Kevin A. Kirby, DPM
2019 Biomechanics Summer School Lecture/Workshop Abstracts
June 21-22, 2019
Lecture #1: Opening Lecture
The LBG Medical Biomechanics Summer School is now in its 25th year and is arguably the best podiatric biomechanics seminar in the world. Ray Anthony from RX Labs began the idea of a Biomechanics Summer School in 1994 and LBG Medical has continued the tradition every year since 2011. Biomechanics Summer School has brought and continues to bring, the world’s best lecturers to the UK so that podiatrists, researchers and foot-health professionals from around the globe can learn more about the biomechanics of the foot, lower extremity and foot orthosis therapy while interacting with each other academically and socially.
Interesting new theoretical concepts, the latest foot and lower extremity biomechanical research, the most recent treatment techniques and clinical examinations have all been integral parts of the lectures and workshops offered during this 25-year tradition. The Biomechanics Summer School has provided the podiatric, foot-health academic and research communities with an annual meeting that places foot and lower extremity biomechanics together with foot orthosis therapy, on the academic pedestal it so rightly deserves. This opening lecture of the 25th Annual Biomechanics Summer School will highlight, along with lots of photos, the people, topics and events that have made this meeting so special over the years.
Workshop: Easy and Quick Tissue Stress Orthosis Modifications
Foot orthosis are in-shoe medical devices which should be ideally designed to alter the magnitudes and temporal patterns of the reaction forces acting on the plantar foot. This optimises foot and lower extremity function, to decrease pathologic loading forces on the structural components of the foot and lower extremity during weightbearing activities as well as prevent future mechanically-based pathologies from occurring. The treatment goals of foot orthoses are based on the concepts of Tissue Stress Theory. The clinician is more interested in reducing pathologic stresses acting on and within the feet and lower extremities of their patients, rather than being interested in the older podiatric concepts of using foot orthoses, to make the patient’s foot function at the subtalar neutral position.
In the pursuit of the goals of foot orthosis therapy, the clinician, regardless of their level of training and skill, may need to modify or adjust pre-made or custom foot orthoses in the clinic to optimize the gait function, to decrease or eliminate the symptoms and to prevent new pathologies from developing in their patients. Podiatrists who are experts in foot orthosis therapy all routinely modify foot orthoses for their patients in their clinics to make certain that their foot orthoses are working optimally. This workshop will discuss and demonstrate a number of easy and quick foot Tissue Stress orthosis modifications to achieve the goals of foot orthosis therapy for patients.
Lecture #2: Understanding the Biomechanics and Treatment of Posterior Tibial Tendon Dysfunction
Posterior tibial tendon dysfunction (PTTD) is a relatively common and disabling condition affecting the posterior tibial muscle-tendon complex: the strongest supinator of the subtalar joint (STJ) within the human foot and lower extremity. In PTTD, the stretching, partial or complete tearing of the posterior tibial tendon produces pain and swelling locally at the medial ankle and foot also producing a profound loss in ability of the body to produce an internal STJ supination moment during weightbearing activities. The posterior tibial tendon injury seen in PTTD, therefore results in the loss of ability for the posterior tibial muscle to produce adequate STJ supination moment which over time leads to; increasing levels of ankle and foot pain, increasing longitudinal arch flattening, increasing calcaneal eversion and increasing forefoot abduction on the rearfoot.
Even though surgical treatment of PTTD is sometimes necessary, prompt treatment of patients with specifically-designed foot orthoses, braces, shoes and physical therapy will often lead to excellent treatment results which allow the patient to recover from their injury and resume normal weightbearing activities without pain. The biomechanical effects of these PTTD-specific foot orthosis design modifications must be fully understood and closely followed to achieve optimum orthosis treatment results in these patients. This lecture will delineate the biomechanics of PTTD, the change in foot shape that may occur and the conservative therapeutic treatment options that have the best chance of reducing the pain and disability of PTTD.