Wednesday, December 31, 2003

Intrinsic pedal musculature support of the medial longitudinal arch: An electromyography study

Just came across this study from the recent Journal of Foot and Ankle Surgery:

The authors did this (I have edited the abstract for brevity):
Ten adults served as subjects. The height of the navicular tubercle above the floor was measured while subjects were seated with the foot in a subtalar neutral position and then when standing in a relaxed calcaneal stance. Recordings of muscle activity from the abductor hallucis muscle were performed while the subjects maintained a maximal voluntary contraction in a supine position by plantarflexing their great toes. An injection of lidocaine (1% with epinephrine) was then administered in the region of the tibial nerve, posterior and inferior to the medial malleolus. Measurements were repeated and compared by using a paired t test. After the nerve block, the muscle activity was 26.8% of the control condition (P = .011). This corresponded with an increase in navicular drop of 3.8 mm. (P = .022). The observation that navicular drop increased when the activity of the intrinsic muscles decreased indicates that the intrinsic pedal muscles play an important role in support of the medial longitudinal arch.

This will make a good study to give to the students ... notice anything wrong reaching the conclusion of indicates that the intrinsic pedal muscles play an important role in support of the medial longitudinal arch based on the methodology used? I have no doubt that the intrinsic muscles are important, but they do not even start contracting during gait until the heel begins to come of the ground - the study tested the intrinsic muscles with the heel on the ground ... to quote CK ... what say you?

Back to home
Intrinsic pedal musculature support of the medial longitudinal arch: An electromyography study

Just came across this study from the recent Journal of Foot and Ankle Surgery:

The authors did this (I have edited the abstract for brevity):
Ten adults served as subjects. The height of the navicular tubercle above the floor was measured while subjects were seated with the foot in a subtalar neutral position and then when standing in a relaxed calcaneal stance. Recordings of muscle activity from the abductor hallucis muscle were performed while the subjects maintained a maximal voluntary contraction in a supine position by plantarflexing their great toes. An injection of lidocaine (1% with epinephrine) was then administered in the region of the tibial nerve, posterior and inferior to the medial malleolus. Measurements were repeated and compared by using a paired t test. After the nerve block, the muscle activity was 26.8% of the control condition (P = .011). This corresponded with an increase in navicular drop of 3.8 mm. (P = .022). The observation that navicular drop increased when the activity of the intrinsic muscles decreased indicates that the intrinsic pedal muscles play an important role in support of the medial longitudinal arch.

This will make a good study to give to the students ... notice anything wrong reaching the conclusion of indicates that the intrinsic pedal muscles play an important role in support of the medial longitudinal arch based on the methodology used? I have no doubt that the intrinsic muscles are important, but they do not even start contracting during gait until the heel begins to come of the ground - the study tested the intrinsic muscles with the heel on the ground ... to quote CK ... what say you?

Back to home

Wednesday, December 24, 2003

Tuesday, November 18, 2003

New stuff published in JAMPA:

The latest issue of JAPMA came out yesterday ... three things caught my eye ...
The first one had to catch my eye cause I wrote it :-)
Static Stance Response to Different Types of Foot Orthoses

This one furthered our knowledge on the effects of variations in the position of the subtalar joint axis (...and Karl, if you ever read this .... at least they think there is an axis there :-)
Relationship Between the Subtalar Joint Inclination Angle and the Location of Lower-Extremity Injuries

The final one was this:
In Vivo Forces in the Plantar Fascia During the Stance Phase of Gait: Sequential Release of the Plantar Fascia This one got me excited .... one of the main findings was the subtalar joint was unable to resupinate as the amount of fascia release increased, indicating a direct relationship between the medial band of the plantar fascia and resupination of the subtalar joint during late midstance and propulsion which is so consistent with the work we are soon to publish that shows the force to get the windlass established is much higher in those with plantar fasciitis. Maybe plantar fasciitis has nothing to do with a pronated foot, but has to do with a lack of resupination due to the high forces going through the windlass .... watch this space.

Back to home
New stuff published in JAMPA:

The latest issue of JAPMA came out yesterday ... three things caught my eye ...
The first one had to catch my eye cause I wrote it :-)
Static Stance Response to Different Types of Foot Orthoses

This one furthered our knowledge on the effects of variations in the position of the subtalar joint axis (...and Karl, if you ever read this .... at least they think there is an axis there :-)
Relationship Between the Subtalar Joint Inclination Angle and the Location of Lower-Extremity Injuries

The final one was this:
In Vivo Forces in the Plantar Fascia During the Stance Phase of Gait: Sequential Release of the Plantar Fascia This one got me excited .... one of the main findings was the subtalar joint was unable to resupinate as the amount of fascia release increased, indicating a direct relationship between the medial band of the plantar fascia and resupination of the subtalar joint during late midstance and propulsion which is so consistent with the work we are soon to publish that shows the force to get the windlass established is much higher in those with plantar fasciitis. Maybe plantar fasciitis has nothing to do with a pronated foot, but has to do with a lack of resupination due to the high forces going through the windlass .... watch this space.

Back to home

Sunday, November 09, 2003

Foot Self Management Program

Interesting study just published - one of the best for the year:

FOOTSTEP: a randomized controlled trial investigating the clinical and cost effectiveness of a patient self-management program for basic foot care in the elderly
Robin Waxman, Helen Woodburn, Melanie Powell, Jim Woodburn, Susan Blackburn and Philip Helliwell,

Journal of Clinical Epidemiology
Volume 56, Issue 11 , November 2003, Pages 1092-1099

Background and Objectives
Podiatry (chiropody) services are one of the most frequently requested services in primary care. The elderly are given priority access to podiatry services in the UK blocking access for other priority groups. To evaluate the clinical and cost-effectiveness of a self-management program as a means of managing nonurgent demands for podiatry services by the elderly without compromising foot-related disability.

Method
Randomized clinical trial with blinded 6-month follow-up and economic evaluation. People aged 60+ seeking self-initiated or primary referred podiatric consultation were screened. Five hundred ninety-nine were excluded on the basis of health status, and 259 refused to participate or did not attend initially. Seventy-eight were randomized to receive a self-management program, and 75 usual care. The main outcome measure was foot disability, as measured by the Manchester Foot Disability Questionnaire.

Results
At 6 months, self-management program participants had lower foot disability scores than the usual care group (difference between scores -1, 95% C.I. -2, 0), and returned for fewer treatments within the 6-month study period (39 vs. 92 treatments). The cost per patient for the self-management program (£10.92) was found to be the same as for usual care (£10.71), but this included the cost of nail care packs.

Conclusion
In this group a self-care program for routine foot care did not compromise therapeutic outcomes, and may be more cost effective in the long term. Further work is required to extend self-management programs to other target groups, such as people with diabetes at low risk for foot problems.

Back to home

Foot Self Management Program

Interesting study just published - one of the best for the year:

FOOTSTEP: a randomized controlled trial investigating the clinical and cost effectiveness of a patient self-management program for basic foot care in the elderly
Robin Waxman, Helen Woodburn, Melanie Powell, Jim Woodburn, Susan Blackburn and Philip Helliwell,

Journal of Clinical Epidemiology
Volume 56, Issue 11 , November 2003, Pages 1092-1099

Background and Objectives
Podiatry (chiropody) services are one of the most frequently requested services in primary care. The elderly are given priority access to podiatry services in the UK blocking access for other priority groups. To evaluate the clinical and cost-effectiveness of a self-management program as a means of managing nonurgent demands for podiatry services by the elderly without compromising foot-related disability.

Method
Randomized clinical trial with blinded 6-month follow-up and economic evaluation. People aged 60+ seeking self-initiated or primary referred podiatric consultation were screened. Five hundred ninety-nine were excluded on the basis of health status, and 259 refused to participate or did not attend initially. Seventy-eight were randomized to receive a self-management program, and 75 usual care. The main outcome measure was foot disability, as measured by the Manchester Foot Disability Questionnaire.

Results
At 6 months, self-management program participants had lower foot disability scores than the usual care group (difference between scores -1, 95% C.I. -2, 0), and returned for fewer treatments within the 6-month study period (39 vs. 92 treatments). The cost per patient for the self-management program (£10.92) was found to be the same as for usual care (£10.71), but this included the cost of nail care packs.

Conclusion
In this group a self-care program for routine foot care did not compromise therapeutic outcomes, and may be more cost effective in the long term. Further work is required to extend self-management programs to other target groups, such as people with diabetes at low risk for foot problems.

Back to home

Wednesday, November 05, 2003

Podiatry Resources

OK .... CK .... I got the hint :-)

Here are two good resources featuring work from Podiatry students:
The Curtin University Podiatry Encylopedia is maintained by Cameron Kippen.
A Podiatry Encylopedia is also being developed at Charles Sturt University by Paul Tinley.

Back to home

Podiatry Resources

OK .... CK .... I got the hint :-)

Here are two good resources featuring work from Podiatry students:
The Curtin University Podiatry Encylopedia is maintained by Cameron Kippen.
A Podiatry Encylopedia is also being developed at Charles Sturt University by Paul Tinley.

Back to home

Saturday, November 01, 2003

Student blogs about podiatry

A student coming to the end of her course and about to get her first job:

Follow the trial and tribulations of her at:
World of Feet

I always find it a lot of fun when looking through lists of email addresses that Podiatry students choose for themselves. World of Feet as an email address of gangrene@...

Back to home

Student blogs about podiatry

A student coming to the end of her course and about to get her first job:

Follow the trial and tribulations of her at:
World of Feet

I always find it a lot of fun when looking through lists of email addresses that Podiatry students choose for themselves. World of Feet as an email address of gangrene@...

Back to home

Tuesday, October 28, 2003

Where do I work

Where do I work?

Department of Podiatry, La Trobe University ... not anymore (finished in 2013)
Croydon Total Footcare (only occasionally, .... married to the boss)

I contribute a lot to:
Podiatry Arena and Foot Health Forum  and Running Shoe Rx
and have a TV channel on You Tube
and blog at Run Junkie and Toning Shoes and on the Soapbox, and more recently at Its a foot
I also run Podiatry CPD
View my profiles at: LinkedIn, Twitter, Google+, Technorati, Social, Reality

Back to home



Saturday, October 25, 2003

Tuesday, October 21, 2003

Looking for a Podiatry or lower limb related conference?

Podiatry Conference (complete listing internationally)
Podiatry Events

Back to home
Looking for a Podiatry or lower limb related conference?

Podiatry Conference (complete listing internationally)
Podiatry Events

Back to home

Thursday, October 16, 2003

Links to Podiatry Schools:

Podiatry Schools in USA, Canada, UK, Australia, New Zealand, South Africa & Spain

Back to home
Links to Podiatry Schools:

Podiatry Schools in USA, Canada, UK, Australia, New Zealand, South Africa & Spain

Back to home

Sunday, October 12, 2003

Website promotion

Search Engine Optimization (SEO) is the business of ranking a site well in the search engines, like Google and Yahoo! to get visitors to your website. If you have a website for your clinic, you have to promote it widely if you want these visitor. It has to be a good website address so that patients can remember; you have to have it in all your advertisements and on your stationary including your business cards. For the search engines, if someone types in "{Your City} podiatrist", does your website show up? If it doesn't then you have got some work to do. See this on how the search engines rank a website. To get a site to rank well, you need to build backlinks by getting other sites to link to your website. Submitting to link and web directories, such as DMOZ also helps link building. Generally, but not always, the more links there are to a site (link juice), the better you will rank in the search engines for yoru keywords. If you serious about your website and have a lot of competition, then you should consider engaging an SEO professional to look after the site (not an SEO Kiddie).

Website promotion

Search Engine Optimization (SEO) is the business of ranking a site well in the search engines, like Google and Yahoo! to get visitors to your website. If you have a website for your clinic, you have to promote it widely if you want these visitor. It has to be a good website address so that patients can remember; you have to have it in all your advertisements and on your stationary including your business cards. For the search engines, if someone types in "{Your City} podiatrist", does your website show up? If it doesn't then you have got some work to do. See this on how the search engines rank a website. To get a site to rank well, you need to build backlinks by getting other sites to link to your website. Submitting to link and web directories, such as DMOZ also helps link building. Generally, but not always, the more links there are to a site (link juice), the better you will rank in the search engines for yoru keywords. If you serious about your website and have a lot of competition, then you should consider engaging an SEO professional to look after the site (not an SEO Kiddie).

Saturday, October 11, 2003

Some of our current research:

Some work we are doing in the Department of Podiatry is looking at measuring how much force is needed to supinate the foot - ie how much force is needed from a foot orthotic if we want to change the position of the foot. We have had several publications on this already and there are a lot more on the way. More information - supination resistance. We have found that the force to supinate the foot is more related to a number of foot problems than excessive pronation is (especially posterior tibial dysfunction and recurrent ankle sprains). Supination resistance is also predictive of dynamic function, whereas most of the measurements routinely done in clinical practice are not predictive of dynamic function.

Back to home
Some of our current research:

Some work we are doing in the Department of Podiatry is looking at measuring how much force is needed to supinate the foot - ie how much force is needed from a foot orthotic if we want to change the position of the foot. We have had several publications on this already and there are a lot more on the way. More information - supination resistance. We have found that the force to supinate the foot is more related to a number of foot problems than excessive pronation is (especially posterior tibial dysfunction and recurrent ankle sprains). Supination resistance is also predictive of dynamic function, whereas most of the measurements routinely done in clinical practice are not predictive of dynamic function.

Back to home

Friday, October 10, 2003

Forum's for those who are evenly balanced:

The Podiatry Forum
Almost Uncensored Podiatry Forum

I call them evenly balanced people as most posters to these two forums seem to have chips on both shoulders :-)
Anonymous posters in forums do not have much credibility in my book ... judge for yourself by checking these two sites.

And for those who want the real truth there is Podiatry Bytes .... yeah right! - I actually note that the almighty Google search engine does not even index this site .... probably reflects its importance....the site is also anonymous (there goes any credibility that it could have had).

I am not anonymous - Craig Payne

Back to home page
Forum's for those who are evenly balanced:

The Podiatry Forum
Almost Uncensored Podiatry Forum

I call them evenly balanced people as most posters to these two forums seem to have chips on both shoulders :-)
Anonymous posters in forums do not have much credibility in my book ... judge for yourself by checking these two sites.

And for those who want the real truth there is Podiatry Bytes .... yeah right! - I actually note that the almighty Google search engine does not even index this site .... probably reflects its importance....the site is also anonymous (there goes any credibility that it could have had).

I am not anonymous - Craig Payne

Back to home page

Monday, October 06, 2003

Charcot's neuroarthropathy:

All the latest information on Charcot's neuroarthropathy from ePodiatry for health professionals and on Charcot foot for those with diabetes.

Back to home page
Charcot's neuroarthropathy:

All the latest information on Charcot's neuroarthropathy from ePodiatry for health professionals and on Charcot foot for those with diabetes.

Back to home page

Welcome to Podiatry Update

Welcome to my blog

I have set up this web log for Podiatry news and my views. To find out more about me, check here:
Craig Payne

Back to home page

Welcome to Podiatry Update

Welcome to my blog

I have set up this web log for Podiatry news and my views. To find out more about me, check here:
Craig Payne

Back to home page