Orthotics & Orthopeadics

Chiropractic Mechanics Love Podiatric Mechanics

Robert Dishman, DC, MA

Podiatry thinks from the "knee down." This refers to how a person of a profession is trained to focus. This is euphemistically called "specialization"; therefore the doctor of podiatry has a particular "mind set" or perception of the human foot in relation to the lower leg. It is unlikely that such a specialty will ever think above and beyond the knee, yet podiatry is a respected and dignified profession offering valuable services to relieve human suffering. But how can a task force of 12,000 podiatrists service the needs of 240 million people? Almost every podiatrist will attend to the observations that 80% of the population over-pronate from a mild to severe degree. Only the more extreme cases are fitted for precision made "functional" type orthotics for the simple reason that podiatrists look at the foot primarily in relation to the foot pathology or severe pronation.

Chiropractic mechanics look beyond the local foot deviation and understand that a few degrees of pathomechanics at the bottom of the weight bearing human frame equal many degrees in the middle and the top. Like a skyscraper such as the empire state building, a few millimeters at the bottom equals many feet of sway at the top. Podiatrists, like chiropractors, devote seven years or more focusing on their education yet each profession has a different perception of the same anatomy. Chiropractors deal with the foot, lower extremity, pelvis and spine as a series of linking kinematic systems -- some closed, as the foot, leg, and thigh during weight bearing -- and some open, as the coxa, sacro-iliac and lumbosacral in non-weight bearing. Not only does the podiatrist not understand this difference in focus, he also does not have any significant degree of interest in these biomechanics. So who is going to take care of these biomechanical problems requiring a knowledge of chiropractic kinematics and podiatric foot orthotics as they relate to each other in an integrated functional structural machine? Who will minister to the needs of 240 million Americans?

Does any intelligent chiropractor really believe a podiatrist spends seven years to learn to practice the art of foot mechanics and then put the patient's foot in a styrofoam box to obtain an "off-the-shelf" accommodative orthotic or arch support? Would you believe that virtually none of the certified podiatrists endorse such procedures or devices? Would you believe that few if any fabricators or manufacturers using styrofoam molds of this type pour a plaster cast to obtain a mirror image of the plantar surface of the foot?

My mission in chiropractic is to combine the knowledge and skills taught in podiatric college with chiropractic mechanics. Chiropractors are not limited in their focus on regional anatomy. Chiropractors are allowed to raise their sights above the knee and examine the whole framework with an eye toward all manner of intersegmental dysfunctions. Irwin Korr refers to it as segmental, intersegmental, and suprasegmental. The mysteries of the neuromusculoskeletal system are just beginning to unfold. The intuition of Thomas Edison was expressed so prophetically, "The doctor of the future-----will concern himself with and care of the human frame-----"

May 1990
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