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Saturday, June 1, 2013

Biomechanics of the Foot: My Love of Teaching

     I have practiced the subtle art of podiatric biomechanics within the world of sports medicine and injury rehabilitation now for 32 years. I believe I have helped most I served, with some exceptions. After my podiatric medical school, I did a one year medical/surgical residency and then a fellowship in biomechanics. I earned my Master's Degree in Education teaching podiatry students the art of the biomechanics. I would have fun walking across the front of the auditorium with ping pong balls taped to various body parts so that I could teach the normal motions that occur in gait.

     My basic need to teach has brought me to this blog in 2010, but started in 1979 with teaching Biomechanics III to sophomore students at the California College of Podiatric Medicine (CCPM) in San Francisco. From 1981 to 1992, I taught the Sports Medicine Spring Semester course also at CCPM. From 1981 to present, I have lectured on podiatric biomechanics and sports medicine throughout the United States, and internationally in Australia, Canada, and England. I have wrote over 50 published articles in this field and attempted unsuccessfully to write a full text book. In 2011, I was honored to be given the chance to teach sports medicine again to sophomore students at Samuel Merritt University in Oakland California. I just finished my third year and it is great to be back with the students. 

    My legacy will always be a type of orthotic device I invented in 1981 while beginning to work at Saint Francis Memorial Hospital's Center For Sports Medicine in San Francisco. It is called the Blake Inverted, the Blake, or the Inverted Orthotic Technique. I have worked there for 32 years now attempting to understand alittle more each year how the foot works and how to fix it when broken (not necessarily literally). While frustrated over helping a patient with knee pain, I changed the orthotic RX forms forever. The standard maximum correction of the foot was 4-5 degrees of varus (arch is raised) forever that we know. Over that amount would cause the foot to roll outwards too much (excessive supination) and produce a variety of injuries. This was an accepted fact. To help my patients with stubborn problems, I have gone past 60 degrees of correction. 1000's of patients have been helped, most did not know the historical significance of the type of orthotic they received, or the name attached. They were just getting their orthotics. 

     Even though the Inverted Orthotic Technique is part of me, and now part of podiatry history, it is only a small small part of what it means to have a biomechanically based podiatry practice. When you practice biomechanics, it means you are always thinking of the possible mechanics behind every injury, every pain, every surgery, every bump on the foot or leg, every step that the patient takes, every move they make on the reformer in pilates or the basketball court. Why do they hurt themselves? Poor mechanics are sometimes the sole source of the problem, or a slight contributory factor affected the rehab. 

     I hope in the weeks and months ahead, in these postings on the Biomechanics of the Foot, to begin to share with you, my readers, the subtleties of this art. I love the art, some hate it. I make 400 pairs of custom orthotics for patients each year, some podiatrists none (because they hate them). Podiatrists are trained to treat the biomechanics of the foot and ankle. This is so much more, so much more, than orthotics. It is toe separators for bunions to align the joint, the proper biomechanically sound way to stretch a tendon, or strengthen a muscle, the proper taping technique, or the mechanics of dunking a basketball (one feat I will never do until it is worth 3 points). What about the mechanics of various athletic shoes that must be considered? So many things. 

     I hope this is interesting. I hope to help my patients to think about why they hurt and can they be part of the problem. Can they do things (training, shoe selection, diet, icing, etc) differently to improve their chances for long term activities and a much better quality of life? Thanks for walking with me.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.