May 2022

Biomechanics: Avoiding the Paralysis of Over Analysis

By Ben Pearl, DPM

Biomechanics research is one of the more layered topics to digest, but it is necessary to keep up with if you want to improve your patient outcomes. Lately, the push has been for evidence-based medicine and that is an admirable goal. We must understand, however, that this goal is a work in progress. Getting a group of subjects to adhere to a set of conditions in a study is no easy task, particularly when there is a requirement for follow-up evaluation over a long period of time. Furthermore, the understanding of a study that includes an analysis of an orthotic is subject to the definition of what one considers a “standard orthotic” and the list goes on: What sort of cushioned shoe? Were the runners competitive athletes or casual weekend warriors? How accurate was the measurement method? One also has to remember that real science demands repeated trials over time and does not base conclusions on just one study.

So, should we throw up our hands then and let the “academics” sift through all the research coming into the various peer-reviewed journals of sports medicine and biomechanics and just keep doing what we are comfortable with? No!!! It is up to each one of us as professionals to educate ourselves in the quest for a better version of a representative model of the answer to the question we are asking. In our quest for evidenced-based medicine, let us not throw out the possibility that a case series or even a handful of anecdotal cases are of value. In the case of a new technology, there should be some advantage, such as more rapid result or production, as with 3-D printing, or some enhanced resolution of imaging and portability, such as in ultrasound, or delivery of energy, such as in prosthetics, etc.

Biomechanics & Orthotics Summit ‘22

Agenda

Welcome and Opening Remarks
Ben Pearl, DPM

Putting Biomechanics Theory into Practice
Stephen Pribut, DPM

An Update on Biomechanics Research from Calgary
Benno Nigg, PhD

Practical Biomechanics
Richard Blake, DPM

Update on New Features & Materials in 3D/4D Printing
Yong Li, PhD

Current Trends in Orthotic Therapy
Stephen Pribut, DPM

Top 5 Orthotic Adjustments and Why
Richard Blake, DPM

Open Forum for Questions
Ben Pearl, DPM

Register by emailing
arlingtonfoot@gmail.com

The benefit of similar spirited colleagues exchanging ideas at meetings like the 50th anniversary of the American Academy of Podiatric Sports Medicine in Seattle October 21-23, 2022, is that the interactions you start in the conference sessions continue with your colleagues on the group runs, over dinner, and after the meeting, and will foster your professional development. There are too many technologies and variations to decipher on your own without some basis of validation from your peers. Just look at all the new sensors, scanners, and 3-D print options that have come out in the last few years. At the same time, you must be careful that you are not drinking some manufacturer’s Kool-Aid in your enthusiasm to add the next cool looking technology or revolutionary concept to your practice.

Bounce your ideas off colleagues on one of the many forums that are too numerous to list. But know your groups. Are they adhered to just ideas that happen to be in the wheelhouse of companies they speak for? Being an opinion leader is not a bad thing, but there can be industry influences, so just be aware of that.

The other way to keep up is to jump on the virtual education train, many events of which are available online in the very magazine you are reading. The Falls Prevention, Balance, and Function virtual seminar series is ongoing on lerExpo (lerEXPO.com) and the first segment (from April 19, 2022) is archived for viewing. On June 7, I will be hosting Biomechanics & Orthotic Summit ’22 virtually at 6:15 pm EST. Luminary panelists include Benno Nigg, PhD, Richard Blake, DPM, Steve Pribut, DPM, and Yong Li, PhD. Sign up for the zoom meeting by emailing ArlingtonFoot@gmail.com.

Instead of binge watching a Netflix series, try listening to a new podcast for a fresh perspective on movement from a coach’s perspective if you are a medical professional, and vice versa if you are a coach. In our quest for the perfect training sequence, therapy, shoe, orthotic, splint, know that somewhere between the truth that we know and the Truth with a capital T that is our ideal, there are smaller truths along the way that will help us get closer to the Truth that we seek.

Ben Pearl, DPM, is a fellow of AAPSM, a ski coach, assistant run coach, and host of both a podcast and a YouTube program—Fit Foot U—which  interviews various coaches, athletes, and medical professionals on a variety of sports medicine and biomechanics topics.

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