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The Myth of the Hereditary Bunion

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Dieter Fellner, Apr 1, 2017.

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  1. Dieter Fellner

    Dieter Fellner Well-Known Member


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    https://www.correcttoes.com/foot-help/hereditary-bunion-myth-part-iii-dr-ray-mcclanahan-dpm/

    Apparently the scientists have it wrong. In this 'article' Ray McClanaghan argues that he is right and why the body of scientific evidence is wrong.

    "In spite of the fact that the medical community has made advances in the care of many common medical conditions, the treatment of bunion deformity is still locked in the dark ages.
    Today’s podiatric students and residents are being taught that bunions are hereditary, represent a bone structure problem, and require surgery for definitive treatment. They are being taught that the progression of bunions can be slowed by supporting the arch (subtalar joint) with orthotic devices. They are encouraged to recommend wide width footwear to their future patients, which does not fix the problem, as you will see below.
    This perspective represents the current standard of care in podiatric education and practice, but is it based in evidence?
    The short answer is no.
    There are several clues as well as self-evident medical facts, that point to the flaws in the presently accepted educational approach and treatment of bunion deformity.
    Humans are not born with bunions. In all but the exceedingly rare case, human babies are born with toes that spread wider than the balls of their feet. We even seem to respect this anatomical reality by manufacturing footwear for babies that are the same shape as their natural feet. However, around the age of 3, we begin changing the shape of the feet of infants by fitting them in footwear that no longer respects natural human foot anatomy, and we start squeezing their toes together. We begin fitting them in shoes that are widest at the balls of their feet, as opposed to where natural feet are widest: at the ends of the toes. This is where bunion deformity begins."
    (see link for more)
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    8
  3. Dieter Fellner

    Dieter Fellner Well-Known Member

    Indeed ... along the way of debating some of this erroneous ideology, I was duly rewarded, on multiple occasions, with personal attacks and expletives too shameful to re-post. I suspect at least some of his 'fan' base consists of multiple ego stroking aliases.
     
  4. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    That is their typical modus operandi - they resort to the whole gambit of logical fallacies including the ad hominem when the actual facts and evidence do not fit in with their echo chamber. Been there, done that.
     
  5. DaVinci

    DaVinci Well-Known Member

    We see these types of people in social media everyday!
     
  6. drhunt1

    drhunt1 Well-Known Member

    Ray is from Portland, OR. 'Nuff written...
     
  7. Dieter Fellner

    Dieter Fellner Well-Known Member

    The strategy is clear: understanding their proposals are garbage they resort to brow beat any objections until the nemesis gets bored and leaves the discussion. Leaving the coast clear to spin more unscientific propaganda and sell toe spacers, funky shoes and socks under the pretense of 'curing' bunions without surgery.

    Shameful.
     
  8. drhunt1

    drhunt1 Well-Known Member

    LOL! Some of these guys will do anything! I guess it depends on what his definition of "cure" is, eh? I've stated it before...but I'll write it again. One of the MAIN problems we have in Podiatry is that some of these pathologies take a lifetime to develop. How many Podiatrists practice over 40 years? A handful. How does emigration and/or geographic relocation influence our knowledge and ability to research effectively? Greatly. "It's not the bunion that is inherited, but the foot type that leads to bunions, that is". It's something we know intuitively...but putting hard numbers to this...quite another matter.
     
  9. Dieter Fellner

    Dieter Fellner Well-Known Member

    'Cure' in the context used to imply the deformity is reversed and / or corrected by application of toe wedge / socks / shoes and exercise.

    It is often possible to detect the indicators of the bunion foot in the pre-teenage years. And yes, I agree it isn't the bunion that's inherited - after all we don't see many babies with bunions. Genetics plays a part. Ray knows better and would seem to want refute those studies.

    Foot-type is an all too easy sound-bite. It's possible to extrapolate and theorize but we're still no closer to nailing the specific foot-type. Experience in the last 18 months leads me to think that talo-tarsal instability plays a part also. I will posit we will hear more about this aspect, in the not too distant future. In itself this isn't a reliably predictable factor but important in some feet.

    The semi-flexible (I have no idea how Kevin would characterize this entity with the 'stiffness' nomenclature) plantar flexed metatarsal likely plays a part. Ligamentous laxity likely plays a part. We can go on listing other contributory factors, variably expressed in the population and in the individual. What I feel quite confident about is the solution isn't a sock / wedge / shoe thing ... (etc)
     
  10. HansMassage

    HansMassage Active Member

    I understand what you are saying. But dose the US Pacific North West have the corner on personality science?
    I know from my experience with Rothbart that he became so fixed on his idea that it became the cure for every thing.
    It helped me with a few clients and I learned to palpate more accurately but even if you have the genotype you don't necessarily develop the phenotype and with a little wisdom you can avoid the phenotype developing. But wisdom is harder to market than gadgets.
     
  11. Dieter Fellner

    Dieter Fellner Well-Known Member

    Not sure what you mean. Those afflicted with bunions show a strong hereditary trait. That's what research has to say about it. I can't comment on the US Pacific NorthWest. I live on the East Coast. I am sure this has its' own personality & science. It's not the science but the lack of science that is the problem. Since you brought it up, what wisdom & skill will prevent the phenotype?
     
  12. drhunt1

    drhunt1 Well-Known Member


    Anecdotally, I can tell you that EVERY 10-12 y.o. girl that is seen for bunions in my practice has a collagen deficiency syndrome...ie., EDS. While this syndrome is good if you want your daughter to compete in the summer Olympics in gymnastics...it sucks otherwise.
     
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