Current Pedorthics July-August 2015 VOL 47 Issue 3

IPsres-uSyemp2o0si1um5

Parallel Equations

Applied Foot And Ankle Biomechanics

Vol. 47, Issue 3 | July/August 2015 | www.pedorthics.org
Vol. 47, Issue 1 | March/April 2015 | www.pedorthics.org

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Pedorthics
current
Editorial Staff COVER STORY
Cover Photo: @shutterstock.com/Yuri_Arcurs
EXECUTIVE EDITOR 16 | Parallel Equations
Tara A. Mina
ASSOCIATE EDITORS By Pam Haig, C.Ped.
Rob Sobel and Tammy Daulton
ART DIRECTOR Working in the team
Kristopher P. Gramza environment can be challenging
DESIGN/PRODUCTION unless one understands
KPG DESIGN and embraces the various
viewpoints and theories that
Advertising & Sales Staff other members of the team
operate under. Pam gives us
CURRENT PEDORTHICS a preview of her upcoming
Tracey Aaron, Arlington Publishing lecture at the APMA/PFA joint
MEETINGS AND CONVENTIONS MANAGER education conference to be
Christopher Costantini held July 23rd through 25th
EXHIBIT AND SPONSORSHIP SALES MANAGER 2015 in Orlando Florida.
Jay Zaffater

Headquarters Staff

MARKETING AND COMMUNICATIONS MANAGER
Christopher Costantini
MEMBERSHIP AND CONTINUING EDUCATION
Althea Powell Chandler and Christopher Costantini
GOVERNMENT RELATIONS DIRECTOR
Dean Mason
LEGAL COUNSEL
Allan J. Weiner, Kelley Drye & Warren, LLP

Current Pedorthics (ISSN 1552-8111) is published bimonthly
by the Pedorthic Footcare Association (PFA), 1610 East
Forsyth St. Suite D, Americus, GA 31709. Telephone:
(229)389-3440 Fax: (888)563-0945, Website: www.pedorthics.
org, Email: [email protected]. Copyright© 2015,
PFA. All rights reserved. No part of this publication may be
reproduced in any manner without written permission.
Letters to the Editor and other unsolicited material are
assumed intended for publication and are subject to editing.
Articles in Current Pedorthics do not necessarily reflect the
opinion of PFA, its board of directors or its employees. Authors
are responsible for the validity of their content and credentials.
Current Pedorthics’ use of trademarked names is done in an
editorial fashion intended to benefit the trademark owner, with
no intention of trademark infringement.
If you have any questions regarding display advertising or
classified ads, please contact Tracey Aaron at (815) 356-8344
or email [email protected]. Please send all product and
industry-related press releases to [email protected].

2 Pedorthic Footcare Association www.pedorthics.org

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Greetings APMA Annual Scientific
Meeting Exhibitors & Attendees!

The APMA room block at the
host hotel, Marriott Orlando
World Center, is sold-out. Here is
information for the overflow hotel,
which is about a 5-minute ride from
the host hotel.

Courtyard Orlando Lake Buena
Vista in the Marriott Village

8623 Vineland Avenue
Orlando, FL 32821
407-938-9001

(Do not use this number for reservations;
use the link below.)

Reservations: https://resweb.passkey.
com/Resweb.do?mode=welcome_
ei_new&eventID=13949429

ALERT: No other entity is authorized by APMA,
Passkey, or Courtyard Orlando Lake Buena Vista
in the Marriott Village to provide assistance
with hotel accommodations. No one from
APMA, Passkey or the Courtyard Orlando Lake
Buena Vista in the Marriott Village will initiate
communication with you regarding your housing

arrangements.

As usual, the room block is limited.
If you are still in need of housing,
you should make your arrangements
immediately. Don't miss out on this
event! Online registration for APMA
2015 Annual Scientific Meeting ends
July 9th! - REGISTER NOW!

current Pedorthics July/August 2015

Volume 47, Issue 3

Features

20 | Why do cowgirls wear high heel boots? 38 | Leveraging Pedorthics to Increase Sales

By Dr. Steven King, DPM by Chris Stanley, C.Ped
Current and future uses of simple machines in our gait Two examples that demonstrate the bottom line pumping power
systems. A primer on advanced-composite spring-lever simple of pedorthics when it is integrated into traditional retail. Read a
machine orthoses to reduce impact of disease and increase little about what Chris and Ben will discuss in their program on
mobility. this subject at this year’s Symposium later in Orlando.

26 | Children and their Feet 43 | Fleet Feet Sports

By Patricia Pande, PT, C.Ped by Berry Craig
Pat gives us a look at the newest trends and research Berry Craig treats us to a look at a Fleet Feet Sports franchise
regarding early interventions for children with symptomatic in Murfreesboro, Tennessee. Read about how the owner has
flat feet. The value of a comprehensive multidisciplinary team integrated pedorthics into an athletic shoe store.
approach is discussed.
44 | Pedorthist makes ‘practice-calls’
30 | The Ten Commandments of Shoe
to Carlisle office for better patient
Fitting outcomes

by Art Oligeri, C.Ped by Susan Kramer
Do you remember your Ten Commandments from school? We all know what house-calls are, but Practice-calls? Take a look
Pedorthic school, that is. Arthur offers pearls from his 40 years at this unique approach to the pedorthist-podiatrist treatment
of shoefitting experience. team being pioneered by Randy Stevens.

34 | Compression Therapy 46 | Understanding Equinus

By Teresa Alpert, Orthotist, C.Ped, PMAC Dr. Patrick DeHeer, DPM
Can dispensing compression hosiery reduce financial pressure on An in-depth look at equinus—anatomy, research and treatment.
you while aiding your customers? Teresa gives us a primer on the
what and why of providing compression hosiery.

2015 The National / Support this years Convention Vendors

Departments 10 Featured Contributiors 50 Marketplace
14 PFA News 51 Products & Services
6 From the President
8 From the Editor

Current Pedorthics July/August 2015 5

PF RR EO SMIDET NH TE Rob Sobel, C. Ped.,
PFA President
[email protected]

2015 PEDORTHIC EDUCATIONAL PROGRAM / PFA SPEAKER ABOUT PFA

When you read this we will be only a few weeks from our joint conference/ The Pedorthic Footcare Association
symposium with the APMA. We are very excited about this as well as the (PFA), founded in 1958, is the not-for-
multitude of other changes we have gone through within the past few months. profit professional association which
Running the PFA is always a delicate dance, trying to balance getting the represents the interests of the certified
important information out to our members without driving them crazy with and/or licensed pedorthist and
daily emails, letters, and phone calls. However, there are things that need to be supports the pedorthic profession
conveyed in a timely fashion for the benefit of those we serve. We hope we have at large.
struck that balance.
It would be amazing if every member was able to attend every symposium. Through PFA’s efforts, pedorthics –
By the same token we understand that is not possible for a variety of reasons; the management and treatment of
financial, schedule conflicts, family or business needs, etc. My experience is that conditions of the foot, ankle, and lower
if you attend the symposium, you will walk out of there with at least 6-12 things extremities requiring fitting,
that you can apply to your professional work making you a better pedorthist--if fabricating, and adjusting of pedorthic
not, you were not paying attention. Some of these benefits are from the amazing devices – is a well-established allied
lectures, some from the chance meetings with strangers, people familiar to you health profession which makes an
during conversations in between lectures, in the exhibit hall, or at a meal. The invaluable contribution to public
potential for this year’s symposium is even greater since we will be holding it in health.
the same place and time as the APMA (American Podiatric Medical Association)
National, an organization that numerically dwarfs our noble organization, but MISSION
at the same time depends on our expertise, whether in their own practices or
outside of their practices. This is not the symposium to miss! PFA’s mission is to enhance the
Podiatry and Pedorthics is a good match. Many podiatric groups employ one or effectiveness and efficiency of
more pedorthists because they see the value in having a pedorthist(s) on staff. credentialed providers of lower
Others find it a better match to utilize the pedorthist down the road. Yes, the extremity pedorthic modalities through
pedorthist and podiatrist may be competitors in certain circumstances, but there education; increase the demand for
is plenty of common ground for both to flourish and combine forces to have services through marketing; and
better patient outcomes, as well as lend a helping hand in the battles against promote the right to practice through
government regulatory issues that make little to no sense. As this historic event government affairs activities.
edges closer, it is our hope that you will be filled with anticipation and a sense
Pedorthic Footcare Association
6 Pedorthic Footcare Association www.pedorthics.org 1610 East Forsyth St. Suite D
Americus, GA 31709
phone (229) 389-3440
fax (888) 563-0945

email [email protected]
website www.pedorthics.org

facebook
Pedorthic Footcare Association
twitter
@pfapedorthics
linkedIn
Pedorthic Footcare Association
google+
Pedorthic Footcare Association
o & p social
Pedorthic Footcare Association

of pride as we embark on a road where familiarity and processing, to discounted shipping, and insurances. We
understanding will benefit both pedorthists and podiatrists recently signed on with a company to give you insurance at
alike. a discounted rate for all of your insurance needs, whether
For those who are fearful of what this symposium means it is health insurance for your family (including your pet),
for Pedorthics, let me make this clear. We are still the or your business.
PFA and remain the entity for Pedorthists. PFA has gone PFA is growing stronger, and we are working to make
through some rough years and financially we were in a bad Pedorthics a stronger more vibrant part of the healthcare
way for at least the last six years and probably more. We system. As always PFA is here to serve you and make
were deeply in debt ($100,000), and our future uncertain, your life as a Pedorthist a little easier. We hope as many
but by the end of 2015, PFA will be “in the black” for the of you who can, will be coming down to Orlando for
first time since I, and most of the current Board members the symposium later this month, and hope all of you
were on the Board of Directors. We have changed the will attend the annual PFA Membership Meeting at the
way we have done things, and it is working to make the symposium. We have been doing great things and would
organization stronger and serve you better. love for you to be a part of it!
How many of you know all of the benefits of being a PFA
member? When was the last time you really examined Rob Sobel
the benefits on the website? Have you sent out an
email or called PFA to ask a question about educational PFA President
opportunities, asked a technical question about adhesives, Note: Be sure to check and see if there is a the chart after
materials, AFOs, foot orthoses, advertising, Medicare each article. In this issue, if an article's author is a speaker
billing, or a bill making its way through our government at the National, this following chart will give all the details on
that may affect your business? These are questions what they are speaking about as well as where and when.
we handle, and are among the many benefits at your Hope to see you there in Orlando!
fingertips. Just ask--we are here for you. You will find
in this issue a host of other benefits from credit card

2015 PEDORTHIC EDUCATIONAL PROGRAM / PFA SPEAKER

DATE: MEETING ROOM: TIME:
SATURDAY JULY 25TH, 2015
COURSE TITLE: CRYSTAL BALLROOM C 1:00 P.M.–2:00 P.M.
PFA Annual Membership Meeting DETAILED PRESENTATION DESCRIPTION: SPEAKER:

All current PFA Members in good standind are invited to join your PFA Board Rob Sobel. PFA President
for the Annual Membership Meeting. Discussions will involve the current status
of PFA and plans for future development in all areas.

Current Pedorthics July/August 2015 7

EDITORF R O M T H E Tara Mina
CP Executive Editor
[email protected]

Are You Following
PFA On Our Social
Media Networks?

Connect NOW with
PFA and Others in the

Pedorthics Community!

This year, along with its organization, Current Pedorthics Magazine experienced Don’t miss out on the latest
a bit of growth. We had our share of budget cuts and management adjustments. announcements and current
All of which lead us to producing an online publication. topics we’re discussing on social
Current Pedorthics Magazine has always been a great added member benefit. media 24/7.
At the risk of losing the publication, it took a team of volunteers to pick up the See what the PFA is doing today
pieces. Saving the publication couldn't have happened without the support of on Facebook, Twitter, LinkedIn,
the publishing committee, several respected foot care professionals who wrote google+ and O and P Social for
articles, our advertisers and dedicated readers. the latest industry and practice
Together, we put our efforts into reviving the magazine & all it stands for in buzz!
the field of Pedorthics. 'C.P. Magazine' is now interactive, downloadable & Join us by clicking on any icon
printable. Archives are accessible on the PFA website and can be shared in an below!
instant.
We are thankful for everyone who contributed to the 2015 issues of Current O&P
Pedorthics Magazine. Keep up the good work!

Tara Mina

Executive Editor

8 Pedorthic Footcare Association www.pedorthics.org

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FEATURED CONTRIBUTORS

IN THIS ISSUE OF CURRENT PEDORTHICS
Teresa Alpert, C.Ped, L.Ped

Teresa Alpert, Certified Orthotist, Pedorthist and P.M.A.C with a concentration in
biomechanics and lower limb modalities she works directly with Dr. Bradley Lamm, DPM, at
the International Limb Lengthening Center at the Rubin Institute for Advanced Orthopedics.
Acknowledged industry leader, consultant, educator and speaker.

Berry Craig

Berry Craig, a freelance writer in Mayfield, Ky., has written on pedorthics for many years for
O&P News, Current Pedorthics and other media publications.

Patrick DeHeer, DPM

Dr. Patrick A. DeHeer, DPM is a member of the American Podiatric Medical Association
(APMA), and a fellow of American Society of Podiatric Surgeons (ASPS) and American
Collage of Foot and Ankle Surgeons (ACFAS), Diplomat of American Board of Foot & Ankle
Surgery certified in foot surgery and reconstructive foot and ankle surgery.

Dr. DeHeer is in private practice in Central Indiana, he also serves as the team podiatrist
for the Indiana Pacers and Indiana Fever. He is on the Editorial Board of Podiatry Today and a
regular blogger for Podiatry Today, Guest Editor for Clinics in Podiatric Medicine and Surgery
Pediatric Edition 2013, Guest Editor for Foot and Ankle Quarterly Clubfoot Edition 2014. Dr.
DeHeer has had several published articles and is an international and national lecturer.
He is the inventor of the EQ/IQ brace and several other medical inventions. He is the
President and Founder of Step-By-Step Haiti and a medical missionary with over 25 trips
worldwide. Dr. DeHeer won the 2014 International Federation of Podiatrist Humanitarian
Award and the 2011 APMA Humanitarian of the Year Award.

Dr. DeHeer serves as a Trustee on the APMA Board of Trustees. Dr. DeHeer is past
President of the Indiana Podiatric Medical Association and serves as continuing education
chairperson. Dr. DeHeer has served on several committees for the APMA and as a delegate to
the APMA House of Delegates. Dr. DeHeer has served on the APMA PAC Board of Directors,
the American Society of Podiatric Surgeons Board of Directors and the American College of
Foot and Ankle Pediatrics Board of Directors.

Pam Haig, C.Ped, BOCPed

Serving the industry with over four decades of clinical experience, specializing in advanced
orthotic and AFO posting for chronic and unresolved pathologies. Using her career resources,
she is past co-owner of OSI Labs; a nationally recognized podiatric manufacturing lab, the
visionary founder of the first Pedorthic medical clinic in Indianapolis and The Robert M.
Palmer, M.D., Institute Of Biomechanics - a Not-For-Profit Pedorthic Biomechanics School.

Donating her expertise; has previously served on OSU-Okmulgee’s Pedorthic Advisory
Board, past Treasurer to The Alliance of Educators and previous consultant to many national
and international footcare and footwear companies; currently Therafit Shoes and ING Source
Inc., makers of OrthoSleeve, OBrands and the Foot Gym.
10 Pedorthic Footcare Association www.pedorthics.org

Steven King, DPM, C.Ped

Steven King, DPM, CPed, is a practicing Podiatrist and Pedorthist in Maui, Hawaii, and the
sole podiatric voting member of the American Society of Testing Materials F13 Footwear
Safety and E54 Homeland Security Applications and Body Armor committees. Reach him at
[email protected].

Susan G. Kramer

Susan G. Kramer has been with the Pennsylvania Podiatric Medical Association and the
Goldfarb Foundation for 15 years as Director of Communications. Susan wears many hats in
this position: Internet/Social Media Content Manager, Graphic Designer, Editor, Proofreader,
Website Administrator, Printer Liaison, and Writer. She has had articles published in the
APMA News and Podiatry Management magazines and is an avid photographer and fiction
writer in her spare time.

Patricia Pande, PT, C.Ped

Patricia Pande, founder of FootCentric, is a Physical Therapist, Pedorthist and Strength and
Conditioning Specialist who retired from her position as a foot and pedorthic expert at the
University of North Carolina Physical Therapy Faculty Clinic and Kinetic Institute of Physical
Therapy. For over thirty five years, Patricia has educated professionals on topics related to
sports medicine, fitness training, biomechanics and injury prevention. She is the owner of
Foot Centric LLC a continuing education company devoted to educating professionals in foot
treatment and conservative care.

Patricia holds a Bachelors Degree in Physical Therapy and a Masters Degree in Physical
Therapy, both from the University of Western Ontario in Canada. In addition, she has
completed Doctorate-level courses in Ergonomics and Public Health at the University of
Michigan.

Chris Stanely, C.Ped

Chris Stanley is the Director of Pedorthic Education for Lamey Wellehan Shoes, a Maine-
based independent retailer. Chris is a longtime footwear retailer, having entered the industry
in 1987 with a major running specialty company. Lamey Wellehan recruited him a few years
later to be the Athletic Department Manager of their newly expanded flagship store. Chris has
continued his career there serving as Merchandiser, Store Manager and Wholesale Manager.

In 2002 he became a Certified Pedorthist. As part of his newest position, Chris has created
educational programs for Lamey Wellehan's six retail stores. In addition, he has worked with
safety managers of local manufacturers, event managers of nursing homes and others groups
in promoting foot health. At home he enjoys spending his free time with his wife of 29 years,
their two daughters and three grandchildren.

Current Pedorthics July/August 2015 11

Are You Looking To Earn CEU/CEP Credits to Help Keep
Your Professional Certification Current?
Then Consider Writing an Article for Current Pedorthics!

Did you know pedorthic and health care practitioners, who submit an article
or research abstract/research paper, are eligible to earn one or more CEU/
CEP Credits towards keeping their professional certification current when
accepted and published in our magazine?

The Pedorthic Footcare Association (PFA) offers our members and other
affiliated health care professionals an additional way to earn their mandatory
Continuing Education Units/Continuing Education Points. After successful
publication of your submitted article or abstract/research paper, our staff
or you can report your publication to many of the numerous professional
health associations and certification/accreditation organizations that recognize
publication as a means to earn your certification credits.*

For more details, contact Current Pedorthics magazine at (229) 389-3440
or by email at [email protected] for additional upcoming special
interest topics, guidelines and other ideas you may want to discuss as topic
ideas beneficial to health care, patient care and all areas of interest in the
pedorthics practice and other associated industries.

*Credit value is determined by the certification/accreditation organization, not PFA.

ADVERTISERINDEX The advertiser index is published for the readers’ convenience. Click on the
hyperlink to take you to the advertiser's website. If you have any questions
about advertising, please contact our advertising sales representative Tracey
Aaron at: (815) 356-8344 or email: [email protected].

ADVERTISER PAGE WEBSITE

American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc. ICF http://www.abcop.org

Atrex pg 1, pg 50, BC http://www.aetrex.com

Amfit pg 9 http://www.amfit.com
Blintz Company pg 13 http://www.bintzco.com
KLM pg 19 http://www.klmlabs.com
mediUSA pg 3 http://mediusa.com
New Balance pg 44 http://www.newbalance.com
New Step pg 29 http://www.newsteporthotics.com
Norolo24, LLC, Quadrastep pg 49 http://www.thequadrastepsystem.com
Orthofeet pg 15 http://orthofeet.com/
PW Minor pg 42 https://www.pwminor.com/

12 Pedorthic Footcare Association www.pedorthics.org

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PFANEWS News and Happenings from the Pedorthic Footcare Association

PFA’s 56th Annual Symposium For more information, watch for our email blasts, our website and
& Exhibition with APMA's 2015 Current Pedorthics magazine for more information and details as
Annual Scientific Meeting in In they develop.
Orlando (Reserve your space now! See ad this issue and download the APMA/
PFA App for your phone or tablet! See ad below for all the latest as
The American Podiatric Medical Association (APMA) and the the event nears!)
Pedorthic Footcare Association (PFA) are pleased to announce
a new agreement that will enhance your annual symposium Current Pedorthics Digital
and exhibition experience. In 2015, PFA will hold its Annual
Symposium in conjunction with the APMA Annual Scientific We hope you are enjoying the new look and features of Current
Meeting, July 23-26 in Orlando, FL. APMA's Annual Scientific Pedorthics! Here are some exciting new features that we are
Meeting (The National) is the nation's premier foot and ankle exploring and working hard to bring to you;
meeting, attracting podiatric physicians, assistants, and other health- Back Issues: Back issues for the past several years will soon be
care professionals from across the country and around the world. As available online for you to peruse at your leisure! These will be in
you already know, the PFA Symposium is the largest event in the PDF format for easy viewing on most devices. Rediscover gems in
world solely dedicated to the practice of pedorthics. past issues.
Co-locating these two conferences together maximizes the learning Interactivity: The digital format allows for exciting interactive
and networking opportunities available to our symposium attendees. content that just isn't an option in print format. Features
In addition to the traditional pedorthic education track, attendees include hyperlinked advertising that will take you directly to the
will have access to all podiatric education sessions allowing manufacturer or distributor's website and full interactivity featuring
pedorthists to engage in more in-depth lower extremity learning. in-article slide shows and videos!
This longer more extensive program will also allow attendees Print on demand: For those of you that would like to be able to have
to earn more CEUs. Along with the expanded educational hard copies of CP, our interactive publisher of print-on-demand
opportunities, this enhanced conference will offer a terrific services which will allow you to generate and buy hard copies of
opportunity to educate the podiatric community as to why working Current Pedorthics for distribution to your referral sources or an
with a pedorthist should be an essential part of their on-going interesting read for patients and clients in your facility.
patient care and recovery plan during treatment. Attendees can Tell a friend and keep up to date on this news and more by
look forward to the additional opportunities in socializing and checking the PFA website: www.pedorthics.org.
networking with the podiatric community, the largest referral source
for patients for pedorthists, along with offering attendees a great way
to build their practices and businesses.

14 Pedorthic Footcare Association www.pedorthics.org

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This
year’s
56th Annual
PFA Symposium
is a historical event
in pedorthic and podiatric
history. As the opening pedorthic
speaker I am honored to share my life’s
experiences in clinical trials working with both
podiatric and orthopedic surgeons.

By Pam Haig, CPed, BOCPed

Visionary Founder of The Robert
M. Palmer, MD, Institute Of
Biomechanics, Inc.

16 Pedorthic Footcare Association www.pedorthics.org

2015 PEDORTHIC EDUCATIONAL PROGRAM / PFA SPEAKER

rate this:

PPaarraalllleell EEqquuaattioionnss

The title of this article (and lecture) is Parallel clinical experiences. We will explore and review the
Equations. As we all move toward serving our ten biomechanical concepts chosen to give insight
patients, Robert Palmer, M.D. (orthopedic surgeon) into the fascinating world of podiatric biomechanics.
- (paraphrased) “we must respect each discipline. As we explore our pedorthic roots, Pedorthists
We are all moving parallel ideally to improve patient originally were shoe cobblers and shoe makers. We
outcomes; at any given time one discipline may then evolved into Orthopedic Shoe Technicians and
have a theory and prove their hypothesis, and then then Board Certified Pedorthists and our scope of
another discipline builds upon this knowledge or practice continues to expand.
chooses a different theory – if we continue studying In our parallel quest for serving the patients in
the literature and apply what knowledge we have our own communities, first and most importantly,
gained, we learn from one another and serve the next diagnosing begins in an open chain (non-weighted)
generation well.” analysis. From here we learn that there is some basic
Historically I will be sharing quotes by two terminology that is confusing between podiatric
internationally recognized physicians; Kevin Kirby, surgeons, orthopedic surgeons as well as orthotists
DPM and Merton Root, DPM. We recognize that and the pedorthic disciplines. Secondly, we must
podiatry is transitioning and so is pedorthics. In my recognize that the foot is a moving tripod and
own personal quest to understand both podiatric and therefore, we need to manipulate it in a method
orthopedic theory, I find a common thread with both that simulates human locomotion. Hence, in
of their quotes. Merton Root, DPM stated, “if in the locomotion, the forefoot should be in a neutral
next five years, I am unable to find the answers to position at terminal midstance (slightly abducted, yet
why my patients have (specific types) of pathologies, I moving towards resupination) to begin the locking
am going to leave the profession; it isn’t fair to charge mechanism of the midtarsal joints. An ideal position
them when I am guessing”. in treating the cause and not merely the symptom.
My lecture takes the inquiring mind through the The integrity of the human arch is required for
pearls of my podiatric manufacturing and orthopedic longevity, performance and in preventing pathologies.

Current Pedorthics July/August 2015 17

Parallel Equations

Each degree of compression matters in a foot with axis motion is a complex topic; and still a mystery
biomechanical deficits. A one millimeter fracture/ to the biomechanical sciences. But by attempting
discolocation (deviation of joint space) in the Lis to measure this range of motion, one can predict
Franc Joint Complex warrants surgery; otherwise, the force flow that the forefoot will endure and the
in time the foot will vastly require surgery, as compensatory responses to the midfoot, hindfoot and
quoted by Robert Palmer, MD (forensic expert). suprastructure and offer insight into when to upgrade
To treat complex pathologies, we must attempt the product line(s) or increase the posting at a specific
to optimally align the human foot and therefore, axis of motion.
we must recognize the expected (Newton’s Law) We acknowledge that there is controversy in the
compensatory responses to the five most common various disciplines such as: Can the osseous structure
“tripodial” planal positions or deformities in open of an adult foot be improved? If radiographs are
chain: 1) neutral forefoot, 2) forefoot varus, 3) subjective and gait analysis research is too cost
forefoot valgus, 4) plantarflexed first rays with 2-5 prohibitive, then how do prevent early stage diabetic
neutral, 5) plantarflexed first rays with 2-5 varus (and Charcot feet or posterior tibial tendon dysfunction in
recognize when specific foot types are treated the the aging.
same as others; such as a true forefoot valgus or the First we must work together as a team of practitioners;
plantarflexed first ray with 2-5 valgus; a rare foot type understanding one another’s theories and casting
in our clinical trials). aside those that are antiquated. I have heard many
The contribution of podiatric biomechanics is that it old school practitioners state that casting Rootian
offers the practitioner angles (deformities) quantified subtalar neutral “captures” the forefoot plane of
in open chain, within the forefoot plane and rearfoot deformity and doesn’t reduce or correct it. This is
plane of deformity and then uses formulas to post a gross misunderstanding of the effects of properly
the foot (induce a specific: 1) motion, 2) osseous performed intrinsic posting techniques published
position, 3) proprioception 4) muscle timing or 5) in the literature and performed in quality podiatric
joint moment). Each podiatric lab has what is known (or other) labs in the USA and abroad. Intrinsic
as “lab policy”. Regretfully, for the contribution Dr. posting to the open chain forefoot varus, applies
Root made towards quantifying forefoot and hindfoot a force to the medial column at a location chosen
pathologies, most podiatric labs have not increased from the theories that are published in podiatric
their degrees of posting to the human foot as the literature to induce the first ray to plantarflex. This
styles and widths of shoes have become healthier and is accomplished by a measurement obtained in the
less constricting over the years (excluding fashion Rootian casting technique, but more importantly, this
shoes). What was once considered the maximum casting technique is published in history and offers
degrees of posting that could be applied to a foot theoretical simulation of a hindfoot with structural
orthosis (for shoe fitting – not because the maximum integrity (neutral position on the figure 4 leg position,
amount of degrees was ever published), is antiquated non weightbearing / frontal plane position in supine
with the advances made by numerous practitioners; position) and the midtarsal joint (and arch) in an
Lundeen, Blake, Kirby, Dannenberg, Glaser, etc. optimal decompressed position and models (captures)
With the evolution towards library systems we the structural deficit. From here, the practitioner
have grown to accept that accommodating a foot choses the theory that they subscribe to such as Root,
is acceptable in the vast majority of cases we are Modified Root, Functional, Modified Functional and
presented with as practitioners; hence treating the advanced theories such as Lundeen, Blake, Kirby,
symptom and not the cause. Dannenberg, Glaser, etc in a scientific, quantifiable
But when treating chronic or unresolved pathologies, attempt to restore function and optimal anatomical
we must also recognize that the midtarsal joint alignment.

Parallel Equations

18 Pedorthic Footcare Association www.pedorthics.org