ImpressionsPosted by Diana on 1/19/04 at 13:02 (142374)
I am going for impressions this Friday and after reading some of the comments I am looking for any helpful information to prepare me for it. I take it not to have impressions taken in a standing position. Any information you can give me would be appreciated. I was debating whether to have impressions done but after reading other peoples comments I think it would be the best route to take. I am really greatful for this website, THANK YOU.
Re: ImpressionsRichard, C.Ped on 1/19/04 at 13:23 (142376)
That is correct. Never have the impression done in a standing position. I take mine with the patient seated. Others make a slipper cast with the patient lying down.
If the impression is taken while seated, make sure you do not push your foot down. Let the person taking the impression do the pushing. Also, keep your head up and do not bend over to see what is being done. Both of those cause the muscles to flex in your foot, thus not allowing a proper impression. This is why the 'do it yourself' foam boxes mail order orthosis do not work correctly.
If a foam box is used, make sure your foot does not hit the bottom of the box. This causes the heel of the cast to be flat instead of its natural shape. If your foot hits the bottom, have them do it again. Trust me on this one.
They should have two fingers on your ankle trying to find sub talor neutral. That is when they can not feel the talus bone on either side.
I hope the orthosis will be made on site. Are they shipping the impression off to be made? If so, any adjustments needed may take a while to be done.
How long did they say it would take them to have the orthotics ready? If more than two days, tell them you know a C.Ped that has them ready in one hour (meaning me...haha). If the patient can not wait for what ever reason, I almost always have them ready the next day.
See if they want you to pay up front. If filing through insurance, I only take what the co-pay will be up front. Thats me though...everyone is different.
Re: ImpressionsDiana on 1/19/04 at 14:02 (142378)
Thank you for the information. They told me that it would take 2 weeks to get the inserts made and shipped back. The doctor will do any adjustments there on site (I was told he has the tools). I have to pay 1/2 when the impressions are made and the other 1/2 when I pick them up.
He did show me how my foot is suppose to be aligned using the two finger method. I will watch closely but with my head up. Thank you again.
Re: ImpressionsDr Kiper on 1/19/04 at 18:10 (142394)
Saying that making an impression standing up 'doesn't work' is a grandiose statement. There are new technologies, new materials, new methods. Maybe it doesn't work for you.
Re: ImpressionsDr Kiper on 1/19/04 at 18:17 (142395)
To say that standing up to make an impression 'doesn't work' is a pretty grandiose statement. There are new technologies, new materials,new methods and new ideas about how to do it. Maybe it doesn't work for you, or maybe you don't know how to make it work.
When Pasteur told his colleagues to wash their hands prior to child delivery to cut down post partum infections, they ALL laughed at him.
Re: ImpressionsWendyM on 1/19/04 at 21:51 (142410)
I'm supposed to get my orthotics this week...and drat!!!...I looked down when he was pushing on my foot. Too late! I hadn't yet read that post!
My doctor is telling me that it will take a few months to see if there is any positive results with these orthotics. Does that sound right? Can anyone tell me how will I know if I need them changed, or if this style is not for me?
I thought I had all the pain there could possibly be with my PF and now I have a throbbing arch on the top! Have any of you ever had pain at the top of your arch? This is new to me, and I'm wondering what the cause is. I only ever wear one pair of shoes, these New Balance walkers with temporary inserts. /:) ~WendyM
Re: ImpressionsDr Kiper on 1/20/04 at 06:55 (142431)
Wait and see what happens. However, as to how long it takes to see positive results, if you're lucky you may feel them very quickly, but it's not unusual for it to take several months too.
The pain on top of your arch comes from the jamming of the joint as your foot (arch) pronates (spreads down). A proper fitting orthotic should relieve this if there isn't already any extensive damage to the area.
Re: ImpressionsLarry T on 1/20/04 at 15:47 (142464)
Dr Kiper, how did you come to the conclusion that her pain was from over pronation?
Re: ImpressionsDr Kiper on 1/20/04 at 19:18 (142488)
Over 30 years of experience.
Re: ImpressionsLarry T on 1/20/04 at 20:08 (142493)
Wow now THAT is GRANDIOSE indeed!!!! very assumptive on your part.
Re: ImpressionsWendyM on 1/20/04 at 20:58 (142494)
How would someone know if there is extensive damage to this arch area? This is such tricky business. All my doctor keeps talking about is this surgery he seems to have success with. I'm so sick of hearing about it. I've just asked my PCP if I might get a second referral to another Dr. I wouldn't have gotten these orthotics if I hadn't pushed for them. I like to think surgery is the last resort, especially after all I've read here.
Re: ImpressionsLarry T on 1/20/04 at 21:49 (142495)
What if she doesnt pronate but supinates? What if she had an old lis franc that was missed?
Re: ImpressionsJulie on 1/21/04 at 02:22 (142505)
Dr Kiper did not assume that Wendy over-pronates. He commented on the pain she gets as her foot pronates. I believe everyone pronates. Pronation is the natural rolling-in movement of the foot after the heel strikes.
Re: ImpressionsDr Kiper on 1/21/04 at 07:56 (142521)
If she had a post Lisfranc, she would have indicated so. Anyone with that condition would have been totally knowledgeable about its name, the history of the trauma it took to produce it. The ordeal to go through the healing of it.
BUT, assume for a moment you are correct. What about her mechanics could possibly cause her to supinate rather than pronate????
Re: ImpressionsRichard, C.Ped on 1/21/04 at 08:23 (142524)
We are not laughing at your methods, sir. A person can not obtain a proper impresion in a seated position when taken by themselves because they can not properly push down into the foam. On the other hand, if they stand in the box by themselves, most often you will get false metatarsal arching because they push with the toes. Are your impressions made by the customer at home then sent to you??
Seated or lying down works best (with someone else taking the impression). Standing does not work as well. Flat is not functional. Standing up is flatter even at sub-talor neutral. By the way, I know what works and I know what does not. Thank you very much for your concern though.
Re: ImpressionsLarry T on 1/21/04 at 08:35 (142525)
Actually lis francs are missed many many times. The ER GP usually says you sprined/strained it but nothing is broke. Put ice on take some advil and stay off it and you will be fine. A simple search can reveal that injury is very often missed.
MY point was not that she had one but that could be one of the many causative factors for her symptoms. I just thought your immediate claim that her problem was 'pronation' was a bit assumptive imho. Unless she posted more information somewhere else, that was not very much info to guess on
Re: ImpressionsLarry T on 1/21/04 at 08:41 (142527)
Thanks for your view but I respectfully disagree not everyone over pronates and not all pain is caused from that
Re: ImpressionsJulie on 1/21/04 at 09:11 (142532)
Re-read my post. I did not say that 'everyone over-pronates' (any more than Dr Kiper did). Nor did I say anything about pain.
Re: ImpressionsLarry T on 1/21/04 at 09:36 (142533)
Dr. Kiper did not assume that Wendy over-pronates. He commented on the pain she gets as her foot pronates. I believe everyone pronates. Pronation is the natural rolling-in movement of the foot after the heel strikes.
I did re-read your post above. You stated 'I believe everyone pronates'
My point is eveyone does not pronate, some under pronate some not at all. That comment is just like saying everyone supinates, and that is also vague and incorrect.
AGAIN if she posted a more detailed history on another thread that I missed, I apologize. If her post above is all information she has given then you are both wrong to assume that 'pronation' is the cause of her pain.
Re: Impressions P.S.Larry T on 1/21/04 at 09:39 (142534)
Another consideration, she stated the pain was 'on top of her arch'. Many patients will actually refer to the instep as the arch. Another reason your assumption could be wrong
Re: ImpressionsLarry T on 1/21/04 at 09:42 (142535)
Making a squish box mold at home is not very accurate. Other than what Richard said you can also get an elongated foot,an artificial forefoot supinatis and wider margins in the reslting plaster cast to name a few.
Re: Impressions P.S.Julie on 1/21/04 at 16:19 (142554)
Re: ImpressionsDr Kiper on 1/21/04 at 16:48 (142561)
You have inundated me with remarks here that I will address. I am going to explain my viewpoint, take it or leave it, but I don't have time to do this.
As for Lisfrancs injuries being missed 'many many times [1/21/04 at 08:35] a study was done of over 82,000 fractures [several years back] and only 14 or 16 were Lisfrancs. Assuming they missed 10% of those diagnosis, well you do the math. I don't think 'many many times is reasonable!
Injuries such as we see here at HEELSPURS are ALMOST ALL secondary to 'overpronation [similar pain can be caused by other physiologic and organic problems], how do I know this, because the type of injuries are cumulative, from the repetitive action of the foot with every step. I make the analogy to my patients that for every decade of life, they are like a car with 100,000 miles. After a few hundred thousand miles, no one should be surprised that something that never was before, now is.
If you want to talk about the odd pain from other pathological sources, you could list them on the head of a pin [maybe a large pin]. Probably 85% of each medical Specialty sees the same thing day in day out [of their specialty].
For me to 'assume a pronation/overpronation injury is an educated guess based on experience.
Your other comment at [9:39] was that 'on top of her arch'. Many patients will actually refer to the instep as the arch.
That is EXACTLY CORRECT, hence my deduction was that, that pain was at the 1st metatarsal-1st cuneiform articulation. This is where we see exostosis (spur formation) in accordance with 'Wolfe's Law . This is an pronation/overpronation result.
Now as to your post at [9:36], your comment My point is eveyone does not pronate, some under pronate some not at all. That comment is just like saying everyone supinates, and that is also vague and incorrect
Let me explain, that this common confusion comes from the fact that people just don't understand the terms and how to apply them:
Pronation and supination are motions. These are complex motions that take place in 3 directions simultaneously.
Pronator and supinator are classifications, which are positional relationships of the front of the foot to the heel.
Supinators are aka 'underpronators -this does NOT mean that they DON'T pronate, it means they pronate 'LESS than a pronator.
Now let's get to the tough stuff.
Overpronation [in my humble opinion] is the total range of motion available within the joint BEYOND the 'optimal position (you call this 'neutral position , that's too rigid for me). The foot pronates to the point of optimal/neutral, as it goes beyond this point, it OVERpronates in order to absorb shock. Every foot does this whether you are a supinator or a pronator. The difference is that the supinator has a shorter range of motion available to the point where it OVERpronates, hence the term 'underpronator . This is why we see identical biomechanical injuries in pronators and supinators.
Let's take one more term 'hyperpronation this is what we see in physical activity [especially running] where the foot overpronates and with the excessive forces stretches just a little bit further or rather ‘hyperpronates .
As far as I'm concerned both pronation and overpronation are 'normal , because this is how we were designed to absorb shock. But it is the repetition that eventually produces the injury.
So, now let me make the controversial statement, that in my opinion every human foot on the face of the earth OVERpronates [this includes coalitions, not the specific joint itself, but the adjacent joints not involved in the coalition] with perhaps one exception, an inherited genetic hand and foot anomaly called 'ectrodactyly . I will be able to determine in a couple of weeks if this is true or not, because I have been asked to see a patient with this disorder.
If there is any other condition other than the stump of an amputation, please enlighten me.
Lastly your reference to the 'squish box . Anyone familiar with this knows that it is a box with two sides filled with a very soft, crushable foam. The idea is to have the patient sit down and guide their foot to a neutral position. The consensus is that this doesn't work. Well, maybe in some other practitioners hands it does, I don't know what they might be doing different that is successful. Personally, I don't do it that way because I don't trust it either. That's why my boxes are designed with a dual density foam that I've developed for the very purpose of capturing both the impression AND the position of the foot, such that the patient can do it themselves. And they do it standing so that I can capture their normal weight-bearing position, just like the way they walk. After all an orthotic has to match the way the patient walks and not just the shape of their foot.
Before you jump on me, let me tell you that I have over 30 different levels of dual density foams, based on the size of the foot and weight of the patient. What I do thereafter is proprietary.
I hope this has been of some help to someone. I'm not trying to sell you, convince you or teach you. This is what I do.
One more thing, OTC orthotics are decent products, many have had
Reasonable and varying levels of success. And that is because anything that minimizes overpronation is helpful. The more precise the fit, to the way the foot walks (to the satisfaction of the muscles and nerve senses)the better and faster it works and the better and longer it will hold you over time.
Re: ImpressionsDr Kiper on 1/21/04 at 17:05 (142566)
Before you do any surgery, try everything and anything. Even if someone wants to sell you a magical potion, as long as it's guaranteed your money back, try it!
Re: ImpressionsDr Kiper on 1/21/04 at 17:06 (142567)
Please see my unfortunately long post to Larry T.
Re: Impressionswendyn on 1/21/04 at 20:00 (142578)
That was a really interesting post Dr Kiper!! Even though you weren't trying to teach, I think I still learned a lot.
Re: ImpressionsDr. Zuckerman on 1/21/04 at 20:42 (142587)
Please explain how you conclude that everyone on this earth OVER pronates?
Re: ImpressionsDr Kiper on 1/22/04 at 06:43 (142613)
Picky, picky. picky. All right, let me be clear;
The person must be alive
Must be ambulatory.
Must have at least one foot.
Re: ImpressionsDr. Zuckerman on 1/22/04 at 06:57 (142614)
I was serious. I don't believe that every one on earth has excesssive pronation or overpronates. Please help us out
Re: ImpressionsDr. Zuckerman on 1/22/04 at 06:58 (142615)
Oh I was talking about people being alive, and having two feet
Re: ImpressionsDr Kiper on 1/22/04 at 09:40 (142623)
Better yet, you explain to me who does overpronate and who doesn't. Enlighten me.
Re: ImpressionsLarry T on 1/22/04 at 09:45 (142625)
My reference to lis franc fx was not how many there are relative to percentage of fractures seen. My point was MANY actual lis franc fractures ARE missed or not properly diagnosed until much later. Many times after they have seen 2 or 3 other practitioners.
Most are from auto accident, work injury or football. The reason I made that reference was not to say she had a lis franc, but that pain in that region of her foot could be any number of things, not just 'pronation'.
I do relaize that pronation and supination are 3-d motions, for the sake of simplicity on this site it can be used as a term to define the posture or function of a foot. Your assertion that 'every human foot on the earth overpronates' is a rather broad statement.
What percentage of the population would you qualify as supinators or under-pronators if you will? I would like you to give me a rough estimate of your population, is it 10-90 60-40 or what?
Re: ImpressionsLarry T on 1/22/04 at 09:50 (142627)
I would respectfully suggest that you start looking for some zebras on your horse farm..............they are there, your just not counting them
Re: ImpressionsRichard, C.Ped on 1/22/04 at 14:20 (142646)
I have to ask. If you 'capture their normal weight bearing position, just like the way they walk', how can it really benefit the patient? If you have a pes planus patient suffering from plantar fasciitis and they stand to take an impression, that is exactly what you get....a flat foot impression.
There is a local company here that does just that. Guess what I get all the time? Prescriptions to add arch fill to what they did. I have also started to get their patients because the doctors are figuring out that you can not take an impression correctly this way. If this is done, you can not post the orthosis correctly for fore foot varus or any other contributing factors to their condition.
Re: ImpressionsDr Kiper on 1/23/04 at 09:25 (142702)
I have no zebras on my horse farm. I realize that your thinking as anybody who disagrees with me is based on the available literature, and I know what it says. I studied under Root, Weed and Sgarlatto.
I think the biggest difference is that my thinking is outside the box.
I'm not going to convince you now, only time will tell.
Re: ImpressionsDr Kiper on 1/23/04 at 09:28 (142703)
For 'simplicity's sake I went with the odds that her pain was a pronation/overpronation injury. Using Lisfrancs as an example is in my opinion a poor choice. Her history was brief. She had pain on top of her foot. Chances are high if she had been hurt at work or in a car accident severe enough to CAUSE THIS TYPE of injury in the foot, she would probably have related some more information. I am aware that patients can be poor historians, but if you'd like to take it further why don't you ask her. Besides, without looking back chances are, I said 'is probably a pronation injury .
I don't agree in using the terms improperly for simplicity's sake. This is the very reason, there is so much confusion. The civilians want to understand what is correct, so that they can make the best decisions based on that information.
As for a percentage of sup/pro, I will tell you categorically, that supinators are in the majority. My best scientific guess based on the numbers of people at marathons and triathlons over the last several years we have examined with a ground reactive force system from Tekscan (Matscan and Footscan), I would say that at least 70% maybe 80% or more are supinators.
Thank you for your interest.
Re: ImpressionsDr Kiper on 1/23/04 at 09:33 (142704)
Your getting me into proprietary information now. While it may not satisfy your scientific interest, go to my web site, drkiper.com
and on the left is an index of content. Click on 'talk to patients'.
From there you can talk to several patients (some international) and ask their results or comparisons about past treatment with traditional orthotics. They've all had one or maore pairs.
By the way, these people are purely voluntary and agreed they will receive no perks or special treatment other than my thanks.
Re: ImpressionsLarry T on 1/23/04 at 10:51 (142716)
So I guess you cant answer the question I had about what your ratio of pronators to supinators is? If you dont want to address mine then maybe you can answer the question Dr. Z asked?
I know you are busy but it would only take a single sentence
Re: ImpressionsRichard, C.Ped on 1/23/04 at 11:12 (142718)
Whatever. We will agree to disagree then. This all started with a pompus response to my answer to a posters question. I have never done that with your posts so I expect the same respect to mine.
Re: ImpressionsDr Kiper on 1/23/04 at 11:29 (142723)
I'm not sure if you read my response to this and Dr Z in my posted reply on 1/21 at 16:49. I believe this post answers absolutely all that you've asked.
I believe I've answered your questions, but unfortunately not to your satisfaction. This I can't help.
Frankly, this message board I thought is really for the patient. This is not the forum for my explaining my opinions to you.
On occaision I do look at this board and when I see a post by a patient I try to offer another perspective about that post. I hope it gives that patient a chance to think about something new and sometimes different than the standard information that is provided by the professionals who post here.
My intent is as yours, to help the patient. My orthotic is different, my thinking is different. When a patient comes to me (I hardly ever have a patient that comes to me other than through referral, or the internet that hasn't tried most everything else and failed, and sometimes repeatedly), I make what I believe is a fair and reasonable offer. Give me a chance to help you, if you're not satisfied, return the product.
Other than that, continue as you are, I will do the same.
Thanks for your challenging questions, I've welcomed them to this point, but now I must bid you adieu.
Re: ImpressionsLarry T on 1/23/04 at 11:39 (142724)
I guess that means you cant answer a simple question? I didnt want a rehash of your policies, how wrong others are or who and where you studied. I asked a simple querstion and Dr Z also asked a simple question.
Some of your biomechanical claims as well as your comment to Richard left you open for questions. You didnt address them directly but rather danced around them. Thats fine as this is a free forum.
Touting your policy and patient testimonials does not render the questions answered. Giving the old, you guys just dont understand is an opinion but not an answer
Thanks for your time
Re: ImpressionsLarry T on 1/23/04 at 14:35 (142735)
Thanks for the response. I was using the terminolgy for simplicity sake. I dont think it confuses the civilians. I wont belabor this with you but you said that 100% pronate but 70 to 80 percent supinate.
Re: ImpressionsDr Kiper on 1/23/04 at 16:46 (142747)
I think I need new reading glasses, I could swear that my post states nothing about 100% pronate and 70-80% supinate.
As often as I read and re-read it I see that I said 'I would say that at least 70% maybe 80% or more are supinators.
This is not the same as saying 70-80% supinate. You clearly do not have a grasp of these terms. Please look at my earlier posts where I go through great lengths to make this clear. As I said, these terms have been bantered about and have created confusion. You don't think that the civilians are confused because you think you've got it. I respectfully disagree.
And while I did not say in the same statement that 100% pronate, I have probably said that somewhere else, yes, 100% of people with a 'normal locomotive foot do pronate, to take it a step futher, they all overpronate too.
All right let me try another angle. You are among those that think not everyone overpronates and that all you need to do is 'control the foot with an orthotic where there is overpronation, I'm not 100% sure, but I think that's what you think.
You cannot 'control overpronation. Overpronation is normal. It's part of the shock absorbing system of our ontogeny. All you can do is 'minimize overpronation.
Traditional rigid orthotics to me are like the wagons they used in the days of Robin Hood. No shock absorption, just a hard chasis and an equally hard ride. When the semi-rigid orthotic came along, a little bit better but not much, kind of like a Conostoga wagon, still a hard ride, but there are at least some leaf springs.
The SDO 'guides (rather than 'controls ) the foot through it's own comfortable angle and base of gait. It works with the motion, by catching the foot as it pronates, decelerating it, and cushioning it to the end of that range of motion. It simply limits the excessive range beyond that which is more destructive on a repetitive basis. This leaves the foot in the most efficient, natural and comfortable position on the ground (this would be neutral in your terms) and reduces the poor alignment characteristics throughout the lower extremity into the low back. Isn't that what an orthotic is supposed to do?
This may or may not satisfy your questions about the kinetics or biomechanics as we were taught in our school and in your school (I take it you're not a DPM). I suppose you and the others would like to get into the planes of motion, the biomechanical angles etc. This is not the forum. I'll try to answer patient questions in a simple easy to understand manner. I've been explaining things that way so long I can't even do podiatry speak anymore.
I feel I've at least tried to answer the simple questions and the tough ones too, Someone doesn't agree, that's OK, it won't be the first time.
Re: ImpressionsDr. Zuckerman on 1/23/04 at 19:38 (142758)
You cannot 'control overpronation. Overpronation is normal It simply limits the excessive range beyond that which is more destructive on a repetitive basis.Overpronation is normal.
This is the part that confuses me. Is overpronation the same as excessive pronation?
Are you sure you are saying that overpronation is the same as excessive pronation and that is normal.
In my mind it is normal if there is no lower extremity pain
Re: ImpressionsLarry T on 1/23/04 at 20:24 (142762)
Most people are democrats but the majority are republicans. 2/3 of the population feel they are more like libertarians. The ones that vote mostly follow their gut but usually will deviate from the party they claim to belong to. Further 60 to 70 percent will answer in pols that they are members of a party they identify with for socio-economic reasons.
So if you follow me then you should know that most ( 85 to 95%)people vote but not for whom they really want but what they feel. The result is that studies show 95% dont agree with the electoral college during leap years or times when the prime interest rate dips below 5%
I hope I have made it simple for everyone
Re: pronation vs. overpronationEd Davis, DPM on 1/23/04 at 22:02 (142768)
Excess strain on the plantar fascia is caused by a combination of subtalar joint over-pronation and midtarsal joint oversupination.
Dr. Kiper is quite clear on how the SDO reduces subtalar joint overpronation. He is not clear on how the SDO would reduce midtarsaljoint oversupination.
I have noted that among posters, magazine article writers and even professionals there is a lot spoken concerning subtalar joint overpronation. Unfortunately, that is only half of the equation. It is often possible to reduce plantar fascial tension by working primarily on one end -- ie the subtalar joint. Interestingly, the Alznner device sold by the Goodfeet Stores works primarily on the midtarsal joint -- sort of a unique idea and that is why they satisfy a portion of the population where midtarsal joint oversupination is the major issue (although many of us are not fond of their sales tactics). Podiatrists are trained to understand and treat the entire 'equation' and to do so precisely. Do they always do what they are trained to do? Apparently not based on a number of posts here. The trick is to find a good one who is doing his job properly.
Re: ImpressionsEd Davis, DPM on 1/23/04 at 22:06 (142769)
Perhaps I missed your response. But would you give a patient his money back if a surgery did not work?
Re: ImpressionsDiana on 1/26/04 at 06:20 (142850)
I want to thank Richard for answering my concerns. Even tho I find the rest of the comments quite interesting would you please find a different thread to use. You are overloading my mailbox with issues that someone else asked on my post. I don't care to read the banter about who is right and who isn't. It's all about personal opinion and nothing more. Please move on ..... THANK YOU !!!!!!!!!!!
Re: ImpressionsEd Davis, DPM on 1/26/04 at 18:51 (142892)
Please see my post entitled 'pronation vs. overpronation.' Over-stretch on the plantar fascia is caused by a combination of subtalarjoint overpronation and midtarsal joint oversupination. Please address the latter. Thank you.
Re: ImpressionsEd Davis, DPM on 1/26/04 at 18:53 (142893)
Could you please consider an answer to the question I posed? I think that the principle behind it is very relevant to the subject matter.
Re: ImpressionsLarry T on 1/27/04 at 07:27 (142931)
Good question Dr Ed. Was that post in this thred? I could not locate it
Re: ImpressionsDr Kiper on 1/27/04 at 07:50 (142935)
You've asked me this twice before. I explained that this is too complicated for me to type out. I invited you to give me your phone # and best time to call, and I'd be happy to spend my dime doing it.
Since we look at things differently, each post invites newer questions and I am trying to get out of this as I don't have the time. My posts as you know can be lengthy because I try to make things clear and easily understood. This has not worked on the message boards.
Re: pronation vs. overpronationDr Kiper on 1/28/04 at 10:26 (143039)
Based on the number of complaints here @ heelspurs.com now and in the past about all the footdocs who have been unable to help their patients
with orthotics that cannot be worn, don't help, or make the problem worse, compared to the number of success stories does not speak well of our profession, if you evaluate this based on their 'training'.
While you speak of the entire 'equation', just maybe we need to re-evaluate that entire 'equation'.
Doing a job properly doesn't just mean 'following' the trend, sometimes leading can get it done too, maybe even better.
Re: pronation vs. overpronationEd Davis,DPM on 2/02/04 at 21:13 (143513)
Keep in mind that the thousands of satisfied patients treated successfully do not wind up on chat boards such as these. I don't feel that this, or any similar chatboard, is a basis to make conclusions on the state of PF treatment by the podiatric profession.
Re: ImpressionsEd Davis,DPM on 2/02/04 at 21:15 (143514)
With all due respect, why not post an answer here for all to see?