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I have found the cure for achilles tendonitis.

I have done Roberts course: PERSONNAL IMPROVEMENT STARTER SCHEME (Robert, in case you read this, I still waiting for the steak knives).

So, I am going to patent this treatment for achilles tendonitis, so none of you can use it unless you pay me royalities (send them to my paypal account). I got to start making some money out of these inventions.

How did I discover this remarkable treatment? I have been struggling with my own achilles tendonitis for 6 months now. I added a Cluffy wedge to my orthotics (for another reason) and viola!, the achilles tendonitis went away! What more proof do you need other than it fixed me? Who cares about the evidence? Who takes any notice of RCT's anyway?

There is actually some evidence ... my buddy, Shannon, recently presented his systematic review at the APodC Conference and in that review he mentioned the work of Van Ginckel et al & Baur et al who showed that there is a delay in the forward progression of the centre of pressure and more lateral forefoot loading in those with achilles tendonitis.....the exact thing that a Cluffy Wedge is supposed to help with! Surely that explains why they worked in me!

What more evidence do you need than that? It worked on me and there is a little theory that explains the evidence. Thats what most of us work on anyway don't we?

I love it when a plan comes together!

....send me the money :dizzy:

 

and you can also run faster http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=60432

 

Funny thing if you think about the mechanics involved it makes sense.

Reduced tension in the plantar fascia should reduce tension in the achilles tendon.

Reduced length of the foot length (length of lever arm) reduced requirement of the achilles to plantarflex the ankle joint.

There is more but got to go cut the lawns and get the BBQ out

I've been talking about FhNL and increased load on the achilles for ages.

 

Does that mean I have to share the royalities :boohoo:

 

Nope you go for it

 

lol theyre marketing it already craig http://www.algeos.com/acatalog/Cluffy_Wedge.html bit too late i think , have fun at the Del Cam conference

 

NO! Its the specific application to achilles tendonitis I want to patent. I proved it worked, so why should I not get the $?

 

Has anyone done a plantar pressure study pre and post cluffy wedge?? Does it actually move the centre of pressure (CoP) medially and re-establish normal forward progression of CoP?

 

Who really cares about the minor detail of research not showing that?

In all seriousness, the putative effect of a Cluffy Wedge is to bring the windlass mechanism on earlier. Those with a delayed onset to the windlass (ie large range of hallux dorsiflexion before windlass initiates) tend to have a delayed heel off (as windlass is not working) and less initial first met head loading (so lateral is loading more) .... hence leading me to the remarkable discovery above (as that plantar pressure pattern was typical in achilles tendonitis!). It kinda makes sense in that the calf muscles are having to work harder to get that load off the heel --> achilles tendonitis.

So the effect is theoretical and assumed to occur (but it worked in me, so what more evidence is needed than that?)

 

Just cut pieces of 3 mm adhesive felt in the shape of a "Cluffy Wedge", patent it and then market it as the "Payneful Wedge".......should be an instant success!:rolleyes:

 

Craig:
I would think that the proximate effect of the Cluffy Wedge to be on FHL, that is, an effect on retrotalar pain as opposed to the achilles tendon. Was your pain in the achilles tendon itself?
Regards,
Ed

 

It was in the achilles - its been swollen and I been battling this for >6 months .... but it was all gone with the Cluffy wedge until yesterday when I put the MBT's on for the day (but that another story)!

 

Did you want to overuse the Achilles tendon again to see if the Cluffy wedge worked a 2nd time ?;)

 

Lol craig are you just randomly testing every product on offer ?? Fitflops next ??? :D

 

Not all ideas need a level 1 study before they work, fortunately. But, the data is nice to have and fosters more ideas. The Cluffy Wedge works for Achillodynia as well as insertional Achilles problems. I suspect it is that the ankle joint plantarflexes more as FHL is addressed. Gait studies have not validated my findings , but have not isolated FHL as a variable. Could it be the asymptomatic subjects also had FHL? Just conjecture. FHL is much more common than currently appreciated.
Like the scissor jack analogy, restriction in one joint will restrict another. You can see this clinically, once the FHL is addressed with a CW, as the patient walks faster and takes a longer stride the findings become more obvious. I suspect this is why eccentric strengthening works so well to rehab these people. Just better motion of the ankle, I wonder if it is not necessarily the eccentric motion, but the concentric motion that may work?

Anyway its all theory at this point,, no data to support the observations, other than clinical experience and looking at things over and over again. My findings are biased of course. I have used the Cluffy Wedge now quite often for these problems. The results have been quite compelling. This is possibly some interesting material for someone to explore? In the meantime, I use what works. The CW definitely works.

 

Re: The Cluffy Wedge and Recalcitrant Diabetic Ulcer

Hi Craig,
I have had an excellent result using the cluffy wedge to resolve a chronic diabetic ulcer on the plantar aspect of 1st IPJ.
The patient had an orthosis + ppt extension to the toes with a cut-out at the hallux. I filled in the cut-out and used a shorter wedge to dorsiflex the distal phalanx. The ulcer, which had been treated by debridement and dressing (by another podiatrist) for 11 months, resolved within 4 weeks. The patient stll develops a callus at the site but only sees me every six months to debride.

 

Perhaps these 2 short videos will be helpful:

Treadmill study of the Cluffy Wedge

Dynamic Study: Effect of the Cluffy Wedge on Plantar Foot Pressures