2020: The Year That Was!

By Phil Maffetone, DC

Some years it’s hard to say good-bye…and then there’s 2020. We’re sure we’re not the only ones happy to see it in the rearview mirror. But to just drive away is to ignore the words of Socrates, who rightfully said,

“The secret of change is to focus all of your energy not on fighting the old, but on building the new.”

We want to take this opportunity to express our appreciation for all those who have supported Lower Extremity Review this past year in oh, so many ways. And we want to thank those who have supported lerExpert, and now, lerEXPO. We’re focused on building the new and are glad to have you with us.

2020 obviously saw a much-curtailed schedule for in-person visits, but we still want to thank our hosts:

• NY Podiatric Clinical Conference (NYC)
• American Academy of Orthotists and Prosthetists (Chicago)
• No-Nonsense Seminar (North Central Academy of Podiatric Medicine, Cleveland—ok, this didn’t actually happen, but we made some good friends so that still counts)

While travel was curtailed, lerEXPO had the opportunity to launch and we want to acknowledge the sponsors for those events (check out lerEXPO.com for follow-ups):

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Transverse Arch Importance Overstated

By Kevin A. Kirby, DPM

I write in response to the September 2020 LER article, “Overlooked Arch in the Foot Is Key to its Evolution and Function,” by William Weir, which discusses the article, “Stiffness of the Human Foot and Evolution of the Transverse Arch,” by Venkadesan et al, published in Nature in early 2020.1

The article by Venkadesan et al discussed the possible importance of the transverse arch of the midfoot to the stiffness of the longitudinal arch of the foot. Unfortunately, both articles overestimate the biomechanical influence of the transverse arch on foot stiffness and whether Venkadesan et al’s ideas truly “have not been studied previously.”

For many years, the longitudinal arch was thought to provide most of the stiffness to the foot to improve the mechanical efficiency of human bipedal gait. In their paper in Nature, Venkadesan et al make claims that the transverse arch of the midfoot contributes “more than 40% of the longitudinal stiffness of the foot.” While the authors have done their homework in modelling the transverse arch of the midfoot to estimate its contribution to longitudinal arch stiffness, the authors omitted important factors regarding the biomechanical importance of the longitudinal arch in increasing the mechanical efficiency of gait within the human bipedal animal. In other words, the estimate made by these authors that the midfoot transverse arch contributes “more than 40% of the longitudinal stiffness of the foot” appears to be wishful thinking on the part of these researchers.

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