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Wednesday, July 29, 2020

Thank You Dr. Kevin Kirby!!

     This post is a thank you to a Rock Star, so to be noticed will probably never happen!! Dr. Kevin Kirby from the Sacramento area of California has greatly influenced my beloved profession and my beloved field of biomechanics. He has his beliefs, and stays true to those beliefs, a trait I completely admire. 
     So, let me explain why this overdue thank you in cyberspace is happening today. Today, I saw a typical patient needing my biomechanical help. At 17, and a runner, he had already had his left accessory navicular removed, and was trying to avoid the same surgery on the right side. This is a small extra bone that 10% of the population has, and only 3% have on both sides. Lucky him. It is both aggravated by pronation, and can cause pronation by weakening the arch. 
     One of my measures of a patients pronation is called the relaxed calcaneal stance position or RCSP for short. This measurement is ideally vertical (standing straight up) or a few degrees in varus. For my patient he stood 6 degrees everted RCSP, so very pronated, and this matched his pronatory gait and pronatory symptoms. 
     The technique I use for this is called the Inverted Orthotic Technique. It is a highly corrected orthotic device, which I felt important for the need to let the patient run and attempt to avoid right foot surgery. These are both moderate to severe implied needs for maximal correction on my part.
The technique is based on a 5 to 1 orthotic correction to foot change. Therefore if I correct the foot 5 degrees I get 1 degree of foot change. 
     So, what happened? I gave the patient with 6 degrees everted RCSP a 30 degree Inverted Orthotic Device and the feet changed to 4 degrees everted. I realized I was a little wide with the heel cup so I lost a degree or so, but this is common when you are initially trying to grab the foot that the foot does not respond how you want it. 
     So, at last visit with the patient, I gave him the 30 degrees of correction with a 2 degree foot change, and ordered a new orthotic at no cost to the patient. I was committed to helping. I added a 3 mm medial Kirby to the existing mold (which normally gives me 2-3 degrees of change when added to the Inverted Technique). I called the dad a week later just to see how he was doing and he said that the new orthotic (that I was unhappy with) was far superior to his previous orthotics and he was really enjoying running in them painfree. 
   Today, I dispensed the 30 degree Inverted with 3 mm Kirby and his heels stood straight up and down at vertical RCSP. This was then reflexed in his gait walking and running. At times it is the Kirby Skive that makes the most difference, and at times the Inverted Orthotic that makes the most change. So, we are inseparable (since I invented and the trustee of the Inverted Technique) and I thank you Dr. Kirby. This is how Dr. Kirby works in the shadows in my office daily, and why his technique has been vital now for over 30 years. 
Thank you Dr. Kirby for always being there for 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.