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Can Facial Pain be secondary to abnormal foot motion

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Brian A Rothbart, Aug 9, 2006.

  1. Brian A Rothbart

    Brian A Rothbart Active Member


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    Dr Gerald Smith (a cranial dentist practicing in Langhorne PA) posted an interesting case - a patient with intractable facial pain that was unresponsive to allopathic therapy. The etiology was eventually traced to (1) iatrogenic occlusal reconstruction and (2) abnormal foot pronation secondary to the Primus Metatarsus Supinatus Foot type. You can access the case history at the following webpage: http://rothbartsfoot.info/DentalFootCase.html

    Comments?

    best regards,
    Brian R
     
  2. DaVinci

    DaVinci Well-Known Member

    yawn

    yawn :eek:

    [​IMG]

    Is anyone else tired of this?
     
  3. Hey Leo...is the kid wearing a set of proprioceptive insoles? :eek:
     
  4. Brian A Rothbart

    Brian A Rothbart Active Member

    Facial Pain linked to abnormal foot motion

    Several interesting comments from Podiatrists recently posting on the ThatfootSite Forum:

    regarding facial pain, Dr Brian Beber (Chairman of the College of Holistic Podiatrists) says "In my practice we have noted that patients prescribed FFO's have reported improvement in facial pain". You can read his unabridged post at the following URL: http://www.thatfootsite.com/forum/viewmessage.php?rootid=7557

    Dr Peter Morgan (Podiatrist practicing in the UK) states the following "I have seen facial pain many times from "abnormal" foot motion. It occurs in patients who experience symptomology arising from pathomechanical foot function. The net result is contortion of the face (we call this in our elite field of maxio-facial holistic Podiatry as the "Grimace")leading to discomfort of the facial musculature, furrowing of the brow, and emission of a low monotoned Groan." You can read his anabridged post at http://www.thatfootsite.com/forum/viewmessage.php?rootid=7564

    Brian R
     
  5. Peter

    Peter Well-Known Member

    STOP!

    I am not a Dr.
    I am a Podiatrist (musculoskeletal).
    I do not support Rothbarts principles.
    I posted in sarcasm.
    I have my own voice.

    I hope you read the post, and realise that I was criticising Dr Rothbart, and this flimsy notion that his insoles cure facial pain, infertility, haemmorhoids etc.

    I am in the "show me the evidence" camp.
     
  6. Brian A Rothbart

    Brian A Rothbart Active Member

    Dear Peter,

    You certainly have a right to your opinion. And I appreciate you taking the time to post it on this forum.

    best regards,
    Brian R
     
    Last edited: Aug 11, 2006
  7. DaVinci

    DaVinci Well-Known Member

    How much longer do we have to tolerate this idiot with his continual posts and failure to answer repeated questions in other threads? He deserves to be ridiculed for his continued silly claims in the absence of evidence (and even evidence to the opposite). He has sent me a PM with stupid allegations. I vote that he be banned.

    I have also added him to my Ignore list. On the home page. Click on User CP; then click on Buddy/Ignore list. Add Brian A Rothbart to your ignore list and you won't have to see any more of the rubbish.
     
  8. Dieter Fellner

    Dieter Fellner Well-Known Member

    Breakthrough discovery: Hot of The Press !
    (Ref: The World Dental and Podiatric Biomechanical Association 2006; Vol 2, pp 211-214)

    A world first report from respected international consortium of doctors:

    A study investigating a correlation between the correction of congenital / acquired malalignment of front incisors (known more commonly as a 'buck' or 'hang' tooth) with ceramic crown implants, has unexpectedly effected a marked improvement in lower limb kinetics (mechanism as yet uncertain). Startling the dental and podiatric workers.

    The doctors further stated there was also a profoundly improved capability in a select and specific group of fascial muscles responsible for creating homo sapiens unique ability to effect fascial movements creating the impression of happiness and smiling. This as yet unreported link is confounding the experts.

    Note: a temporary set back was noted within days of administering treatment when the subjects' improved fascial changes (described as increased capacity for sustained smiling to reveal newly acquired dental improvements i.e. straight white teeth) was adversely affected. The noteworthy post-procedure face lift effect recorded by the specialists (pictures posted) caused a worrying deterioration resulting in a pronounced "frown effect" marked by an intense furrowing of eyebrows, and a downturn of the corners of the mouth (beyond the acceptable neutral alignment)with changes in the fascial colouration to mauve / blue. This was associated with an as yet inexplicable and unexpected episode of a Tourrett-like outburst lasting several minutes. Staff were able to adminster immediate psychological (I.V.) support when this worrying episode slowly subsided. The primary cause appears to be related to the sudden exposure to dental fees amounting to many thousands.This also caused a marked worsening of body posture described by experts as the UHWLF syndrome.

    It is unknown at this time if the initial improved lower limb kinetic changes suffered a permanent deterioration on account of the psychological trauma sustained by the recipient. Researchers are unable to agree on measurable biomechanical parameters relying instead strongly on symptomatic improvement as the' sole' outcome measure.

    To investigate further, reseachers are now proposing a double blind randomized controlled study to anaylze the link between tooth malalignment syndrome, biomechanical lower limb dysfunction and Tourrets syndrome.

    Candidates are invited to participate in this to know if absence of direct billing would improve the outcome.
     
  9. admin

    admin Administrator Staff Member

  10. achilles

    achilles Active Member

    What is The World Dental and Podiatric Biomechanical Association????
    Cannot find any reference to this body??!!
     
  11. Tony....it's the Foot 'n Mouth Association and they're fighting tooth and nail to defend the claim that proprioceptive insoles have been shown to cure avian influenza in prepubescent chickens with elevated claws and impacted peckers.
     
  12. Scorpio622

    Scorpio622 Active Member

    I have been treating facial pain with foot orthoses sucessfully for years. My technique is quite simple- neutral rigid shell with 45 degree rearfoot posts- worn backwards and upside-down. I don't have scientific data to support how these work, but I hypothesis that pedal nocioception somehow gates the facial pain. Sometimes this technique causes ulcers (but my patients don't mind). As such, I have dubbed this "hole-istic podiatry"
     
    Last edited: Aug 16, 2006
  13. Brian A Rothbart

    Brian A Rothbart Active Member

    Post off the SOT Forum

    The following was recently posted on the SOT forum by David Beltakis DC

    Prof,

    What you've got is really a simple problem. It is a clash of models. You've got podiatrists trained in a biomechanical model and you are sharing information within a neurological model. The biomechanical model is a subset of the neurological, meaning the neurological model far exceeds the biomechanical. Let's think about this for a minute. If you put a 3,6 and 9mm wedge under the first metatarsal, biomechanically it will only prevent a minor amount of pronation and that is really all it can do, in that model. However, when I measure the height of a patient’s ear, shoulders and lateral iliac crests, I see dramatic changes with those 3, 6 and 9mm inserts. I see the ears, shoulders and iliac crests increase in height, become level and even over-compensate. It simply doesn't make sense within the biomechanical model so I have three choices (1) ignore the date, (2) deny the data, or (3) change my mind.

    Some of your colleagues choose to ignore and/or deny the data. That's their right. Then some even try to make childish analogies which follow no logic. Any professional with analytical ability can see through these. Other may even try to be scientific about it and experiment, bottom line is you are getting other health professionals involved and they are moving ahead. Let your colleagues be stuck in the past and move with the ones that are willing to adopt a more complete view of the human organism.

    David Beltakis DC (USA)
    http://groups.yahoo.com/group/SacroOccipitalTechnicForum
    Message Number 2899
    Posted Wed Aug 16,2006 2:32PM
     
    Last edited: Aug 16, 2006
  14. Dieter Fellner

    Dieter Fellner Well-Known Member

    Brian Rothabrt - please forward this message to David Beltaski

    So David Beltaksi: you need to read the threads on thatfootsite.com and others like it on Podiatry Arena.
    No-one is denying new technology or knowledge in the quest to help our patients. All we ask, all we beg, is this: provide a shred of coherent, robust and dependable scientifically sound evidence.
    We should not be expected to function on blind faith.

    Present this data you have mentioned to the professional community for scrutiny. We are ready... are you?
     
  15. Brian A Rothbart

    Brian A Rothbart Active Member

    SOT Seminar in St Louis

    Dieter,

    Attend the SOT seminar in St Louis this October. Half a day (I believe) is reserved for presentations on this insole technology. Contact person is
    David L. Rozeboom D. C. chiron@rozeboom.com However, if you inclined to dismiss subjective outcomes as being meaningless or irrelevant, you will find many healthcare providers who are going to disagree with you.

    If you are unable to attend the SOT seminar, attend the International Convention of Posturology that is being held the end of this year in France. Dr Pierre Marie Gagey (the author on THE textbook on Posturology) will be presenting this insole technology himself. Being a world recognized expert on Proprioceptive Stimulation and the changes that occur from it (he has published many many papers on the subject), I believe you will find his presentation very informative. Go the following URL for more info on Posturology: http://orthoptie.net/divers/posturelist/posturelist.htm or you can contact Dr Gagey directly at pmgagey@club-internet.fr

    EBM is important, so are subjective outcomes. 35 years ago, if you read the POD journals, most (if not all) of the published papers were case histories. At that time, we thought it was necessary to also do single or double blind studies. Then in the 1980s when the PhD PTs became interested in biomechanics, the EBM papers flourished, but at the same time, subjective outcome studies became 'out of vogue'. My point is, BOTH are important and relevant. In the 1950s the pendulum had swung to the far left (subjective outcomes). Presently the pendulum has swung to the far right (EBM). The pendulum needs to be in the middle.


    Please excuse my typos or poor spelling. Living in Italy (speaking Italian), I seem to be losing some of my English skills.

    Brian R
     
    Last edited: Aug 17, 2006
  16. Brian A Rothbart

    Brian A Rothbart Active Member

    Point of fact:

    The Washington State Podiatry Board make allegations against me regarding using orthoses, committing fraud because from 1995 -1999 I practiced as an Orthotist. The allegation was I had no license to do so. Interesting enough, there was no licensing requirements in the State of Washington, requiring licensing as an orthotist, until the year 2000.

    Based on their allegations they (1) voided my Washington State Podiatry license, and (2) make threatening accusations that could have led to prison.

    At that time I decided to leave the US (I heard the golf courses in prison are presently in terrible repair). We resettled in Europe where the medical community is much more open to new ideas.

    Brian R
     
  17. Dieter Fellner

    Dieter Fellner Well-Known Member

    Brian

    Thanks for making me aware of these presentations. Sadly I doubt I can attend either one.

    Certainly I do not think subjective outcomes or the single case study is irrelevant. Primarily a Podiatric Surgeon, a field in which there is a relative paucity of good quality EBM (i.e. RCT's etc), I am only too aware of the limitations.

    I suspect probably David Beltakis is on to something and there are indeed different mindsets at work here, and 'never the twain shall meet'. For the time being we have to agree to disagree on certain aspects. My guess is what will, or what I hope will happen is this: a researcher will put to test your theory and analyse the effects of the PCI on the foot and body posture. How this could be done I am not sure but perhaps those of our colleagues with research experience and access to suitable equipment and facilities can help? Personally, I would be surprised if there is no measurable effect when wearing PCI, with such equipment as video analysis, force-pressure plate technology etc. The question also is what theory can be developed to explain the effects on symptoms. The latter of course would also concern conventional orthotic intervention.

    I have to hold up my hand here and declare this again; I have had a benefit from the effect of wearing the PCI, on my heel pain. There is not a shadow of doubt about that. But I sure cannot explain the underlying biomechanical principle with any degree of confidence. And what you propose as a model to explain the effects does fly in the face of conventional theory and modern understanding.

    Please don't apologize - your English is certainly better than mine and I will be the last to bicker over typos (English is not my first language either!)
     
  18. achilles

    achilles Active Member


    Brian,
    Do you know of the above study, and are the insoles yours??
    regards
    Tony Achilles
     
  19. Ok I'm struggling to take this seriously now. I suspect that the good prof may be having a laugh at our expense. In the words of the great tennis player you cannot be serious! That quote from peter off your website was so obviously dripping with sarcasm you cannot have honestly thought he meant what he said!

    Come clean. This is a wind up right? :rolleyes:

    Regards
    Robert
     
  20. Peter's post

    Oh yes And for the benifit of those who can't find a link to Brian's useful and informative site :rolleyes: Here is Peter's Post IN FULL.

    Puts a slightly different spin on it if you only include the bits you like does'nt it. Been misquoting "Mark" by the sound of it as well.

    In the spirit of revisionalist quoting i present a quote directly from prof Rothbart (very slightly cut)


    So there it is. The washington state podiatry board make him insoles and he practices threatening accusations at the golf course! you heard it here first

    To my mind deliberately misquoting people is the worst type of deception.
    :mad: :mad: :mad:
    Regards
    Robert
     
  21. Dieter Fellner

    Dieter Fellner Well-Known Member

    PCI Update

    To those interested in a single subject outcome assessment using the PCI.

    Since around June this year I have been wearing the PCI, which, to my surprise has improved activity related inferior heel pain (plantar medial calcaneal tubercle) by at least 80%. I observed also that I developed no obvious problems with the 1st MTP joint from any jamming effect which could have been expected to occur with this insole, and that after a period of two weeks or so, the inital discomfort form the 1st MCJ also then settled.

    I am continuing with my energetic morning and evening walks with my new pup (Norwegian Elkhound).

    Two further observations since then:

    1.) I also have bilateral tibialis posterior insertion pain, to a lesser extent. This problem has not improved. I have not at any time felt as if the insole corrects any pronation / foot posture abnormality when standing or walking and the persistent PTT pain seems to correlate with my observation. This is in spite of applying the prescribed assessment protocol using the micro wedges. There is a curious sensation of a generic whole body effect on 'better' (?) posture during gait but this could be but an artefact of my imagination.

    2.) What is not an artefact is that since using the PCI the skin has thickened over the plantar medial inter-phlangeal joint of the hallucis. This is indicative of greater weight bearing pressures being exerted. In other words the wedge is pushing on my toe causing roll-off callus, which is now building up to a point where I may soon need to consider Dr. Scholls callus file, or similar.

    So how does the PCI help with plantar fasciitis and not PTT insertion pain?

    The 6mm wedge confined to the 1st metatarsal and hallux could help to relieve the tension on the plantar fascia enough to rest the tissue and alleviate the pain? Can we ever know this information unless we have the means to measure tissue tension on this structure in vivo?
     
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