Dear Colleagues,
Regarding Kevin Kirby questions, the foot behaviour to a varus o valgus
wedge it will depends on own propioception reponse and muscle activity.
Also, you have Bart Van Gheluwe paperwork "Changes in Plantar Foot Pressure
with In-Shoe Varus or Valgus Wedging "(J Am Podiatr Med Assoc 94(1): 1-11,
2004) regarding this subject, although they did not use 20º wedges.
Finally, I would like to add that one can change foot supination or
pronation moments by adding wedges at midfoot joints not at the heel. I do
not know if there is some research due to a comparison between wedges effect
depending on plantar location.
Regards,
Xavier Ordoyo
Private Practice
Barcelona -Spain-
-----Mensaje original-----
De: A group for the academic discussion of current issues in podiatry
[mailto:[log in to unmask]]En nombre de Kevin Kirby
Enviado el: viernes, 28 de mayo de 2004 5:13
Para: [log in to unmask]
Asunto: Varus heel wedge response
Colleagues:
The topic of the medial heel skive as a method to increase subtalar joint
(STJ) supination moment brings up the topic of how a varus heel wedge works.
One interesting observation that I have made some time ago while testing
simple 20 degree wedges under the heel of subjects is that these 20 degree
varus wedges will many times cause STJ supination but will also, in many
cases, cause no STJ supination motion at all. I would suggest that those of
you that have access to a lot of feet make a 20 degree wedge of korex or EVA
(or some other similar material) and keep it in the clinic so you can see
the difference in how the relaxed calcaneal stance position (RCSP) of
different feet responds to standing on a 20 degree varus heel wedge.
I performed this unpublished experiment about 19 years ago in my
biomechanics fellowship and this greatly helped shaped my thought pattern
early on in my career.
Here are the questions:
1. Does standing on a 20 degree varus heel wedge cause 20 degrees of heel
inversion in any feet?
2. If not 20 degrees of inversion, then how much, if any, inversion of the
calcaneus will occur?
3. Why do some feet invert more than others when standing on a 20 degree
varus heel wedge?
4. What theory (theories) of foot biomechanics predicts that a constant
degree of varus wedging acting on the plantar heel in different feet will
produce a variable response in the frontal plane rotational movements of the
calcaneus?
Answering these questions would be an excellent research project for a
student or clinician looking to produce a paper for publication.
Cheers,
Kevin
****************************************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
Voice: (916) 925-8111 Fax: (916) 925-8136
****************************************************************************
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