Practical Biomechanics for the Podiatrist

Name: Practical Biomechanics for the Podiatrist | Book 1
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Book 1

Richard L. Blake DPM MS Carlos Martínez Sebastián Joseph D'Amico DPM Álvaro Gómez Carrión(Autor*in)

BOOKBABY (Verlag)

1. Auflage

Erschienen am 17. April 2022

184 Seiten

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Chapter 1: Introduction to the General Principles This chapter concerns some general information about the book and some general rules that govern my practice. They include: 1.Utilizing this Book in Developing Plan B 2.Purpose of Book 3.General Book Topics 4.What classifies as Podiatric Biomechanics 5.Is This a Book about Orthotic Devices or a Specific Theory? 6.Biomechanics in a Nutshell 7.The Author's Personal History 8.More About Rules 9.Phases of Rehabilitation 10.Keep it Simple (whenever possible) 11.Slight Changes at the Foot can make Big Differences 12.Sources of Pain 13.Rule of 3 14.Occam's Razor 15.Treat Asymmetry 16.How Much Correction? And Where Do We Start? 17.Standard Biomechanical Treatment Utilizing this Book in Developing Plan B Welcome to Practical Biomechanics for the Podiatrist which is the accumulation of my 42 years of being a practicing podiatrist in the fields of biomechanics, sports medicine, and general lower extremity rehabilitation. I have been privileged to practice in a multi-discipline center with orthopedists, sports medicine MDs, physiatrists, physical therapists, and dance medicine specialists. I also trained under top biomechanical specialists and focused on the mechanics of injuries, which help in overall rehabilitation, cause reversal, and hopefully prevention of recurring injuries. I went into practice with one of the top orthopedists in the world Dr. James Garrick in the field of rehabilitation of injuries which continued my early training. I have learned that the mechanics of any injury or pain syndrome can be either complex or rather quite simple. I hope I can give the reader the tools for either beginning a practice based on mechanics or improving the ones they already have. Please feel free to use any of the information for developing office handouts (see Chapter 18 in Book 4), EHR templates, or just reference. I have questions throughout the book with answers at the end of the book for self-study. I have a podiatry blog called drblakeshealingsole.com where the reader can get more information. The world of biomechanics and rehabilitation, in general, is wide and deep and will be practiced by everyone differently due to our disciplines, training, and experience. The goal of this book is to make you see things you didn't look for previously, or maybe allow you to think about it from a little different viewpoint. Thank you for joining me in this fascinating and ever-changing world of biomechanics. I once did a review article on legitimate treatments for plantar fasciitis. I found 72 treatments that help plantar fasciitis which almost all fell into 3 categories: mechanical, inflammatory, or flexibility. All practitioners are limited by your disciplines to some degree, but there are so many ways to help patients. I have definitely found what helps one patient may not help another at all. The average practitioner will offer the patient about 5-6 treatment options within the first 3 office visits. So, when the patient is not improving in their treatment, or hits an impasse in some way, there may be many other options available that you can learn. This book will definitely help your initial treatment for injuries or pain syndromes, but probably help you the most with developing a Plan B or C or D when the injury is not improving dramatically. Practical Biomechanics Question #1: What position is the ankle in when it is the most relaxed, or the least stressed? Practical Biomechanics Question #2: What are the 3 Phases of Athletic Rehabilitation that we help patients work through to get well? Purpose of Book The purpose of this book is to train the next generation of podiatrists, and those interested in this field, on how to think mechanically about the problems that our patients have in terms of cause, cause reversal, and treatment options. During these last 4 writing years, I have traveled to Toronto, Canada, Santiago de Compostela, Spain, Charlottesville, Virginia, and New York, New York, and I found great excitement to learn biomechanics in many young podiatrists and podiatry students. I also teach part-time at the California School of Podiatric Medicine at Samuel Merritt University, Oakland, California, as a guest lecturer, and I am so excited about the enthusiasm of the students. The next generation of podiatrists will create some of their own rules fueled by new technologies, and thoughts, and their own experiences. I have loved my sports and biomechanics practice, and with all the different sports out there, it has been and will always be challenging. I hope to keep some of the past thoughts alive as the pace of the human race speeds forward with the speed of light. This book is more about how to think through a problem mechanically, than exactly what to do, although I will have many examples of treatment options. Most overuse injuries have a mechanical cause(s) and discovering that cause or causes will help in the treatment and prevention of the injury. This is of vital importance to the longevity of an athletic career. Finding the weaknesses of a patient through an analysis of why they got injured, for every injury that they get, and correcting those weaknesses with simple or complex measures, will help patients stay active. And, luckily this patchwork of health management can be pieced together over a long time.The healthcare provider is mending the weak links of a patient. I will have my own approach to problems but will emphasize the thought process involved. In a minute, we will discuss the causes of pain with mechanical pain as only one of them. I must emphasize that there are mechanical causes of any injury, and just mechanical treatments to help an injury, or both. If we take any injury or pain syndrome, some of our mechanical treatments will be reversing the actual cause of the injury (and these should remain in the patient's maintenance program), and some of our mechanical treatments will just be helping the phase of rehabilitation that the patient is presently within (like placing a cam walker on a patient during the Immobilization Phase of an injury). Here A Patient is in the Immobilization Phase with A Removable Boot and EvenUp on the Opposite Side Practical Biomechanics Question #3: What are the 3 main sources of the actual pain that patients feel? Practical Biomechanics Question #4: What can be the mechanical cause(s) of lateral ankle pain? General Book Topics This book is divided into chapters of varying topics to make the reader more aware of the key points in evaluation and treatment. It is important to note that for an individual patient, one treatment may be more effective for them than with another patient (A cluffy wedge may be helpful for a sesamoid injury in one patient but not help another). This is why your treatments must be tailored to keep the symptoms within a healing range of 0-2 pain level. This forces us to continue to experiment with different treatment options to achieve this goal. We have to follow the patient carefully and make sure our treatments are successful with at least monthly visits. If the patient is not getting better, it is time to make changes, even to go to Plan B if that has been formulated. I always expect to improve month by month as I follow them. The topics included in this book are: 1.Introduction to the Book and General Principles 2.Basic Approach to Patients (with an emphasis on Biomechanics) 3.Gait Evaluation Findings and their Meaning 4.Basic Components of a Lower Extremity Biomechanical Examination 5.General Mechanical Changes for Various Injuries (Foot to Low Back) from a Podiatrist's Standpoint 6.Various Theories and Their Role in Treatment 7.Various Mechanical Syndromes 8.Custom Orthotic Designs and Components 9.The Role of Shoes and Modifications 10.Specific Examples of Treatment (Foot to Low Back) 11.Examination Questions for Self Testing 12.Common Office Handouts in a Biomechanics Practice 13.Index Practical Biomechanics Question #5: What is so sacred about maintaining a patient within a 0-2 pain level? Practical Biomechanics Question #6: If a patient's injury necessitates a removable boot (cam walker), but the pain remains around 6-7, what additional steps are needed in this treatment? What classifies as Podiatric Biomechanics? The world of...

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