Thursday, November 1, 2007

The Foot Bone Connected To The Leg Bone

Foot problems can cause problems with the knee hip and low back. While many may be inclined at this point to say “DUH?” the connection between the foot and the rest of the body is not widely accepted in modern medicine. In medicine there is a disconnect between medical doctors, podiatrists, and for that matter, dentists. Dentists take care of the teeth, podiatrists take care of the feet, and medical doctors take care of everything else. Even when I worked as a research engineer at Mass General we spent all our time studying the biomechanics of the knee and hip. These were some of the most brilliant researchers in the world but never once did I hear anyone bring up the possibility that foot problems may be the cause of at least some of the causes of hip and knee osteoarthritis. When I finally opened my medical practice and began treating my own patients with joint pain I was able to finally appreciate that problems with the feet often cause problems with the joints further up.

This seemed obvious to me at the time and I felt a little stupid for not realizing it before. However I was quickly disappointed to find that the research that was done did not show conclusively that improving the foot biomechanics with foot orthotics improved the biomechanics of other joints. This did not make a lot of sense to me so I then set up equipment in my office to study this for myself. I set up video cameras and bought special equipment that allows pressure sensors to fit inside the shoe and I began doing gait analysis. I asked doctors to send me their patients with foot, knee, hip and low back pain so that I could do this analysis. When I discovered problems with the foot biomechanics I corrected the biomechanics with foot orthotics. To my delight, and I will admit surprise, these patients would come back reporting that not only was their foot pain relieved but if they had pain in other joints this was improved as well.

When I see my patients getting better but most of the research says they shouldn’t be getting better then this tells me more research needs to be done. I now focus my entire practice to studying the biomechanics of the foot and its influence on the biomechanics of the knee hip and low back. I am conducting my own studies and trying hard to educate both patients and physicians. This blog is one part of the education process.

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