This was published in The Journal of Current Podiatric Medicine June-July, 1989, pg. 41
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it was a Biomechanics Issue edited by Justin Wenick, D.P.M. and I was the guest editorialist.
The Future of BIOMECHANICS
The following guest editorial addresses the issues of competency in biomechanics treatment of foot problems and competition among various branches of the health professions for the dispensing of orthotics. The importance of clinical and public education and the role of professional societies are discussed.
Dennis Shavelson, D.P.M.
__________________________DENNIS SHAVELSON, a Diplomate of The American Board of Podiatric Surgery, is a Clinical Associate Professor in the Department of Medicine at NYCPM
In my opinion, the future of podiatry lies in the practice of Biomechanics. Biomechanical evaluation, gait analysis and the casting and fabricating of orthoses can be the cornerstone of success for the podiatrist.
If what we believe is true, that the effects of gravity, hard, unyielding shoes and ground surfaces , poor posture and poor foot mechanics will eventually lead to pain, deformity and reduced quality of life then biomechanics should be easy to promote to the public. Orthoses should be accepted like eyeglasses and both we and our patientswould benefit from wider use of prescription inserts.
Yet, while other professions are taking advantage of the opportunity in biomechanics, podiatrists have not kept in stride. We appear to be losing our “foothold” as foot function experts. Physical therapists, chiropractors, orthopedic shoe stores and ski shops are fabricating orthotics from casting foam and less than custom prescriptions.
If we are to remain leaders with them, we must take steps to correct our own complacency.
We must educate podiatrists, other professionals and the foot suffering public about orthotics biomechanics and neutral foot casting just as we have taught them about lasers and same day surgery. We must especially find a way to speak to the lay person in simple, understandable terminology that enhances their awareness of the podiatrist’s role in treating feet biomechanically.
As a teacher at one of the colleges of podiatry and someone who works closely with preceptees, externs and residents as well I can see that one of the problems associated with our being “upstaged” by other professional biomechanicsts is the insufficient clinical exposure to the subject that our students receive in school and at the postgraduate level. We must pay more attention to cultivating enthusiasm in our young podiatrists for this specialty.
Also, there have been few additions to the podiatric literature on the subject of biomechanics. Fundamental scientific research into foot types, mechanical and postural pathology and clinical control of the foot is sparse and has been largely conducted by other professions.
The Journal of the Foot and Ankle, Orthopedic and Sports Physical Therapy and The Journal 0f the American Chiropractic Association all have published research of the kind that should be published by podiatrists.
To hear us talk, the podiatric community contains experts in sports medicine, podopediatrics, biomechanics and orthotic fabrication. If this is true , we should be more visible at seminars and publishing more regularly on the subject. I believe The Amerian College of Foot Orthopedics is missing a golden opportunity to publish a journal and sponser seminars, pamphlets and public relations programs that would enhance the field and the opportunities for all of us.
At present, there are no true standards to the science of biomechanics. Today, the same patient, examined by ten different practitioners, would get ten different diagnoses and ten different orthotics. It is crucial that podiatrists be able to assess patients accurately in order for the credibility of biomechanics to broaden. Podiatrists must step to the forefront of this issue. We must invest more time and effort in upgrading our expertise and set the standard for biomechanical diagnosis and treatment in order to remain at the top of The Biomechanical Pyramid. □
1989!!
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