[pa-l] bone spurs and bursitis

February 9, 2007

I'm sorry, Alon, you say that on the basis of what evidence?

Avery

On Fri, 09 Feb 2007 11:24:19 -0500, Alon Marcus <alonmarcus

wrote:

> Very few chiros are well trained in orthotic therapy

>

> -

> " Dr. Avery Jenkins " <docaltmed

> <Chinese Medicine >

> Friday, February 09, 2007 6:02 AM

> Re: Re: [pa-l] bone spurs and bursitis

>

>> Many chiropractic physicians cast and fit orthotics. That would probably

>> be your best option.

>>

>> On Thu, 08 Feb 2007 22:46:40 -0500, Alon Marcus <alonmarcus

>> wrote:

>>

>>> Pete

>>> You need to see someone that specializes in biomechanics. Most

>>> pediatrists do not

>>>

>>> -

>>> Pete Theisen

>>> Chinese Medicine

>>> Thursday, February 08, 2007 7:43 PM

>>> Re: Re: [pa-l] bone spurs and bursitis

>>>

>>> On Thursday 08 February 2007 1:47 pm, Alon Marcus wrote:

>>> > unless

>>> > forces are triggering the body to fill in those spaces of excess

>>> tension.

>>> >

>>> > Richard

>>> > That is correct and with some foot dysfunctions unless foot

>>> biomechanics is

>>> > corrected with a GOOD orthotic

>>>

>>> Hi Alon!

>>>

>>> How do you get a good orthotic?

>>>

>>> --

>>> Regards,

>>>

>>> Pete

>>> http://www.pete-theisen.com/

>>>

February 9, 2007

I have taught biomechanics in seminars were many DCs attended and seen many

devices done by DCs. I am not saying all are poorly trained but many just

make generic devises many using foam molds and even worse many make weight

bearing foam molds

-

" Dr. Avery Jenkins " <docaltmed

Friday, February 09, 2007 9:09 AM

Re: Re: [pa-l] bone spurs and bursitis

> I'm sorry, Alon, you say that on the basis of what evidence?

>

> Avery

>

> On Fri, 09 Feb 2007 11:24:19 -0500, Alon Marcus <alonmarcus

> wrote:

>

>> Very few chiros are well trained in orthotic therapy

>>

>> -

>> " Dr. Avery Jenkins " <docaltmed

>> <Chinese Medicine >

>> Friday, February 09, 2007 6:02 AM

>> Re: Re: [pa-l] bone spurs and bursitis

>>

>>> Many chiropractic physicians cast and fit orthotics. That would probably

>>> be your best option.

>>>

>>> On Thu, 08 Feb 2007 22:46:40 -0500, Alon Marcus <alonmarcus

>>> wrote:

>>>

>>>> Pete

>>>> You need to see someone that specializes in biomechanics. Most

>>>> pediatrists do not

>>>>

>>>> -

>>>> Pete Theisen

>>>> Chinese Medicine

>>>> Thursday, February 08, 2007 7:43 PM

>>>> Re: Re: [pa-l] bone spurs and bursitis

>>>>

>>>> On Thursday 08 February 2007 1:47 pm, Alon Marcus wrote:

>>>> > unless

>>>> > forces are triggering the body to fill in those spaces of excess

>>>> tension.

>>>> >

>>>> > Richard

>>>> > That is correct and with some foot dysfunctions unless foot

>>>> biomechanics is

>>>> > corrected with a GOOD orthotic

>>>>

>>>> Hi Alon!

>>>>

>>>> How do you get a good orthotic?

>>>>

>>>> --

>>>> Regards,

>>>>

>>>> Pete

>>>> http://www.pete-theisen.com/

>>>>

February 10, 2007

suggest having a look at proprioceptive insoles ( Prof.. Brain A. Rothbart)

vs orthotics

Ross Ralph Dr.TCM

-

" Alon Marcus " <alonmarcus

Friday, February 09, 2007 8:24 AM

Re: Re: [pa-l] bone spurs and bursitis

> Very few chiros are well trained in orthotic therapy

>

> -

> " Dr. Avery Jenkins " <docaltmed

> <Chinese Medicine >

> Friday, February 09, 2007 6:02 AM

> Re: Re: [pa-l] bone spurs and bursitis

>

>> Many chiropractic physicians cast and fit orthotics. That would probably

>> be your best option.

>>

>> On Thu, 08 Feb 2007 22:46:40 -0500, Alon Marcus <alonmarcus

>> wrote:

>>

>>> Pete

>>> You need to see someone that specializes in biomechanics. Most

>>> pediatrists do not

>>>

>>> -

>>> Pete Theisen

>>> Chinese Medicine

>>> Thursday, February 08, 2007 7:43 PM

>>> Re: Re: [pa-l] bone spurs and bursitis

>>>

>>> On Thursday 08 February 2007 1:47 pm, Alon Marcus wrote:

>>> > unless

>>> > forces are triggering the body to fill in those spaces of excess

>>> tension.

>>> >

>>> > Richard

>>> > That is correct and with some foot dysfunctions unless foot

>>> biomechanics is

>>> > corrected with a GOOD orthotic

>>>

>>> Hi Alon!

>>>

>>> How do you get a good orthotic?

>>>

>>> --

>>> Regards,

>>>

>>> Pete

>>> http://www.pete-theisen.com/

>>>

February 11, 2007

Ross

The type of device really depends on the type of foot. Some patient do very

well with accomodative devises which stimulate proprioceptive input, others

need a lot of control, and some need some of both. There is no fit all

device

-

" Ross Ralph " <courtenayhealing

Saturday, February 10, 2007 12:57 AM

Re: Re: [pa-l] bone spurs and bursitis

> suggest having a look at proprioceptive insoles ( Prof.. Brain A.

> Rothbart)

> vs orthotics

> Ross Ralph Dr.TCM

> -

> " Alon Marcus " <alonmarcus

> <Chinese Medicine >

> Friday, February 09, 2007 8:24 AM

> Re: Re: [pa-l] bone spurs and bursitis

>

>> Very few chiros are well trained in orthotic therapy

>>

>> -

>> " Dr. Avery Jenkins " <docaltmed

>> <Chinese Medicine >

>> Friday, February 09, 2007 6:02 AM

>> Re: Re: [pa-l] bone spurs and bursitis

>>

>>> Many chiropractic physicians cast and fit orthotics. That would probably

>>> be your best option.

>>>

>>> On Thu, 08 Feb 2007 22:46:40 -0500, Alon Marcus <alonmarcus

>>> wrote:

>>>

>>>> Pete

>>>> You need to see someone that specializes in biomechanics. Most

>>>> pediatrists do not

>>>>

>>>> -

>>>> Pete Theisen

>>>> Chinese Medicine

>>>> Thursday, February 08, 2007 7:43 PM

>>>> Re: Re: [pa-l] bone spurs and bursitis

>>>>

>>>> On Thursday 08 February 2007 1:47 pm, Alon Marcus wrote:

>>>> > unless

>>>> > forces are triggering the body to fill in those spaces of excess

>>>> tension.

>>>> >

>>>> > Richard

>>>> > That is correct and with some foot dysfunctions unless foot

>>>> biomechanics is

>>>> > corrected with a GOOD orthotic

>>>>

>>>> Hi Alon!

>>>>

>>>> How do you get a good orthotic?

>>>>

>>>> --

>>>> Regards,

>>>>

>>>> Pete

>>>> http://www.pete-theisen.com/

>>>>

February 12, 2007

Alon,

I would like to respond to your statement that chiropractors are not

properly trained in the use of prescription foot orthoses and that the

techniques that some chiropractors use to cast the foot are invalid.

With regard to your first statement, that chiropractic physicians are not

well-trained in prescription or use of orthotics, you are either ignorant

of, or are willingly misrepresenting, the facts. Chiropractic physicians

are trained in the biomechanics of the foot and the use of custom orthoses

as a core part of their training. The chiropractic colleges whose

curriculum I am familiar with instruct students in the prescription and

preparation of both NWB and weight-bearing orthoses. In addition

chiropractic physicians who are board-certified specialists in either

sports medicine or orthopedics receive additional training in the use of

foot orthoses. As I'm sure you know, those two specialities are two of the

largest in the chiropractic profession.

It may be that the chiropractic doctors that attended your seminars were

unaware of their proper prescription or use, but I doubt that is

representative of the profession. I was intrigued that, despite being

active in many facets of the profession for over a dozen years, I had

never heard of your seminars until you mentioned them. In fact, when I

queried the largest chiropractic listservs regarding your seminars,

representing thousands of chiropractic physicians nationwide, including

research scientists as well as college, state association and national

association presidents, nobody had even heard of your seminars.

Thus, I would suggest that the number of chiropractic physicians attending

your seminars is probably a rather small, self-selecting sample.

Secondly, with regard to the use of weight-bearing casts for foot

orthoses, your statement is out of sync with the research. Both

weight-bearing and NWB orthotics casting techniques have their place,

depending on the patient and the condition.

As you should know, the subtalar joint neutral system of podiatric

biomechanics upon which you apparently base your concepts of appropriate

orthotic prescription is well over 40 years old, and serious challenges to

Dr. Root's initial research (as comprehensive as it was) have been around

for decades. There is, of course, the work of McPoil and Hunt, as well as

Payne and Dananberg, which demonstrated that alternative orthotic

prescriptive procedures, specifically weight-bearing pressure analysis,

were highly effective, particularly in dealing with problems relating to

the other joints of the lower extremity, pelvis, and lumbar spine.

I hope that this clears up any misconceptions that other participants on

this list may have gotten as a result of your statements.

I appreciate the moderator's tolerance of my reply. Since the allegations

were made publicly, I felt it appropriate to respond publicly, but I truly

do not want to detract from the purpose of this list, and would request

that any further comments be made privately.

Avery L. Jenkins, DC, FIAMA, DACBN

Chiropractic Physician

Fellow, International Academy of Medical Acupuncturists

Diplomate, American Clinical Board of Nutrition

www.docaltmed.com

--

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February 12, 2007

Avery

At least in CA DC schools most advance foot biomechanics are elective

classes. I once helped Michael Brown teach one so i am familiar at least

with the San Jose school. I am especially aware of Dananberg's work as he is

one of my main mentors and while he uses a gait lab he usually cast in

neutral. Here in northern CA i see pt getting generic foam casted devices

every day. There are no corrections in them, at best they can be called arch

supports. At the same time i do know some DCs as well as quite a few PTs

that are very well trained.

-

" Dr. Avery Jenkins " <docaltmed

Monday, February 12, 2007 11:06 AM

Re: Re: [pa-l] bone spurs and bursitis

> Alon,

>

> I would like to respond to your statement that chiropractors are not

> properly trained in the use of prescription foot orthoses and that the

> techniques that some chiropractors use to cast the foot are invalid.

>

> With regard to your first statement, that chiropractic physicians are not

> well-trained in prescription or use of orthotics, you are either ignorant

> of, or are willingly misrepresenting, the facts. Chiropractic physicians

> are trained in the biomechanics of the foot and the use of custom orthoses

> as a core part of their training. The chiropractic colleges whose

> curriculum I am familiar with instruct students in the prescription and

> preparation of both NWB and weight-bearing orthoses. In addition

> chiropractic physicians who are board-certified specialists in either

> sports medicine or orthopedics receive additional training in the use of

> foot orthoses. As I'm sure you know, those two specialities are two of the

> largest in the chiropractic profession.

>

> It may be that the chiropractic doctors that attended your seminars were

> unaware of their proper prescription or use, but I doubt that is

> representative of the profession. I was intrigued that, despite being

> active in many facets of the profession for over a dozen years, I had

> never heard of your seminars until you mentioned them. In fact, when I

> queried the largest chiropractic listservs regarding your seminars,

> representing thousands of chiropractic physicians nationwide, including

> research scientists as well as college, state association and national

> association presidents, nobody had even heard of your seminars.

>

> Thus, I would suggest that the number of chiropractic physicians attending

> your seminars is probably a rather small, self-selecting sample.

>

> Secondly, with regard to the use of weight-bearing casts for foot

> orthoses, your statement is out of sync with the research. Both

> weight-bearing and NWB orthotics casting techniques have their place,

> depending on the patient and the condition.

>

> As you should know, the subtalar joint neutral system of podiatric

> biomechanics upon which you apparently base your concepts of appropriate

> orthotic prescription is well over 40 years old, and serious challenges to

> Dr. Root's initial research (as comprehensive as it was) have been around

> for decades. There is, of course, the work of McPoil and Hunt, as well as

> Payne and Dananberg, which demonstrated that alternative orthotic

> prescriptive procedures, specifically weight-bearing pressure analysis,

> were highly effective, particularly in dealing with problems relating to

> the other joints of the lower extremity, pelvis, and lumbar spine.

>

> I hope that this clears up any misconceptions that other participants on

> this list may have gotten as a result of your statements.

>

> I appreciate the moderator's tolerance of my reply. Since the allegations

> were made publicly, I felt it appropriate to respond publicly, but I truly

> do not want to detract from the purpose of this list, and would request

> that any further comments be made privately.

>

> Avery L. Jenkins, DC, FIAMA, DACBN

> Chiropractic Physician

> Fellow, International Academy of Medical Acupuncturists

> Diplomate, American Clinical Board of Nutrition

> www.docaltmed.com

> --

> E-MAIL CONFIDENTIALITY NOTICE - This transmission may be: (1) subject to

> Physician-Patient confidentiality, or, (2) strictly confidential. If you

> are not the intended recipient of this message, you may not disclose,

> print, copy or disseminate this information under the Health Insurance

> Portability and Accountability Act. If you have received this in error,

> please reply and notify the sender (only) and delete the message.

> Unauthorized interception of this e-mail is a violation of federal

> criminal law.

>

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February 12, 2007

Every

Let me give you an example i saw a few weeks ago. I saw a pt for chronic PT

dysfunction and pain. His wife, a DC, made a weightbearing mold and gave him

a very accomodative devise which did not help. The pt had a typical PT

dysfunction with severe arch collapse as well severe FHL. Her devise

actually increase hallux height and thus his FHL. I talked to her and she

admitted to not really understanding orthotic therapy. She told me they did

learn orthotic therapy and that these were mostly elective or post grad

classes (she is 18 yr out of school). In many ways this is true for many

DPMs as well. Those that are interested learn a lot and take a lot of

biomechanics, however many do not even though the RX these daily. I have

never said no Chiro physicians understand orthotic therapy just that from

what i see many do not take additional training and tend to make generic

devises that often do not help and are inappropriate for the patient.

Michael Brown DC, MD is one of the most educated practitioners i have ever

met and was the one that actually got me into using orthotics. So don't take

me wrong i have nothing against chiros i am just speaking to what i see. And

by the way the courses i was talking about are courses were i was assisting

in not running. None were geared to DC professions and i do not think were

advertised there but i have no idea.