I came across this text which refers to the vault of the foot: http://books.google.co.uk/books?id=...&resnum=1&ved=0CBgQ6AEwAA#v=onepage&q&f=false
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Can anyone tell me which structures make up the vault of the foot and whether this terminology is valid ? The text I linked to suggests 'vault' is an invalid term and that the foot acts more like a truss, can anyone provide evidence as to why the foot should be considered as a vault and or series of vaults? Who is the father of the the term "vault' when applied to the foot? Kapandji seems to suggest that this term was already questionable when his book was published- when was this?
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Re: vault of the foot
Nah, it a vault....
Provided the first met is nailed to the floor.
Seriously, If the foot truly behaved as a vault, there would surely be no tension in the plantar fascia. There rather obviously IS.
So if the foot IS a vault, what is the plantar plantar fascia for?
I think Kapanji physiology of the joints was 1971. -
Re: vault of the foot
The Vault of The Foot is a bioarchitectural term that I use educationally to explain the foot architecture to students, patients, DPM's and the foot and postural suffering public.
In architecture, when two walls or arches are connected by a roof, that is a Vault, In fact, the foot is probably closest osseously to a Joint Vault with its rear pillars being narrower than the fore pillars.
If we eliminate the phalanges of the toes, The Vault of The Foot is composed of all of the other bones, The MLA, The LLA and all of the transverse osseous arches that exisit above the hollow formed by them and the foundational pillars.
The functional concept of "Vaulting" in an educational sense is the need to fill up the hollow under the osseous vault in order to prevent collapse of the foot and this can be broken down even further utilizing the independent tests of functional foot typing to the rear and fore pillars.
In a Bioengineering sense, the architecture of the foot, functionally, relates best to a truss system with a flexible tie beam as Robert pointed out.
I use this concept educationally to explain the tissue stress failure of the tie beam structures and realate that foot type specific to the rigid, stable, flexible and flat types of the rearfoot and forefoot as a great starting point to explain custom care from a professional perspective when it comes to designing a shell and the prescription for custom foot orthotics.
When you build arches or vaults in architecture, one method is to construct a centrum or centring as a model for the voissours to lie on and for me, the centring is placed under The Vault of the Foot to supply the support needed to allow a lifetime of efficient function and to train the soft tissue structures to perform more efficiently. So I am a functional foot typer dispensing foot centrings and not a biomechanist dispensing orthotics (or is it orthoses? another red herring).
Finally, the concept of working with The Vault of The Foot takes the focus of where to support the foot biomechanically to the transverse and sagital planes and away from frontal plane and subtalar joint treatment and in addition, away from the MLA and/or LLA to The Vault, where I believe it belongs (#4).
I have always maintained that Root et al have had 30 years to explain biomechanics and orthotics to the foot suffering public and the medical community and both words are misspellings in windows word spellcheck. The use of Bioarchitectural language offers a simple, commonly understood language for this purpose even though it is not "scientifically" accurate when scrutinized to uphold Newtons Laws since it has no real research value.
Robert is correct when he states that TSP and Foot Centering Paradigm (FCP) are apples and oranges. What he fails to mention is that the tissue stress and/or phyical stress theories are their common threads and they are interchangable.
Dr Sha -
Re: vault of the foot
Hey Dennis
A vault is essentially an arch (as per the dictionary definition. We were thinking in terms of supporting the arch 50 years ago, pre root, pre Kapanji. Kapanji introduced the concept of an arch (vault) in the frontal plane (the transverse metatarsal arch). Is not returning to this, whether in terms of how we as professionals think of what we do
The fact is, as you say, that the MLA functions closer to a truss system than a structural arch. That being the case I don't understand the merit of treating it as an arch when considering treatment.
As to the concept of moving away from the concept of treating the sub talar joint and towards treating the arch, for me that depends on what I'm treating. For EG when I see a presentation of DCIS I am thinking very much in terms of the behaviour of the MTJ, and the apex of the arch and my ideas for prescription start there (although they will also include and consider what the STJ is doing). Whereas if I am treating a Tib post or deltoid ligament problem, my thoughts will be focussed around the behaviour of the STJ because that is the joint about which these muscles primarily work.
Kind regards
Robert -
Re: vault of the foot
I'm not sure who is more deserving of the Well's Termination Button - Simon for starting the thread or Dennis for more UTI discharge..... time for a holiday methinks.. -
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Re: vault of the foot
Why are you so angry and hateful of me? What is your motive?
You've made your point over and over and over. I'm not going away.
I really don't want to go here but you are being chased by your Narcissistic father-in law and his son and me and possibly Dr's Root and Kirby and I don't how many other Narcissists. Maybe you are in need of a self exam? #4, #7.
Dr Sha -
Re: vault of the foot
The Classic Collector’s Edition of Gray’s Anatomy (page 213):
In addition to this longitudinal arch the foot presents a transverse arch, at the anterior part of the tarsus and hinder part of the metatarsus. This however, can scarcely be described as a true arch, but presents more the character of a half-dome. The inner border of the central portion of the longitudinal arch is elevated from the ground, and from this point the bones arch over to the outer border, which is in contact with the ground, and, assisted by the longitudinal arch, produce a sort of rounded niche on the inner side of the foot, which gives the appearance of a transverse arch as well as a longitudinal arch.
Sincerely,
Bob Smith, orphan -
Re: vault of the foot
Please believe me when I say I do not hate anyone. What I can't understand is the singular defence of a theory that has absolutely no biomechanical reasoning and no scientific process or rational. This then becomes a spitting match rather than a scientific debate.
You offer little in professional/scientific discussion and much to YOUR opinion that your opinion is not worth listening to.
Regards -
Re: vault of the foot
I took this form Ian Grffith's Podiatry website as it seems to reflect the opposite point of view from your's in this recurring debate:
It is often stated that the human foot has 3 arches; two longitudinal arches and the transverse arch (sometimes also referred to as the metatarsal arch).1 Whereas the presence of longitudinal arches are unanimously accepted, the transverse metatarsal arch of the foot is considered to be quite controversial. Believe it or not its existence has been debated since last century. But what is the transverse metatarsal arch? And what does the research actually tell us about it?
The existence of a transverse arch at the metatarsal region would require the pressure to be greatest at the areas beneath the 1st and 5th metatarsal heads, and the area of the 2nd, 3rd and 4th metatarsal heads to be elevated relative to this. This gives us the ‘tripod’ like weight distribution of the foot which was first described by Kapandji in 1970.2 However, the first descriptions of the transverse metatarsal arch date back as far as 100 years prior to Kapandji’s work3 and several papers published in Germany between 1882 and 1927 actually concluded that no transverse arch of the foot was usually present.4-7 Much of the research produced following Kapandji’s work concurs with these conclusions regarding the transverse metatarsal arch being a misnomer.
Both ends form the debate I refered to but my question is to what end is this debate? Red herring or something to be learned?
Dr Sha -
Re: vault of the foot
Attached Files:
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Re: vault of the foot
Interesting e-mail sent to me by Dr.Sha,
Comments welcome - my reply is included also.
And Dr.Sha! Ask Kevin if I haven't been as or more critical of some of his posts than yours. However, having a deep respect for Kevin and his work these criticisms are based on observations based on the disclosed theories, and Kevin has always been gracious enough to clarify or defend his position in a professional and educated manner.
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"Why aren’t you calling him a Narcissist or interrupting the flow of his posts?"
My round: pint of bitter?:drinks
P.S. how does someone interrupt the flow of your posts? Or, is it some kind of pelvic floor exercise where you stop yourself mid-stream? -
Re: vault of the foot
Simon:
Looking at this slice of the foot, the bones form The Vault, the space underneath would be the hollow under the vault.
The sum of all the cuts would add up to being The Vault.Attached Files:
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Re: vault of the foot
http://www.sciencedirect.com/scienc...cae411b67098e2746c2b9d0b62013042&searchtype=a
http://www.japmaonline.org/cgi/content/abstract/88/9/437 -
Re: vault of the foot
When you look at the foot with respect to the cardinal planes of the body, you are looking at a section in two planes only. It is not a 3-D object. Hence, the media longitudinal arch of the foot and the transverse arch of the foot at the apex of the arch can be used to describe the shape of two cross sections of the foot at one moment in time. The plantar contour of the foot is a 3-D object. Very different issue, but its shape is direclty influenced by the 2-D relationship of each 2-D section.
None of the description provided are technically correct, since none of them represent the convex, concave, and planar nature of the actual plantar contour of the foot. Hence, they are all wrong. So which model is best depends on what aspect of the structure you’re referring to and whether you are describing it in two or three planes. The problem occurs when the sagittal and transverse arches are taken out of their anatomical context to represent something else.
Sincerely,
Bob Smith, orphan -
Re: vault of the foot
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Re: vault of the foot
Sincerly,
Bob Smith, orphan
http://www.find-your-roots.com/ -
Re: vault of the foot
If as in a CAT scan, we combine all the 2-D slices together to form a foot that can be represented in 3-D and then we limit the motion of the foot so that it does not change as much, especially in a pathological correction (such as collapse or navicular sag) by bracing the area underneath the bony contours, would that possibly have some positive effect clinically? #4 ---big time---
Dr Sha -
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Re: vault of the foot
Dr ShaLast edited: Sep 1, 2010 -
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Bob Smith, orphan
p.s. My friends just call me BS -
Re: vault of the foot
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Dr Sha -
Re: vault of the foot
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Re: vault of the foot
As a rule, I don’t see where supporting the foot is contraindicated and based on average age related adaptations, it seems to make some sense to support the natural contour of the foot. That said, there are a percentage of elderly adults who are asymptomatic and have no significant lifestyle limitations who have never worn orthoses. Since we can not ignore the cost of orthoses and the other financial implications of treatment, we are left with the question of when and when not to treat. The dental profession has done a much better job of providing evidence for the benefit of preventive care or treatment than podiatry, and probably for good reason. It is easier to link dental pathology with lack of care. Foot pathology can be the result of abuse or lack of care (obesity, ETOH abuse, etc.), but the direct correlation is less obvious. Foot pathology can also be related to maintenance of health, such as running or walking for exercise. While not abuse, it can result in heath problems.
Interesting that normal ontogeny is almost the opposite of the age related process in terms of foot structure (arch) development. So would I advocate putting all children in orthoses to assist in this normal process, absolutely not. So to directly answer your question, I don’t know exactly what percentage of adults might benefit from orthoses, so I can’t specifically say that “most” (ie over 50 percent) would benefit from resisting changes related to aging.
Regards,
Bob -
Re: vault of the foot
It must be so frustrating being on the side of Newton requiring proof and evidence when it is so hard to prove very much biomechanically that has clinical significance. #2
The only thing left to do is fire all your weapons at those with opposing viewpoints proving that they have no evidence either. It must be draining and frustrating.
Waiting for TS to produce the pathologies you knowing that it will for most people in your communities and then using your hit and miss protocols that your peers can't agree on without concensus year after year justifying them with Newton's Laws.
but
remember, you always have rule #5 to bail out with, do something diufferent if the TSP doesn't work or produces compensatory failures. #4
Pee Wee -
Re: vault of the foot
Sincerely,
B.S.
Bob’s New Rule: Just because someone says it’s EBM, doesn’t make it EBM! Therefore, a lack of sufficient evidence (E) removes this component of the acronym from the equation and this turns the remainder into just another BM, and we all know what that stands for! -
Re: vault of the foot
Whether or not you want to use physics, it is true that an arch must have its ends held together to keep standing. Dennis, are you willing to concede that the foot, as it functions, is not a vault. If you are not willing to concede this point would you defend the premise that a foot is a vault.
Dennis this is why I think that your paradigm should be rejected. Do you find any fault with my logic?
There is further lack of logic in the following areas. How can you divide support across the planes. It's a three dimensional object. Support happens in 3 dimensions.
For the above reasons, I feel confident that foot centerings as a concept can be rejected as a logical paradigm. Dennis, if you disagree with me, show me the flaws in my logic. I do thank you for expanding on your theory enough to point where I can feel confident in rejecting it. Dennis, this is not bias. I have explained my reasoning. You are welcome to try and refute my reasoning.
Eric -
Re: vault of the foot
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The foot and some manmade structures that rely on tension members for support are significantly different from arches and vaults. If the tension members are cut, the foot will change shape and become flatter due to the loss of compression force created by the tension members. That said, the term arch support is commonly used to describe orthoses.
Bob Smith, orphan
New rule #28: Anyone who uses rule #27 is a putz. -
A foot orthotic shell is a one piece device. In the sagittal plane, it spans the space between the lowest point of the heel and the lowest point of the forefoot (met heads). By nature of its design, it will yield under a certain amount load. A centering transfers load to the supporting surface directly under the arch and is specifically designed not to yield or flex under load. An orthosis is a sprung arch in that its ends are free to float which allows the apex of the arch to become lower under load.
An orthosis must be rigid enough to provide a necessary element of support and sufficiently flexible to yield under certain load bearing conditions. If an orthosis were totally rigid, it would typically be uncomfortable because the arch of the foot (osseous relationship) is dynamic. A dynamic arch is different than a static arch. A vault is not a dynamic structure and a centering is only designed to support a static structure. Can anyone present a reasonable argument to the contrary?
Bob Smith, orphan -
Re: vault of the foot
PUTZ
PUTZ -
You are taking definitions from a text or dictionary of Architecture (or Newton, or Engineering or Mechanics) and saying they either do or don't work biologically.
In this case, The Vault of the Foot is a dynamic vault, just like the arches of the foot of which it is made up of . This means that our Centrings, like your orthotics can flex to yield as well.
BioMechanics, BioNewtonian, BioEngineering, BioArchitecture do not follow the laws of physics, they imitate them. The bird can fly and defy gravity. The foot behaves like a truss with flexible tie beams, it is not one or it would not fail as easily or in as many locations as it does.
Dr Sha -
1. Vault of the foot = arhces of the foot
2. Centerings = orthoses
So what have we gained other than to substitute one set of terms for another. How is that an improvement?
If the laws of physics don't apply to biological structures, then how can you explain a blister without the concept of friction? The laws do apply. Your contention that attempting to apply the laws of physics to living entities is not practical is not accepted by the general scientific community. Therefore, your argument is not valid.
The laws of physics also apply to birds:
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Re: vault of the foot
Thank you for posting your rejection of my work (#4).
It is quite a relief.
Now I can respond to your postings and not be accused of trying to convince you of anything as motive (#3).
I need not respond to your reasoning since they are your own, expert opinion (#7) and have no more value than mine or those of any one else.
If I can sum up the import of your rejection of my work, that and a token will get me on a NYC Subway.
In opposition, I believe the foundations of your work, the tissue stress theory (micro)and the physical stress theory (macro) will serve as the foundation for future research and treatment of pathology, but as far as your tissue stress paradigm, I reject it as it adds nothing to my body of biomechanical knowledge and I have made no changes in practice after having inspected it.
As a matter of fact, coming from a 40 year EBP where prevention and performance and quality of life improvement have been part of my goal set, it serves as a major deterrent of its continued growth.
As I will not wait for occlusive vascular disease to fester, wounds to develop upon insensate patients, irreversible neuropathic changes to grow from neglect, DJD to advance or cancer to harvest without trying to prevent them, I will not idly wait for mechanical pathology to develop.
I teach and believe that there should be a fitness and reduced stress component to any medical practice in addition to the treatment of pathology, whether it be tissue related, metabolic or emotional or mechanical(#7).
Your paradigm is predicated on complaints of pain and/or suffering to exist in order to begin care! I reject that philosophy.
Time will tell what portions, if any, of our paradigms has validity and applicability.
That said,
I am so devastated, crushed and drained by your rejection that I need a few days just to gather strength, save face and recover so I will not be posting until Tuesday (#5).
Oh wait, here at home, it’s our Labor Day Holiday and it’s going to be 5:00 somewhere.
Cheers
:drinks
Dr Sha -
Jeff:
As I told Robert Isaacs earlier, you are wasting your breath arguing with this man. You will only get frustrated and annoyed with this futile process. He will only continue with his marketing approach to foot biomechanics, making up new non-meaningful terms, trademarking them, putting testimonials on his website, and then telling you that Newton's Laws shouldn't apply to the foot.
Please ask yourself this question: do I want to continue wasting my time trying to debate this man in a logical manner? My suggestion? Ignore him. He isn't worth it. You are a much better man and are much smarter than he is.
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