tag:blogger.com,1999:blog-59040762024-02-09T01:26:44.713+11:00Podiatry UpdatePodiatry news, information, links, views & random rantsCraighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comBlogger207125tag:blogger.com,1999:blog-5904076.post-70715217845918488472016-08-01T22:30:00.003+10:002016-08-01T22:30:57.647+10:00Started putting my courses onlineI've been running and teaching the <a href="http://www.clinicalbootcamp.net/">Clinical Biomechanics Boot Camps</a> for <a href="http://podiapaedia.org/wiki/conferences/specific-conferences/clinical-biomechanics-boot-camp/clinical-biomechanics-boot-camp-previous-dates/">a long time</a> and done lots over the years. The feed back continues to be great and it has altered how a lot of podiatrists practice. That is most gratifying for me personally as a teacher. The content of the Boot Camps is always evolving and moving forward as new information is continually being added and old information deleted. The framework or context of clinical practice changes and the content changes. It has now reached the stage that I was becoming a little concerned about the amount I was getting rid of and I was looking at different ways to make that older, but nevertheless good, useful and helpful, material available. I was also beginning to find it more tricky to meet all the requests for Boot Camps in each city every year and finding it tougher to be away so much from the family. The answer was to offer it as an online course with significant amounts of extended content, allowing me to go into much greater depth with the material rather than be restrained by the two days that I typically had for each course.
Over time, as a result of my engagement in debates and discussion on places like on <a href="http://www.podiatry-arena.com/">Podiatry Arena</a>; writing my different websites on critical thinking about the research underpinnings <a href="http://www.runresearchjunkie.com/">(Running Research Junkie</a> and <a href="http://www.itsafootcaptain.com/">Its a Foot Captain, But Not as You Know It</a>) directed me to more issues with critical thinking, logical fallacies and the way to translate research into clinical practice being included in the Clinical Biomechanics Boot Camps. It also guided me on (mis)adventures in social media outside my comfort zone, combating the nutters, pseudoscience, woo, quackery, science deniers and nonsense wherever and whenever it came up(ie vaccines, GMO's, <a href="http://www.chemtards.net/">chemtrails</a>, medical advice on Facebook, and a whole lot more) and also to further comprehend the role that science plays not only in our own clinical practice, but also in being a good person of this world. Rather than add more of this to the <a href="http://podiatrycpdacademy.com/clinical-biomechanics-boot-camp/">Clinical Biomechanics Boot Camp</a> content, I have spun that of into the course concerning how to <a href="http://podiatrycpdacademy.com/become-a-skeptical-and-critical-thinking-podiatrist/">Become a Skeptical and Critical Thinking Podiatrist</a>. The content is entertaining, wide ranging and will make you a more rewarding clinician, thinker, end user of research and a better person of the world. This program is not what you would cover in a research methods program at podiatry school; but this is the program that I think should be the research methods that you do at podiatry school.
With time, more of the new material in the Clinical Biomechanics Boot Camps was emphasizing issues surrounding 'running' as that is where so much was changing that was having an influence on changes in clinical practice, even in non-running associated subjects. It was increasing as a proportion of the Boot Camps material and I was starting to get a little uneasy with just how much when not everyone was interested in it. So I have spun off the running shoe material and considerably expanded it into a very in-depth course on <a href="http://podiatrycpdacademy.com/running-shoes-guru/">Becoming a Running Shoe Guru</a>. You will be a go-to expert and authority at the end of that program.
Watch out for more details as it gets added.Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-33990813867851668282016-04-06T16:51:00.000+10:002016-04-06T17:00:13.317+10:00As most of you know, I run, post at and manage many websites (<a href="http://www.podiatrycpd.com.au/about/">check this list for some</a>). The administration of those websites do occupy and consume a lot of my time so I spent time and money investing in systems and procedures to make it easier. I have also learnt a lot about website softwae platforms such as Wordpress and the forum platforms, vBulletin and Xenforo and how they atcually work and the problems that oour with them. I have also learnt a lot about how to rank websites in the search engines such as Google and have invested in systems and procedures for my sites to be worked on and rank well in the search engines. I have also been on the receiving end of many problems such as server crashes, database errors and a lot of hacked web sites over the years. I have learnt a lot about protecting my websites from all that as well as recovering those affected sites from these problems. I have worked with consultants and experts and participated in forums on these topics and done courses to learn more. These experiences on all of the above have taught me a lot.<br />
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Based on all that experience and the systems and procedures I have in place, I have decided to branch out and offer my services to others through three websites:<br />
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<a href="http://www.podiatryseo.com/">Podiatry SEO</a> - if you are a podiatrist and a clinic website and want to do better in the search results, I can really help. I have become quite good and skilled at this and that 'podiatry' understanding and experience makes it so much easier for me!
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<a href="http://lookafterwp.com/">LookAfterWP</a> - if you have a Wordpress based website and want to have some piece of mind with daily cloud based back ups, updates made and protection form being hacked and a whole lot more, then this is what I do there.I do this every day for my sites.<br />
<a href="http://hostingorangutan.com/">Hosting Orangutan</a> - this is a small website hosting company that I decided to buy. I thought itwould be easier not to pay so many different website hosts for all my sites, it would be better if I actually owned the hosting company and outsourced the servers and technical support, so I did it.If you want some hosting, then give us a go.<br />
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Please contact me via the above websites if you want to find out more; or even better sign up for one or all of the services! Your support is going to be much appreciated by me.Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-4957016555084596562014-08-22T14:36:00.000+10:002016-10-01T18:34:21.801+10:00The Airia Running Shoes to Improve PerformanceI have been following the development and social media spread of these shoes for a while. There was first <a href="https://podiatryarena.com/index.php?threads/airia-running-shoes-the-new-biomechanically-perfect-shoe.94191/">a thread on Podiatry Arena</a> (which the Airia CEO contributes) and I then did two blog posts about them:
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<a href="http://www.runresearchjunkie.com/the-new-biomechanically-perfect-running-shoe-from-airia/">The new ‘biomechanically perfect’ running shoe from Airia?</a>
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<a href="http://www.runresearchjunkie.com/another-look-at-the-performance-claims-by-the-airia-one-running-shoe-a-theoretical-context/">Another look at the performance claims by the Airia One running shoe; a theoretical context</a><br />
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These two posts pretty much sum up my views on the shoes.<br />
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The shoe comes with a lateral forefoot wedge or slant and claims that this can enhance performance. The company has some data that this is the case and I presented in those blog posts a theoretical context on how it could help enhance performance in some runners.<br />
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Since then, they have been getting some pretty good reviews (<a href="http://runners.fr/airia-one-cette-chaussure-fait-elle-vraiment-courir-plus-vite/">like this one in French</a>!) despite the initial skepticism. They have not exactly set the world on fire yet and we watch this pace to see how they develop. <a href="http://www.podiatryfaq.com/airia-running-shoes/">More articles</a>.Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-56192575377239575132014-08-01T14:24:00.001+10:002019-10-23T10:46:24.552+11:00Where do I work<b>Where do I work?</b><br />
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Department of Podiatry, La Trobe University... not anymore (finished in 2013)
<a href="http//croydonfoot.com/">Croydon Total Footcare </a>(only occasionally, .... married to the boss)<br />
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I contribute a lot to:<br />
<a href="http://www.podiatry-arena.com/">Podiatry Arena</a> and <a href="http://www.foot-health-forum.com/">Foot Health Forum</a> and <a href="http://www.running-shoe-rx.com/forum/member.php?5-Craig-Payne">Running Shoe Rx</a><br />
and have a <a href="http://www.youtube.com/user/PodiatrySoapBox">TV channel on You Tube</a><br />
and blog at <a href="http://www.runresearchjunkie.com/">Run Junkie</a> and <a href="http://www.toningshoestoday.com/">Toning Shoes</a> and on the <a href="http://www.podiatrysoapbox.com/">Soapbox</a>, and more recently at <a href="http://www.itsafootcaptain.com/">Its a foot</a><br />
I also run <a href="http://www.fallcpd.com/">Podiatry CPD</a><br />
View my profiles at: <a href="http://www.linkedin.com/pub/craig-payne/12/2a1/21">LinkedIn</a>, <a href="https://twitter.com/CraigBPayne">Twitter</a>,
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<a href="http://podiatric.blogspot.com/">Back to home</a><br />
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<br />Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-28976636173740716212013-01-02T15:43:00.000+11:002013-05-07T18:09:27.194+10:00The Interest in Toning ShoesI am starting to see some renewed interest in the toning shoes niche. These are the shoes with design features that are designed deliberately to make the shoe unstable. This instability make the muscles work harder, giving the so called tone up. Players in this market include the Masai Barefoot Technology (MBT), Skechers Shape Ups and the Reebok EasyTone. Gone are the early claims for these shoes that they will cure things like cellulite. However, the claims that were still made for the benefits of these shoes have certainly been over-hyped, leading to some of the companies having to <a href="http://www.professorlifeuniverseandeverything.com/exercise-shoes-and-legal-action/246/">settle with the FDA for multi-millions of dollars</a>. This was because the science did not support the health gains. That did not mean that the claims were wrong; it just means they were not supported by the evidence. The American Council of Fitness also came out with a <a href="http://www.acefitness.org/pressroom/758/ace-research-study-finds-toning-shoes-fail-to/" rel="nofollow">report</a> casting doubt on the benefits of the toning shoes. This lead to some <a href="http://www.snakeoilquackery.com/toning-shoes-as-snake-oil/9/">waning interest</a> in the use of these shoes.<br />
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However, more recently there has been a whole issue of the journal, <a href="http://www.tandfonline.com/doi/abs/10.1080/19424280.2011.653993" rel="nofollow">Footwear Science</a>, devoted to the science underpinning these shoes. A number of clinicians are reporting them useful for some selected conditions such as painful hallux rigidus. I have a heard of a few chiropractors who trial them in patients with chronic postural low back pain. While most of the research to date as focused on the biomechanical effects of toning shoes, what is need is more on the outcomes with these clinical conditions so we can be better guided as to when and who to use them in.<br />
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I certainly hope that <a href="http://www.toningshoestoday.com/">toning shoes</a> are not relegated to the history books as a result of litigation and some negative research findings, as they will have some good clinical uses. They are not going to be much use to tone the butt, however. I have been working on a <a href="http://podiapaedia.org/index.php?title=Toning_shoes">related project</a>. and an <a href="http://www.toningshoesreview.com.au/">eBook</a>.Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-16587589689659838522012-03-31T10:32:00.002+11:002013-04-21T09:00:44.858+10:00Vibram Five Fingers facing class action suitA <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=76280">class action suit has been filed against Vibram Five Fingers</a> for the health claims that they made for their products that did not eventuate to those who are taking the action. Following the many blog and forums posts on this and the comments on them have been interesting with most missing the point of the suit.<br />
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Vibram made health claims for their product that was not supported by the evidence, when there is none that actually supports the claims. It is that simple. Reebok had to settle with the FTC for $25 million for doing the same thing concerning claims about their toning shoes. Skechers is also facing a number of class actions and is in discussion with the FTC for the same allegations. They have set aside $44 million to deal with this.<br />
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There have been calls, mostly on minimalist and barefoot websites, for a class action against the traditional running shoe companies. The point being missed is that these companies are not making medical or health benefit claims for their shoes. Just check the most recent editions of running magazines and look at the claims being made in the advertisements. The only claims regarding injury and health are being made by the manufacturers of the minimalist shoes. I suspect Vibram is just the first to face a class action and more will follow. A <a href="http://www.runresearchjunkie.com/update-on-the-vibram-fivefingers-class-action/">recent motion to dismiss</a> the case was declined by the judge.<br />
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<a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-46193255480722013432011-12-29T10:52:00.002+11:002013-09-29T10:22:59.606+10:00Overpronation in Runners“Overpronation” has been some sort of buzz word in the running community for a long time, but is generally a meaningless term. It is widely used to wrongly prescribe a specific running shoe (ie motion control). The real problem with the term is that it is a substantial oversimplification of what is actually happening to the foot and the use of the term seems to have made experts in it by some health professionals, running shoe sales people, coaches and even runners who have no sort of medical or related qualification. The blogosphere is also full of non-experts pontificating on myths of overpronation. It is easy to see that they have no real understanding of biomechanics and foot function and what they write is easy to deconstruct. There are numerous reasons why a foot may overpronate, so to advocate one method to treat overpronation over another is just plain ignorance of what the causes of it are. Muscle strengthening will only correct overpronation if a muscle weakness is the cause. Muscle stretching will only correct overpronation if a tight muscle is the cause. <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/gait-retraining/">Gait retraining</a> will only correction overpronation if there is an abnormality in the gait amenable to gait retraining. Foot orthotics will only correct overpronation is there is an alignment issue with the bones. If you have overpronation, do yourself a favor and see someone who actually understands what it is, rather than listen to the unscientific pontifications of self-proclaimed gurus who just happen to have a blog. For more detail on this, I blogged about it <a href="http://www.runresearchjunkie.com/the-nonsensical-understanding-of-overpronation/">here</a>. There are so many <a href="http://www.itsafootcaptain.com/pronation-mythology/">overpronation myths </a>to bust and so little times to deal with them!<br />
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<a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-52449571357532678252011-12-21T17:20:00.001+11:002011-12-21T17:22:40.080+11:00Navicular Stress FractureNavicular stress fractures are a diagnostic challenge and the existence of the so called “N spot” over the navicular is an important diagnostic suspicion. X-rays are not always helpful with a significant number of false positives. There are no short cuts with a <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=2465">navicular stress fracture</a>, the time non-weightbearing away from sport is a minimum of 5-6 weeks. There is no way around this. I have recently spoken to a couple of colleagues who had to deal with athlete with this and they were looking for ways to avoid that. There is no way. The outcomes and success rates and the return to sport for a <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=33842">navicular stress fracture</a>, regardless if it is a surgical or conservative management plan seem to be about the same. The athlete has to be told: no weightbearing for 5-6 weeks. Find a non-weightbearing activity for them to keep going.<br /><br /><p></p> <a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-60227551118081029672011-12-13T19:40:00.002+11:002011-12-13T19:48:56.765+11:00Running With a Cadence of 180 Steps a MinuteThe concept of runners shortening the stride length and increasing the <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=72438">cadence to 180 steps a minute</a> has been coming up as a concept a lot me recently. I am not sure what to make of it. Some prominent coaches and running form experts are advocating it to reduce the risk of injury. At the same time a number of sports scientists are dismissing it as not valid. Most runners tend to naturally adopt a running form that is the most metabolically efficient for them. Any change to that tends to come with a metabolic cost. Those that advocate it are very passionate abut it, but as we know that the more passion there is in defending a theory, the less likely there is to be any evidence that supports it (<a href="http://www.clinicalbootcamp.net/paynes-law.htm">Paynes First Law</a>). I am certainly seeing injuries in those runners who use a <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=72438">180 cadence</a>, so I going to wait until the science tells me which is the better way to go on this one.<br /><br /><br /><p></p> <a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-78665750339824043812011-09-14T19:13:00.004+10:002023-05-05T18:30:23.361+10:00Does the Circulation Booster Work at Improving Circulation?We have all seen the adverts for the <a href="https://medicalreleasesonline.info/cricket-legend-believes-revitive-circulation-booster-has-helped-him-feel-better/">Circulation Booster</a>, but can it really boost the circulation? Surely the claims “<span style="font-style: italic;">as seen on TV</span>” and the reliance on testimonials in the marketing should be enough to set off the ‘snake oil’ alarm bells. There is certainly no good scientific data to support its use at improving circulation to the lower limb and <span style="mso-spacerun:yes"> </span>the <a href="http://www.tgacrp.com.au/index.cfm?pageID=13&special=complaint_single&complaintID=1596">Therapeutic Products Advertising authority</a> in Australia forced the company to modify the claims that they made. A similar ruling was given by the <a href="http://www.asa.org.uk/ASA-action/Adjudications/2011/6/High-Tech-Health-Ltd/TF_ADJ_50690.aspx">Advertising Standards Authority</a> in the UK. <p></p> <p style="font-weight: bold;" class="MsoNormal">So how is the Circulation Booster supposed to work?</p><p class="MsoNormal">When we are walking the rhythmic contraction of the muscles in the lower limb act as a muscle pump to help pump the blood back up to the heart. This is an important way to stimulate the venous return part of the circulation. The idea behind the Circulation Booster is to provide a small electrical stimulus to the bottom of the foot while sitting to gently stimulate the muscles to contract and thereby help the venous return to the heart. This has nothing to do with the arterial supply or the about improving (or “boosting”) the amount of circulation down to the foot and lower limb! </p> <p class="MsoNormal">So, at best, the Circulation Booster may help blood go back up the veins, but the blood supply down to the feet and legs come via the arteries and it won’t affect that!<span style="mso-spacerun:yes"> </span>This maybe help prevent DVT and other thromboembolic events… but so will walking and this will be a whole lot better for people than sitting with their feet on the device. There has been some research that has shown some improvement in the venous parameters, but that is NOT the arterial circulation (<span style="font-style: italic;">funny how the company promotes these scientific studies, but do not point out they are on the venous side of things and not the arterial side</span>!)</p> <p class="MsoNormal">Going for a walk around the block is going to get that venous muscle pump working harder and do a lot more good for the venous circulation that sitting with the foot on the Circulation Booster. Going for a walk (ie gentle exercise) is going to help fitness, general well-being, prevent osteoporosis and actually improve the arterial circulation. So what you going to do? Sit down for 30 minutes on the Circulation Booster or go for a 30 minute walk. Which one is going to help your circulation more? Which one is going to hurt the wallet more?</p> <p class="MsoNormal">Until I see some credible data, think placebo effect when people say they help.<br /></p><p class="MsoNormal">See the Podiatry Arena discussion on the <a href="https://podiatryarena.com/index.php?threads/circulation-boosters-good-or-bad.37534/">Circulation Booster</a> abd this <a href="https://podiatrytube.org/index.php/2023/05/05/the-circulation-booster/">video analysis</a>.<br /></p> <a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-33268388083434500612011-09-01T18:17:00.007+10:002011-09-02T07:51:11.667+10:00'Top of Foot Pain' Management in Barefoot RunnersDespite all the propaganda that barefoot or minimalist running is better due to less injuries occurring, it is now becoming increasingly clear that it is not the way to get less running overuse injuries. Just check any barefoot/minimalist website and look at all those looking for advice on their injuries! Just ask any of the health professionals who treat a lot of running injuries. Most will tell you of the barefoot running injury epidemic that they are seeing. There is no doubt that there are some who have successfully transitioned to barefoot or minimalist running who now claim to get less injuries, but there are also those who are getting more!
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<br />One of the more common injuries being seen is what has become known as ‘<a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=52095">top of foot pain</a>’, which probably is <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=1980">dorsal midfoot interosseous compression syndrome</a> (DICS). The pain of this is usually over the dorsal midfoot area. The cause of this is when the dorsiflexion moments of the forefoot on the rearfoot are higher than the plantarflexion moments, resulting in the dorsal jamming. Forefoot striking has greater forefoot dorsiflexion moments of the forefoot on the rearfoot than does heel striking. I have been involved in the management of a lot of ‘top of foot pain’ now in forefoot strikers or minimalist runners and here is my approach to it:
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<br />1. Firstly you really need to understand the runners views on barefoot/minimalist running and just what they are prepared to do. By this I mean how acceptable of different interventions are they to be; are they training for a specific event (to get an indication of the ‘urgency’ to get over the problem); what sort of time frame they have; etc
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<br />2. Of course we use the RICE principle with this injury like any others in the short term and make modification to the training regime to manage it.
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<br />3. The best way to manage ‘top of foot pain’ in the short term and long term is to decrease that dorsiflexion moment. How can you do that?
<br /><ul><li>a. If you follow some of the advice on the barefoot sites, you need to change your running form or gait somewhat and try to ‘retract’ the toes. As this will put a plantarflexory load on the metatarsals which will reduce the forefoot dorsiflexion moment. Most runners find this difficult and often it does not reduce the load enough for healing to occur (it may work better in the long term once the problem is treated).</li></ul><ul><li>b. Low dye strapping, correctly applied to plantarflex the forefoot in such a way that it decreases the dorsiflexion moment will work brilliantly in the short term, but is not a good long term option. Correctly applying the low dye tape is crucial.</li></ul><ul><li>c. Foot orthotics are easily the best way to reduce that dorsiflexion moment, however they have to have the right design features to do that or they are not going to work. All foot orthotic failure I have seen in those with ‘top of foot pain’, either did not decrease that forefoot dorsiflexion moment or even increased it!</li></ul><ul><li>d. Depending on where they are at, they are also probably better off getting back to heel striking if they can to help reduce those forefoot dorsiflexion moments that are higher in forefoot striking.</li></ul><ul><li>e. Ankle joint dorsiflexion also need to be checked and often a <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=38213">fibula mobilisation</a> is needed to get that going properly.</li></ul><ul><li>f. Increasing muscles strength may be a longer term option to reduce the dorsiflexion moment. However, as the joint moments are high, the muscles are already having to work hard because of that and are probably already really strong. The problem is the lever arm that the muscles have to the joint axes of rotation.</li></ul><ul><li>g. A windlass dysfunction can also be an issue in creating higher forefoot dorsiflexion moments, so some sort of intervention to preload the hallux to get the windlass active sooner can be helpful (this can easily fit in minimalist running shoes)
<br /></li></ul>4. However, depending on some of the answers to the discussion in (1) above, as too how acceptable some of these interventions are, for example:
<br /><ul><li>a. If they are more ‘purist’ in their views on barefoot/minimal, then they are not going to want to use foot orthotics or transition back to rearfoot striking (even in the short term). In this case, the running has to be cut back to level that is tolerable and a slow and gradual build up to allow the tissues to adapt to the load (ie adapt to those higher forefoot dorsiflexion moments). I happy to work with them on this, but they have to realise that in some people the moments are so high, that the tissues may never be able to adapt to the load and changes to the running form or gait. In this case other interventions will be needed if they want to get over it. I also point out that it will be harder and take longer to get better without the use of heel striking and/or foot orthotics.</li></ul><ul><li>b. If they not so ‘purist’ then I will get them into foot orthotics and, if they, can get them back to heel striking in the short term. Once they are better and back to their normal training routine we then decide what to do in the longer term. Ideally they will transition back to forefoot striking (if that is there wish) and away from the foot orthotics. This has got to be a planned process and done incredibly carefully (as the previously injured tissues are very prone to re-injury) and gradually. In some, that forefoot dorsiflexion moment is so high, there is no way that it can be lowered with a gait change and so high that the tissues can adapt to that load. In which case the heel striking and/or foot orthoses are going to have to be a long term option</li></ul>Just why are the joint moments causing this problem so high? I think the most likely reason is the variations that occur in joint exes positions and the lever arms the bones and tendons have to that joint axis.
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<br />‘Top of foot pain’ is common in forefoot strikers (barefoot/minimalist runners). Understanding the role that the higher joint moments play in it guides the short and long term management, as well as the attitudes to forefoot vs rearfoot striking and the role of foot orthoses as a short or long term option and the issue of the magnitude of the moments and if the tissues can adapt to those moments or not.
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<br />Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-69836378847690813402011-08-10T11:44:00.003+10:002011-08-10T11:48:56.180+10:00Do shoes cause flat foot in children?There have been a number of previous studies in children in African countries that have shown a high correlation between flat foot and the wearing of shoes. This often gets touted as the shoes caused the flat foot and is used by those with an agenda to promote barefoot. However, that is not what those studies showed. All they showed was a correlation. Correlation does not mean causation
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<br />The studies could be interpreted several ways:
<br />1. The wearing of the shoes did indeed cause the higher incidence of flat foot
<br />2. Those with a prior flat foot wear shoes more often as the feet feel better wearing them
<br />3. Those that wear shoes more often walk on harder surfaces and it is the harder surface that is responsible for the higher incidence of the flat foot, and not the shoes
<br />4. Etc
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<br />Those with an agenda, clearly like to push option one as to what they think the studies have shown. Those without an agenda are open to all the options as an explanation of the results of those studies.
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<br />Now we have a new study on a population of children in Nigeria that has taken the analysis of these types of studies to a new level (see discussion: <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=68363">Flatfoot not related to footwear in Nigeria study</a>) in which they used a more sophisticated analysis and controlled for some other variables. They concluded that the footwear was not a factor in the development of flat foot.
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<br />Don’t get me wrong, I have no doubt that footwear can and does cause a lot of problems, its just that the studies referred to above cannot be used to imply that wearing shoes in children cause flat feet.
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<br />Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-34400114842122920292011-05-29T14:56:00.000+10:002011-05-29T15:00:01.211+10:00Growing Pains in ChildrenJust have been having to deal with the issue of growing pains in the children. <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=206">Growing pains in children</a> have a very specific definition – its unexplained pain usually at the back of the knee and upper calf muscles that occurs at night. The cause is thought to be fatigue and sleep related, so is probably a biochemical problem. The real problem with the term <a href="http://www.foot-health-forum.com/forum/showthread.php?t=191">growing pains</a> is that any leg pain can often be written off as being a “growing pain” and they will grow out of it. There are several potentially serious (and not common) that cause pain in the leg. This means that every leg pain in the child is not growing pains and must be checked out. I only raise this as a child I know was repeatedly dismissed as having growing pains and it turned out to be an osteosarcoma. If the pain occurs in the day time or in the bone and is not relieved by gentle massage, then its not <a href="http://www.podiatryonline.tv/growing-pains.htm">growing pains</a>.<br /><br /><a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-45476446593246924822011-05-01T17:41:00.003+10:002011-05-01T17:48:31.399+10:00Manipulation for Cuboid Syndrome<a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/cuboid-syndrome/">Cuboid syndrome</a> is an interesting condition with many different understanding about what exactly it is; what causes it; and how to treat it. Everyone seems to have an opinion on <a href="http://www.foot-health-forum.com/forum/showthread.php?t=18612">cuboid syndrome</a>. Is it a <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=1919">subluxed cuboid</a>? Or is it just a strain of the ligaments about the joints the cuboid is involved in. Opinions are also divided on the value of <a href="http://www.podiatryonline.tv/cuboid-manipulation.htm">cuboid manipulation</a>. For some it’s the only treatment, for other <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=20678">cuboid manipulation</a> is dangerous if not done properly.<p></p>Personally, I actually have no idea exactly what <a href="http://www.podiatryonline.tv/cuboid-syndrome.htm">cuboid syndrome</a> is. It does seem to respond to strapping foot orthotics and gentle manipulation. The manipulation does seem to work some times, but not at other times.<br /><br /><a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-41938859012696212752010-12-07T12:45:00.002+11:002011-05-01T17:47:53.223+10:00Is Forefoot Varus Posting Bad?<!--[if gte mso 9]><xml> <w:worddocument> <w:view>Normal</w:View> <w:zoom>0</w:Zoom> <w:trackmoves/> <w:trackformatting/> <w:punctuationkerning/> <w:validateagainstschemas/> <w:saveifxmlinvalid>false</w:SaveIfXMLInvalid> <w:ignoremixedcontent>false</w:IgnoreMixedContent> <w:alwaysshowplaceholdertext>false</w:AlwaysShowPlaceholderText> <w:donotpromoteqf/> <w:lidthemeother>EN-AU</w:LidThemeOther> <w:lidthemeasian>X-NONE</w:LidThemeAsian> <w:lidthemecomplexscript>X-NONE</w:LidThemeComplexScript> <w:compatibility> <w:breakwrappedtables/> <w:snaptogridincell/> <w:wraptextwithpunct/> <w:useasianbreakrules/> <w:dontgrowautofit/> 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<w:lsdexception locked="false" priority="19" semihidden="false" unhidewhenused="false" qformat="true" name="Subtle Emphasis"> <w:lsdexception locked="false" priority="21" semihidden="false" unhidewhenused="false" qformat="true" name="Intense Emphasis"> <w:lsdexception locked="false" priority="31" semihidden="false" unhidewhenused="false" qformat="true" name="Subtle Reference"> <w:lsdexception locked="false" priority="32" semihidden="false" unhidewhenused="false" qformat="true" name="Intense Reference"> <w:lsdexception locked="false" priority="33" semihidden="false" unhidewhenused="false" qformat="true" name="Book Title"> <w:lsdexception locked="false" priority="37" name="Bibliography"> <w:lsdexception locked="false" priority="39" qformat="true" name="TOC Heading"> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} </style> <![endif]--> <p class="MsoNoSpacing"><a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=7822">Forefoot varus</a> is rare, yet some researchers always seem to manage to recruit enough subject for their research that have what they claim is forefoot varus. I suspect that they are not forefoot varus, but the much more common forefoot supinatus and they got confused. The reason that this is a problem is that they are totally different beasts. One is osseous and causes rearfoot pronation and cannot be reduced. The other is soft tissues and is the result of rearfoot pronation and can be reduced. Yet they look the same. They will both respond very different to foot orthoses … kinda think that the distinction between the two would be important in research projects don’t you? Also forefoot varus will respond very differently to rigid compared to flexible/semi-rigid foot orthotics. </p> <p class="MsoNoSpacing">To be clear, <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=889">forefoot varus</a> is a forefoot that is inverted when the subtalar joint is in its neutral position and the midtarsal joint is maximally pronated. As the forefoot is inverted, the rearfoot has to pronate to bring the medial side of the foot to the ground. To treat forefoot varies, you are supposed to use a medial forefoot post to bring the ground up to the foot, so the foot does not need to pronate the rearfoot to bring the medial side of the forefoot down to the ground. Right?</p> <p class="MsoNoSpacing">Consider the very rigid plastic orthotic with a <a href="http://www.clinicalbootcamp.net/forefoot-varus.htm">forefoot varus</a> post, when the foot is placed on top of it the forefoot varus post will invert the rearfoot (or stop it pronating/everting) through its effects on the rearfoot via the rigid plate of the orthotic.</p> <p class="MsoNoSpacing">Consider the less than totally rigid foot orthotic with a <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/forefoot-varus/">forefoot varus</a> post. How will that affect the rearfoot pronation? The only way it can affect the rearfoot pronation is by dorsiflexing the first ray to end range of motion, then invert the midfoot joints to end range of motion, then it has a shot at affecting the subtalar joint. As the orthotic shell is not totally rigid, the forefoot varus post has to affect the rearfoot “through the foot”. Whereas if the shell was rigid, the forefoot varus posts work directly on the rearfoot by tilting the orthotic shell. It cannot do this with a less than rigid orthotic when the person is standing on it.</p> <p class="MsoNoSpacing"><a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=58260">Is the use of forefoot varus posts potentially injurious?</a></p> <p class="MsoNoSpacing"> </p> <p class="MsoNoSpacing"> </p><br /><br /><a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-70306458832283799442010-12-03T11:21:00.003+11:002010-12-03T12:21:36.321+11:00Vibram FiveFingers<a href="http://www.podiatryonline.tv/vibram-five-fingers.htm">Vibram Five Fingers</a> as an alternative footwear to ‘barefoot’ have been getting a lot of attention, especially from the barefoot/minimalist running community. The anecdotal evidence is accumulating that barefoot running is increasing the injury rate in runners. I have seen predictions and posts that say something like because of ‘barefoot running’ that podiatrists must be ‘shaking in their boots’ at the thought of barefoot running due to all the business they will lose. Well, where are the people that made those claims now? The opposite has happened. Barefoot running is turning into an economic stimulus package for anyone who treats and rehabilitates running injuries. If you do not believe me, just ask them. Here is a typical comment:<br /><br />"<span style="font-style: italic;">I do not see many runners in my clinic, but lately over half the ones I have seen are barefoot or minimalist runners. Given that my impression is that barefoot runers make up less than 0.01% of runners, and if 50% of the runners I see with an injury are barefoot, then should not alarm bells be going off?</span>" <a href="http://www.podiatry-arena.com/podiatry-forum/showpost.php?p=182511&postcount=923">source</a><br /><br />and these types of comments:<br /><span style="font-style: italic;">“We’ve seen a fair amount of injuries from barefoot running already, or from just running in the Vibrams,” says Nathan Koch, PT, Director of Rehabilitation at Endurance Rehab in Phoenix, AZ. Vibrams are the barely-there “foot gloves” that have become popular among barefoot running devotees.Steve Pribut, a Washington, DC podiatrist and one of America’s most respected running injury specialists, says he has experienced a recent influx of barefoot runners at his office as well. And, asked by email whether he could confirm a barefoot running injury trend in his clinical experience, Lewis Maharam, a.k.a “Running Doc,” replied with two words: “Oh, yeah!”</span> <a href="http://running.competitor.com/2010/05/features/the-barefoot-running-injury-epidemic_10118">source</a><br /><br />There is no doubt that some are getting less injuries after taking up barefoot running and there is no doubt that there are some that are getting more injuries.<br /><br />There is even a rumour going around about a class action law suit against <a href="http://www.barefootrunningshoesstore.net/category/vibram-five-fingers-review/">Vibram Five Fingers</a> because of all the injuries that are occurring, but it may be just a rumour as I have seen nothing concrete on this. Certainly some running speciality shops have been asking customers to sign disclaimers to waive legal responsibility when the buy the <a href="http://www.barefootrunningshoesstore.com/vibram-fivefingers/4/">Vibram Five Fingers</a>.<br /><br />There was even an insight into the sort of people who buy <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=45715">Vibram Five Fingers</a> - they are being reported as being annoying people by the <a href="http://www.sfweekly.com/2010-11-17/news/vibram-fivefingers-shoes-and-the-annoying-people-who-buy-them/">San Francisco Weekly</a>!<br /><br />See:<br /><a href="http://www.runningbarefootisbad.com/why-are-barefoot-runners-getting-so-many-injuries/381/">Why are barefoot runners getting so many injuries?</a><br /><a href="http://running.competitor.com/2010/05/features/the-barefoot-running-injury-epidemic_10118">The Barefoot Running Injury Epidemic</a><br /><a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=48566">Vibram FiveFingers Cause Metatarsal Stress Fractures?</a><br /><br />While barefoot running or the Vibram Five fingers is certainly turning out to be not all they are touted as being, there is nothing wrong with barefoot running drills as part of balanced running program. Just don’t believe all the hype and propaganda that is being sold.<br /><br /><a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-2623879890702299372010-12-02T18:14:00.002+11:002014-11-08T16:04:21.894+11:00The Foot Posture IndexMeasurements taken of the foot as part of a biomechanical assessment have been shown to be notoriously unreliable and not that repeatable. When the initial studies started to come out showing that, I wanted to disagree with them as “I” was reliable. That was until I became a participant in these studies and realised just how unreliable I was.</p> <p class="MsoNormal">When it comes to determining the posture or alignment of the foot (for whatever reason you might want to do that!) what do you measure. The Calcaneal angle? The arch height? The transverse plane position of the midfoot? Whichever one you choose, you may end up with a ‘normal’ or ‘abnormal conclusion.</p> <p class="MsoNormal">For the above to problems, Tony Redmond developed the <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/foot-posture-index/">Foot Posture Index</a>. The <a href="http://podiapaedia.org/wiki/biomechanics/clinical-biomechanics/biomechanical-assessment/foot-posture-index/">index</a> is based on observations and is based on a number of observations. The <a href="http://www.podiatryonline.tv/foot-posture-index.htm">FPI</a> has been shown to be reliable.</p> <br /><br /><a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-16771029981140256812010-08-31T18:11:00.002+10:002010-08-31T18:15:21.976+10:00Foot Orthotics for GolfWhat do you do with a golfer and the need for foot orthotics? Golf involves a lot of walking, so they need a reasonably firm or rigid pair of foot orthotics to control the foot during that activity (assuming that foot orthotics are indicated). The crucial part of the golf game is the swing. The swing stance involves a reasonable amount of inversion and eversion of teh foot to be done efficiently. How much does a rigid orthotic with a rearfoot post interfere with that motion and affect that efficient <a href="http://www.podiatryonline.tv/golf.htm">golf swing</a>? <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/golf/">Foot orthotics for golf</a> are going to have to be a compromise. It is surprising how often this issue comes up on some <a href="http://www.theforumfinder.org/sports/golf/">golfing forums</a> for discussion.<br /><br /><a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-9063555159289707612010-08-26T08:22:00.002+10:002016-10-23T13:28:19.759+11:00The Cluffy WedgeThe <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=3651">Cluffy Wedge</a> has been getting a bit of attention lately. It was original trademarked by Dr James Clough as a mean to dorsiflex the hallux to help functional hallux limitus. It was first written about in <a href="http://www.japmaonline.org/cgi/content/abstract/95/6/593" rel="nofollow">JAPMA</a>. The concept is based on preloading the hallux to get it to load earlier in the stance phase. The biggest effect of this is to bring the windlass mechanism on sooner as it hold the hallux in a slightly dorsiflexed position. While the <a href="http://www.clinicalbootcamp.net/cluffy-wedge.htm">Cluffy Wedge</a> can be purchased as an orthotic add-on or shoe insert, many people just fabricate their own. The <a href="http://www.cluffy.com/" rel="nofollow">Cluffy Wedge</a> is being marketed through a number of different channels. Podiatry TV has a number of videos on the <a href="http://www.podiatryonline.tv/cluffy-wedge.htm">Cluffy Wedge</a>.<br /><br /><a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-39046694404158859412010-08-24T20:08:00.003+10:002020-06-28T14:44:23.851+10:00Foot Orthotics and CyclingCycling represents interesting challenges for podiatric management of problems. First the cycling bike needs to be <a href="https://podiatryonline.tv/home/sports-medicine/sports/cycling/">set up properly</a> to ensure efficient biomechanics and power generation for cycling fast. Any mechanical problem that needs foot orthotics are going to be difficult as there is not a lot of room in the shoe for <a href="https://podiatryarena.com/index.php?threads/custom-foot-orthotics-in-cycling.65455/">cycling foot orthotics</a>. Also there is no “swing phase” in the cycling “gait” as there is when walking and running. This can result in a type of plantar forefoot neuropathy due to the constant weight bearing (this is also seen in gyms on equipment like the cross trainers in which there is a constant stance phase). A lot of these issues is discussed amongst cyclists on cycling forums and Podiatry Arena has had a few discussions on <a href="https://podiatryarena.com/index.php?tags/cycling/">cycling</a>.<br />
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<a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-49750251218675983852010-08-14T12:06:00.006+10:002020-06-25T11:33:43.187+10:00Chilblains<a href="http://podiatryarena.com/index.php?tags/chilblains/">Chilblains</a> or <a href="http://www.epodiatry.com/chilblains.htm">pernio</a> are interesting when it comes to the textbooks. You hardly see <a href="https://www.itsafootcaptain.com/beetroot-juice-for-chilblains-say-what/">chilblains</a> mentioned. They are really common in the colder climates. I can only assume that the editors of a lot of the text books do not live in climates where <a href="http://www.epodiatry.com/chilblains.htm">chilblains</a> are common?<br />
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The biggest misconception I see about <a href="https://croydonfoot.com/chilblains-season-is-here/">chilblains</a> is that they are caused by the cold. They are not really caused by cold, but are caused by the too rapid warming of the foot after they get cold and circulation has not responded adequately to that warming. They are also not caused by poor circulation, they are caused by how the cold responds to the changes in temperature, so the volume of the circulation is not an issue.<br />
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Why are <a href="http://podchatlive.com/episode-80-chilblains/">chilblains</a> more common in females? - it is either a footwear thing and that causes pressure on the toes that causes changes to the circulatory response; or it’s a hormone thing as a lot of the female hormones do affect the circulatory responses.<br />
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<a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-82088401808015757622010-08-08T16:55:00.004+10:002010-08-08T17:06:14.422+10:00Foot orthoses or gait retraining for patellofemoral pain?Its long been held that excessive foot pronation causes the tibia to rotate excessively internally causing a misalignment of the patella and results in patellofemoral pain syndrome or anterior knee pain in runners. Therefore, based on this you use foot orthotics to correct the foot pronation to treat the problem. Two reasonably well conducted RCT’s shows that foot orthotics are successful at that. <br /><br /><strong>However:</strong><br />1. Almost the cross sectional and prospective evidence shows that foot pronation is not associated with patellofemoral pain (despite the fact that foot orthotics been shown to help).<br />2. Even though the foot and tibia are coupled, the research as to which is the driving force, shows that it is tibial internal and external rotation that drive foot pronation and supination. It is not foot motion that drives leg motion, it is the other way around (see this <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=49332">discussion</a>). This is so counter-intuitive to what podiatrists, in general, have believed.<br />3. More and more physiotherapists are using proximal control exercises and gait retraining to treat patellofemoral pain without the use of foot orthotics, and the evidence shows that this is just as effective as foot orthotics in treating this problem.<br /><br />What is going on? Is it proximal or distal that the problem is coming from? Should we really be using foot orthotics is the problem is proximal? Should physiotherapists be using proximal control exercises if the problem is distal?<br /><br />I have been in a couple of conference debates with physiotherapists at both a physiotherapy and a podiatry conference. I have learnt a lot through that and I genuinely do believe that the solution to patellofemoral pain syndrome is proximal control exercises. However, I also believe that this proximal control will not work if the ankle inversion moment (or supination resistance) is above a certain threshold (which will probably vary from individual to individual). For example, if the ankle inversion moment is low (i.e. supination resistance is low), then the proximal control exercise should work easy to help and they may not even need foot orthotics. However, if the ankle inversion moment is high (i.e. supination resistance is high), then it does not matter what you do proximally, it’s not going to work as the foot won’t move. So, therefore the role of foot orthotic in patellofemoral pain could be to reduce the ankle inversion moment to below a certain threshold, so the proximal control can work. This theory makes sense to me and is consistent with the most recent evidence.<br /><br />For more see:<br /><a href="http://www.clinicalbootcamp.net/knee.htm">Foot Orthoses for Knee Pain</a><br /><a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=8777">Foot orthoses and patellofemoral pain syndrome</a> <br /><a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=2334">Foot pronation and knee pain</a> <br /><a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=49332">Does the tibia drive the foot or does the foot drive the tibia?</a><br /><br /><a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-39554706471184601392010-07-10T14:30:00.001+10:002013-05-19T15:55:17.866+10:00Peroneal TendonitisPeroneal tendonitis is an uncommon overuse injury that occurs to the peroneal tendons and sheath, usually just above or below the lateral malleolus. I never used to like seeing patients with peroneal tendonitis. They never seem to get better when I treated them and it always puzzled me. It always great when the research you do has an impact on your clinical practice. This is exactly what happened with peroneal tendonitis. We looked at the force needed to supinated the foot in those with it and it really surprised me how low it was. It was so low, that it easily explained why the tendonitis was there .... it was because the peroneal muscles had to work so hard to stop the foot supinating. That now makes <a href="http://www.clinicalbootcamp.net/peroneal-tendonitis.htm">peroneal tendonitis</a> easy to treat with lateral wedging. Changes in running form also <a href="http://www.runresearchjunkie.com/peroneal-tendonitis-in-runners/">alter the load in the peroneal tendons</a>.<br />
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<a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-68058482646710476302010-06-05T09:26:00.003+10:002010-06-05T09:32:28.937+10:00What’s up with the Weil Osteotomy?What’s up with the <a href="http://www.podiatryonline.tv/weil-osteotomy.htm">Weil Osteotomy</a>? Not doing any surgery I was not up to speed with opinions about this. First there was <a href="http://drjpdriverjowitt.wordpress.com/foot-abnormalities/the-weil-osteotomy/weil-osteotomy-2/" rel="nofollow">this blog post</a> condeming it. Then there was a point/counterpoint debate in <a href="http://www.podiatrytoday.com/is-the-weil-osteotomy-overused-by-dpms" rel="nofollow">Podiatry Today</a>, followed by a poll on the <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=49616">Weil Osteotomy</a> on Podiatry Arena.Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.comtag:blogger.com,1999:blog-5904076.post-68900524406180178462010-04-06T14:13:00.002+10:002020-06-25T11:26:47.720+10:00Severs DiseaseA tight calf muscle has often been mentioned as a factor in Sever's Disease or Calcaneal apophysitis in kids. When you examine a lot of these, the calf muscles feel tight. But how do we know that this has anything to do with the cause of this problem? ...we don't. There are 3 explanations:<br />
1. The calf muscles are tight and they were a cause of the problem<br />
2. The calf muscles are tight, but the tightness came on after the Sever's developed due to, perhaps, some gait alteration<br />
3. The calf muscles are not tight, but appear tight on examination due to a splinting like action due to the pain.<br />
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Which of these is the answer? ...I have no idea.<br />
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For the latest see Podiatry Arena on <a href="https://podiatryarena.com/index.php?articles/severs-disease-treatment-from-the-parents-perspective.3/">Severs Disease</a>; or this video on <a href="http://podchatlive.com/episode-28-alicia-james-calcaneal-apophysits-severs-disease/">calcaneal apophysitis on PodChatLive</a>.<br />
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If you have Severs disease then it all comes down to managing the loads via modficiation of the activity and perhaps using a <a href="https://www.footstore.com.au/severs-disease-heel-pad/">cushioned heel pad</a>.<br />
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<a href="http://podiatric.blogspot.com/">Back to home page</a>Craighttp://www.blogger.com/profile/11191146938355087780noreply@blogger.com