Dear All,
About that brick .....
I think that the point I wanted to get to was the one picked up by Eric
Fuller, there is a lot of soft tissue on the sole of the foot and it
compresses. Some of my students and I did some experimental work back in
the UK, some years ago. We measured between 11mm and 13mm (or there abouts,
I don't have access to the results now) of compression in the soft tissue
of the heel on standing. Although we didn't measure the compression at the
forefoot our observation was that it seemed similar to that of the heel. At
the time, one of the students asked, "How, with that amount of distortion,
can you measure 2 or 3 or 5 degrees of varus or valgus this-or-that?" Well,
the question, in its broadest sense, still remains. With that amount of
potential for soft tissue distortion plus the additional shape change that
comes from movement at so many small joints, what exactly does constitute
the "right" shape?
I think that dynamic analysis / assessment will be the way to progress.
However, I do not feel that we will have to put bone markers on all of our
patients. My own thoughts, for the time being, are that we might be able to
develop a series of functional tests (you know the sort of thing; balance
on one foot, stand on tip-toe etc but structured more objectively) in order
to assess our patients. The tests will have to be established and
substantiated by solid and reproducible research. We have a long way to go.
In the meantime we have to care for our patients the best we can and we
ought to keeps our minds open to new ideas. Personally I think that we
would do better if we reduced trying to guess the answers and just cracked
on with the experiments.
Cheers for now.
Steve
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Stephen Urry
Lecturer
School of Public Health - Podiatry
Queensland University of Technology
Kelvin Grove Campus
Victoria Park Road
Redhill
Q 4059
Australia
Tel: (07) 3864 5649
Fax: (07) 3864 5628
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