam...
    https://www.youtube.com/watch?v=ov9fjaRZT4E
     
  25. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,

    Dennis, sorry not a good enough answer yet, for me... it needs a bit more meat.

    "Materials you described only "cushion" the intense forces--not a bad thing, but fluid "cushions" naturally, thru biomechanical loading."

    https://www.youtube.com/watch?v=Ug75diEyiA0


    J.R. "Hotrod" Dobbs Who cares how it looks all that matters is how it works at least for those who can think like an engineer...

    https://www.youtube.com/watch?v=toIg6w1jo9k

    A Hui Hou,
    Steve
     
  26. Griff

    Griff Moderator

    Steven

    I have no idea what you are talking about. I have made no such statement. Please show me where I have. (FYI if I want you removed I'll do it myself - I don't need to ask permission)

    Look forward to your apology.
     
  27. Dennis Kiper

    Dennis Kiper Well-Known Member

    Dennis, sorry not a good enough answer yet, for me... it needs a bit more meat.

    "Materials you described only "cushion" the intense forces--not a bad thing, but fluid "cushions" naturally, thru biomechanical loading."


    I was really hoping that my inadequate explanation, coupled with your scientific mind would fill in the blanks.

    One is static that displaces foam under pressure in place- a cushion (not a bad thing, just not as accurate—the good thing is a minimization of some of the over-pronation available) .
    The other (and the way I remember it is: “Fluid seeks the area of least resistance and greatest need”.) So the fluid under pressure and the forward momentum of the “dynamic” foot coupled with wt. bearing and pronatory forces is displaced as the cushion, and compressed within the arch space.

    Hydrodynamics spreads the fluid out. At midstance (even though I prefer “dynamic stability” as a description), the fluid has reached an equilibrium state of stability.--I think that's a pretty good cushion.--The EVA is a cushion--”not a bad thing, just not as accurate)

    I remember many conversations with colleagues who referred to an orthotic as a cushion for the foot.
    Made sense to me, good, dynamic and biomechanical efficiency. That's a health benefit.

    How dat?
     
  28. Dennis Kiper

    Dennis Kiper Well-Known Member

    HANG IN THERE WEDERMEYER

    YOU MIGHT LEARN SOMETHING YET.
     
  29. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,

    My deep appologies Ian G, you do have the power.

    The request was from,

    Blinda


    My feet do fail as well as my spelling and my ability to call for assistance and action.
    Steve

    i believe that my heart is in the right place and that i must stand firm when it comes to the safety of my fellow soldiers and the loved ones of others.

    https://www.youtube.com/watch?v=dy9nwe9_xzw
     
  30. Dr. Steven King

    Dr. Steven King Well-Known Member

    MO Bettah,

    Does the viscosity of your gel allow it to freely migrate to these areas of need?

    I remember using some fluid inserts once, full length. You could feel the fluid move/squirt back and forth from heel to forefoot to heel. Trouble was the bladder on them burst and i got all gooey feet.

    Are you still reliant on EVA and PU under your device?

    If i supinate the heel what is to stop/support my ankle from inversion sprain when the gel has moved medially?

    If you nail it down right i bet you could compensate for shear forces well, if the gel does not move out of the way under high pressure.

    Ascics has made a good living with their gel systems thus far. But fluids/gels are a bit heavier that blown air filled foams.

    A Hui Hou,
    Steve

    Here is a small plug for the company if i remember right that donated over $17 million to change the name of my podiatry college.

    https://www.youtube.com/watch?v=a6EiqcuGpV4
     
  31. Dennis Kiper

    Dennis Kiper Well-Known Member

    Does the viscosity of your gel allow it to freely migrate to these areas of need?

    Yes, it's an open chamber

    I remember using some fluid inserts once, full length. You could feel the fluid move/squirt back and forth from heel to forefoot to heel. Trouble was the bladder on them burst and i got all gooey feet.

    There were (I think there still are) some generic liquisoles (not sure of name) sold throu Sharper Image and catalog sales—around $30.00? Othwerwise it would have been the silicone orthotic?

    Other than the breakage, I got a lot of good feed back from pts who tried them. You know, comfy.

    Are you still reliant on EVA and PU under your device?

    I'm not sure what you mean by reliant, the factory does use some hi tech foams in some models

    If i supinate the heel what is to stop/support my ankle from inversion sprain when the gel has moved medially?

    Are you talking about –in motion?, nothing going to prevent that inversion. The fluid doesn't move medially even if you did have an inversion motion.
    The fluid as I see it, only moves about ¼ “ back and forth and up into the arch maybe another 1/4”--
    Now, if you did have an inversion moment, some fluid would displace medially, but the fluid does not fill the entire rear of the orthotic, and in that inversion moment, remember the motion is at the ankle. If the calc is still perpendicular to the shoe, I don't think the fluid has moved too much.

    I never think about what you just asked, it's not an issue. Also, I really am not looking to type this all out.


    If you nail it down right i bet you could compensate for shear forces well, if the gel does not move out of the way under high pressure.

    It's not a gel, it's a highly viscous fluid. I think it's 10,000 poise if that helps you. I see you did not fully get my last post with the “cushion”--the fluid is displaced under pressure, shear forces are reduced thru mechanical efficiency.

    Ascics has made a good living with their gel systems thus far. But fluids/gels are a bit heavier that blown air filled foams.

    What air system and shoe are you referring too? The fluids are heavier, no question. Depending on size of foot from a small womens foot to a basketball player <30gms-100+ gms.

    My snake oil approach has been that the advantage of the biomechanical efficiency in a marathon distance for example is greater carrying an extra oz or two for that distance. I've had runner's who “think” that's a lot of wt, but I wore them when I ran and I don't think I could really tell. After those individuals did run with it, they changed their minds.

    Being curious myself, I looked at a gait pressure analysis system and noticed that due to the biomechanical efficiency of the foot with the silicone orthotic, the foot toed off just slightly quicker than the bare foot for the same gait cycle.
    I don't even remember how I calculated it, but the difference in time in that analysis would have been around just under 2 and ½ minutes for 42,000 foot steps.
     
  32. David Wedemeyer

    David Wedemeyer Well-Known Member

    I'm more concerned about you Dennis, you obviously haven't learned ANYTHING new since we last met in 2008. My my name is spelled Wedemeyer FYI:empathy:
     
  33. These fluid insoles sound interesting. Could somebody kindly direct me to a thread where there is a discussion on them? (rather than a balls out flame war;))
     
  34. efuller

    efuller MVP


    In post #41 on this thread Dennis wrote:
     
  35. J.R. Dobbs

    J.R. Dobbs Active Member

    Steve "Naive" King
    I like you Stevie you are showing true sub-genius. Have you considered joining The Church? I think you could be ordained as a minister.

    You are right, you shouldn't care how it looks because how it works has nothing to do with how it looks. You can rightfully extrapolate the data from the insoles used by Nigg to other designs of orthotics and suddenly start claiming that other insole designs do or don't do the things that Nigg said his designs did or didn't do without issue. Thinking like an engineer is a good start, but you need to develop more SLACK and forget about research science as well. You are looking good at this "Brother Naive", very good indeed. Come join The Church and immerse yourself in slackness. Sales will improve once you pay the fee for ordainment.

    Dennis, you ooze slackness. In my day as a salesman I had to hawk my wares from door to door, you just sit back and sell via the great teleweb of the ether without ever having to share your aura with the Pinks. Now that's what I call sub-genius. Send you money today and I'll personally fast-track you to the highest order of the sub-genii.

    July 5th, 1998: that'll be the day when insoles become correctly engineered.
     
  36. Dennis,

    Let's re-read this through. In your opinion piece published in the magazine you said:
    "The fluid support effect on foot function suggests that stability at the midtarsal joint complex is primary and stability at the subtalar joint complex is secondary. Once the midtarsal joint is fully loaded and stable, rearfoot pronation is already limited. This concept has support in a 2008 study about invasive in vivo measurement of rear-, mid- and forefoot motion during walking.3 The study showed that “the movement at the talonavicular joint was greater than at the talocalcaneal joint and motion between the medial cuneiform and navicular was greater than expected.”"


    I said:
    Your response to my question of how the bone-pin data supported your contention:
    Which doesn't answer the question. Your appeal to the audience with "Simon doesn't understand" not withstanding, just because one joint may show greater excursion during dynamic function than another does not mean the "midtarsal joint complex is primary and stability at the subtalar joint complex is secondary". That just doesn't make mechanical sense. Like I said last night you have not even considered variable accelerations at the differing joints, let alone given any thought to the variation in the internal and external moments acting about each of the instantaneous joint axes; nor the stress and strain within the joints tissues themselves.

    I added:
    To which you responded by saying:
    Specifically, your answers to the points I raised were:
    OK, so show me when each of the bones of the foot are stable during dynamic function. Lets start the with the data I've attached. Then we can move on to why you believe stability is a good thing in a moving foot.
    No, the study you cited didn't employ either "fluid technology" nor "traditional technology," so are you saying the reference you used did not support your conjecture?

    OK, so far you've called me a liar, full of hot air, stupid and lacking knowledge, and stupid again, yet you haven't addressed the moot point. So let's make it really simple: I've attached three .jpg files from the team who carried out the bone-pin studies which you cited in your opinion piece to support your conjecture. The files show the kinematics of the tarsal bones during gait. This data is probably the best data we have to date which demonstrates tarsal movement during gait. It would be really helpful if you could download these files and mark on the graphs with an X at the points were you believe these bones are demonstrating 3-dimensional stability during the contact phase of gait and then re-post them here so we can all see.


    Dennis continued:
    What is the point on moving to more of the erroneous issues with your article before you have even addressed the first? There's plenty of time. For the record, my A level in physics had fluids and waves as an advanced module, and I've been researching non-Newtonian fluids for the last 4-5 years, so I'm reasonable OK with fluids. But we'll come to that when you've addressed the first point- that of stabiity in the midfoot during dynamic function. Here's those graphs for you to mark up...
     

    Attached Files:

  37. "His silence speaks volumes, his silence speaks volumes.

    Won't you, and won't you,
    won't you, and won't you,
    won't you, and won't you, get better.

    His President's fireside chat, his president's fireside chat.

    His thinking knows no bounds, his thinking knows no bounds.

    won't you, and won't you,
    won't you, and won't you,
    won't you, and won't you, take him away.

    Hold me, and get better, hold me, and get better.

    We'll all be smiling then, we'll all be smiling then.

    Won't you be smiling then, won't you be smiling then."
    New Fast Automatic Daffodils- Get Better. http://www.youtube.com/watch?v=EaCaSb-109k
     
  38. Robert:

    So good to see you are still alive. We all have missed your postings here on Podiatry Arena lately and do hope to stay awhile and participate.

    The Orthotic Trolls are trying to take over....now is the time to smite them back to the infernal regions where they reside.:butcher:
     
  39. Dennis Kiper

    Dennis Kiper Well-Known Member

    Hi Eric,


    Dennis, are you just going to play the "I know something you don't know" game or are you going to try an educate us. At this point I'm doubting you have super special science based technology. If you did you would try and explain it. One reason that I doubt you have anything is you make some pretty wild assumptions that you know what I know.

    I wasn't playing any games“I know something you don't”--I'm saying that I was trained as you were and am knowledgeable (and have used) your technology. I've read the journals, other than materials and the use of other fields of technology most applied to theory. I've had a chance to hear from the best on your site about pressure scans, and found you all don't know how to use the information it's giving you. You don't even realize the information it's giving you. A shell orthotic remains the same. A medical device that is inconsistent in it's performance, and has a very inadequate success ratio, let alone over the long term since it's very difficult/ (I'd say practically impossible) to recapture the correct new Rx as biomechanical position changes. With a quantitative device I just add or remove fluid to change the “optimal biomechanical position” for changes that I've seen occur over a 10 year period for each pt.

    Fluid technology is “scientifically” quantifiable PERIOD.
    Someone actually had the nerve to mock that. I have to shake my head, thinking there's no chance to be educated for these people.

    The fact that you and the others didn't have a good experience (and failed) was Marty's fault. As I stated in a previous post, Marty thought he'd insult his colleagues by trying to tell them anything about “how to do this , what to expect over the next few days, the different sensations, what to do if it felt too full or felt like a “lump, or a ball, or how to determine stability when the fluid is moving under foot, and which direction, and so on. ”--The practitioner has to be able to help with this and assess whether the Rx needs to be changed or not.
    (if you're interested on how previsely this orthotic should fit, it's in the article)
    So he made them for you and just let everyone go. You and Kirby were among them, I wasn't there, but I'd be willing to bet other than asking “how it was”, I'll bet he didn't really do the proper follow up. While Marty understood how to make a Rx work (by proper fit), he didn't realize what he already learned that he took for granted and didn't pass on to you. At that time Marty had only been doing this for a couple years. Marty didn't help me much either and we were friends. Believe it or not, there's a lot to know especially in the follow up that you don't (just being factual). I didn't come here to educate you, not necessarily you personally, but the big shots who hold the power over what is accepted are the ones who took offense and refuse to be “educated”

    I was pulled in by one of your group and then “mocked”. Many like Simon refuse to accept the science, and the technology, probably because if the technology were accepted he and others like him would find their theories busted. I'm sure they're thinking, that might cut into speaking fees or books coming to an end.

    I see articles about trying to quantify a Rx in order to better determine a surgical procedure or determine an outcome. You and Simon and the gang can't do that accurately with a present day inaccurate shell orthotic. There are no principles of physics (OK, maybe one) unless you talk about applying whatever science to theory/ technology (that's because a shell orthotic is inadequate and faulty)-- It has nuances of its own, but fluid technology based orthotics work exactly the way an orthotic should.--I don't want to bicker about specific anomalies. This technology is not for every biomechanical problem or general wear and tear or injuries secondary to biomechanics, just most.

    So, for your friends to constantly throw in that I don't see the pt physically (no exams, no dancing etc), therefore I'm a charlatan. They don't get that this technology allows me to do what I do without physical contact. I only need to add or remove fluid from a Rx to pronate/sup a foot. Hydrodynamics, self posts the foot as necessary at midstance and is prolonged (thru principles of physics) at heel off. I only need to “hear” what the pt's muscles perceive as they step down. If I determine with any new pt that the problem is not biomechanical or even suspect that it's not bio=mech, I refer them.

    I've written several posts here, that fully explain the technology, the biomechanics and the principles of physics as they apply to those moments of biomechanics. Simon keeps twisting and denying. I can't help him. He's a waste of time. You on the other hand, if you could be unbiased and fair, I'd be happy to show you how I do it.--if you're having any additional issues in the lower extremity that might be affected by your functional shortage, we could even try a lift and see if that helps (most of the time it doesn't)

    When I bring someone along, whether it's a pt or doc, I give them a set of instructions and a daily report to get back with me on (I'm sure you can figure out why). It normally takes me less than two weeks (including an adjustment) to fit most anyone. Then you're good to go for 1-2 years until your first Rx change takes place.

    BTW this isn't a “super special science based technology. “--this technology has existed even longer than when the worst English criminals became Australians.
     
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