Education

EDUCATION

For the last 50-60 years the percentage of feet and spine deformations demonstrates dramatic increase from 4-7% to 85-97% (these numbers are for population of developed countries of Europe and North America). Orthopaedics does not view deformations as distortion in functioning of venous-muscles and lymph pumps that are responsible for cellular metabolism of the human organism. This pivotal pump function of skeletal muscles is not taken into consideration when orthotics are manufactured, thus bringing health damage to human being.

I am addressing the scientific community with a proposition to jointly evaluate the situation and to perform right steps towards improving and perfection of orthotics manufacturing.  Time comes for assigning the status of medical devices to orthotics, and certainly it is long overdue to explain the extent of damage to human health from available contemporary orthotics.

All following issues and conclusions are based on 45 years long experience in scientific research and applied orthopaedics and prosthetics. I would like to share these conclusive facts with you.

Basics of correction are the following:

  1. It is not possible to properly correct the feet arches not taking into account the position of General Centre of Gravity (GCG) for the body, i.e. without considering the load. It is vital to know exactly what function is fulfilled by each of the three arches. Feet and spine correction must be carried out in the single technological process, by specialist of universal profile.
  2. Understanding on what exactly is deformation  may be considered critical. Namely, deformation is the distortion in balance of forces in system of inverting and diverting muscles, which distortion occurs under influence of external forces affecting the body skeleton. It is not right to confuse the consequence, – descending of internal arch or “flatfoot”, – with the reason. When we uplift internal arch with the help of rigid orthotics, we deprive the foot of its amortizing function, i.e. we produce the equivalent of flatfoot.
  3. Arches correction constitutes the necessity of putting skeleton on its three anatomical (skeletal) support points. Projection of GCG for the body have to coincide with Centre of Gravity (CG) for support triangle of the feet. Feet arches, like arches of the bridge, bear the load, being supported on the skeleton points.   If additional support point appears for some reason, this violates the amortizing function of the arches. But notice – precisely this takes place when rigid orthotics is used.
  4. Restoration of gait biomechanics constitutes restoration of pump function of skeletal muscles that sustain cellular metabolism. It is obvious that orthopaedic specialists and footware manufacturers do not possess enough knowledge in the field of geometry, mechanics and biomechanics. Otherwise it is impossible to explain such rapid growth of deformations in population groups of all ages.
  5. Feet deformations are equivalent to functional shortening of the limb. This shortening inevitably affects the vertebral column structures as well as entire human organism condition. Quality of correction and quality of orthotics must be evaluated by how they impact human organism as a whole. Orthotics manufactured by method of getting negative imprint (in foam or in plaster), in lying or sitting position, without considering GCG for the body, – such orthotics are not able to resolve orthopaedic problems of feet correction and posture improvement. Such orthotics could not be attributed to category of orthopaedic devices. The usage of such orthotics would bring to existence even more substantial deformations and consequently more serious irregularities in cellular metabolism. All these facts indicate that any treatment has to have basic initial stage – correction of skeletal-muscular carcass and restoration of muscles pump function.

Usual mistakes in the process of orthotics manufacturing:

  • Diagnostic process for feet arches deformation must be the necessary part of orthotics manufacturing and of their quality control. Unfortunately, this is not the case in reality. Absence of diagnostic for feet arches is serious drawback of standard approach. The existing computer diagnostics does not provide information on position of structures overlying the feet skeleton. Neither does this diagnostic inform on numerical value of difference in lower limbs lengths ( knowledge of this difference is necessary for proper orthotics manufacturing).
  • The tone of feet muscles is not at all the object of diagnostics and is not considered in orthotics manufacturing process. Meanwhile about 65% of the people have the muscles hyper-tone, and for them rigid orthotics should be excluded from wearing.
  • Negative imprints in foam or plaster are produced without taking into account the position of the body’s GCG. For this reason the feet arches are not loaded uniformly and therefore they are deformed.
  • Operations of pouring molten substance into the mould undoubtedly contribute additional error into orthotics configuration. The obtained model does not correspond to the corrected foot.
  • Both external and transversal feet arches define position of body’s GCG with respect to support points. These arches are not diagnosed and not corrected by orthotics either. Rigid orthotics deprives the arches of their amortizing function.
  • Rigid supinator plane affects only the heel-bone. This firm hard piece does not stabilize heel position and subtalar joint position. The string function of support external arch is distorted as well as amortizing and pump functions of internal arch.
     
  • Rigid orthotics does not secure the parallelism of heel-bone and foot front section (under heads of 1st and 5th metatarsals). Notice: a-normal position; b-with half-orthotics).
  • Rigid orthotics prevents pronation of internal arch. As the result, the foot loses its ability to extinguish inertia forces Fᵢ  that emerge with movement process:                                             Fᵢ= (5-20)g × m
     
  • The application of rigid orthotics distorts biomechanics of the gait. Rhythm coefficient is Kᵣ = 0.46 for walking on rigid orthotics. The lymph and blood circulation in human organism is substantially worsened.

The described factors are pointing to the fact that contemporary orthotics manufactured with rigid materials and without considering position of body’s GCG, do not fulfill medical purposes of feet correction. Moreover, they have negative influence on general condition of entire human organism.

Below the example is given of another technology and another understanding and approach to importance of proper feet correction. Find out how this correction affects various functional parameters of human organism and its ability to self-regulation. It is well established that the basis for self-regulation is active functioning of skeletal muscles.

Hydrostatic Method for Correction of Locomotor System Elements. Manufacturing of Functional Off-loading Orthotics BIO-PODOCORRECTORS.

This method is based on the knowledge of Physics laws of hydrostatics and hydrodynamics, on biomechanics, mathematics and human physiology.

  • Process of obtaining positive feet imprints is performed in standing position with feet soles located on the diaphragms of connected vessels (Pascal Law). Stable vertical body position on the diaphragms is secured by the fact that the body’s GCG is projected into Centre of Gravity of the feet support triangle. This happens when pressure in connected vessels is levelled and the diaphragms compensate the difference in lower limbs lengths.
     
  • According to Pascal Law, force of pressure affects skeletal-muscular feet carcass in the direction from the bottom upwards. Pressure corresponds to body mass.  Under such load skeletal-muscular feet carcass occupies the median balanced position that is one of necessary conditions for restoration of contractile pump function of the muscles.
  • In the standing position, liquid pressure inside connected vessels under each lower limb becomes equal, and body weight is uniformly distributed over entire support surface of the feet soles. Pressure per unit of orthotics surface does not exceed biologically permitted amount of 5-6kg/cm². This leads to improving of microcirculation in the surface tissue as well as skin dryness and calluses disappearance.
  • Diaphragm under the shorter lower limb is ascending, which distance is measured by electronic system under support points of the feet or by imprints. This numerical information serves also for defining the difference in lower limbs lengths. It can be used as well for finding the proper heel-piece height of casual footware.
  • Prior to obtaining the feet imprints, relaxation of spine and feet muscles must be performed, as well as elimination of posture irregularities and toes deformations. If vertebral column is not corrected, it is impossible to properly load feet arches and manufacture orthotics.
     
  • All influences and effects on feet and spine correction are routinely tested with computer system. The feet imprints are produced only after the organism energy balance is reached. The physical material of bio-podocorrectors fixes the organism’s energy field using reflective zones of feet soles. In this way, the feet correction process includes not only orthopaedic problems and challenges, but prophylactics and treatment of illnesses as well.
     
  • With the help of podo-correctors the variety of problems are solved, for example, development and treatment of veins varicose , swollen feet, diabetic angiopathy, arthroses and arthritis, correction of vertebral column deformations and normalizing of internal organs functioning.