Orthotics Are Not Biomechanics

Start Page: 66
Author(s): 
Kevin A. Kirby, DPM

   Foot surgery alters the internal structure of the foot in order to decrease the pathological loading forces acting on injured structures of the foot and lower extremity. Foot orthotics alter the locations, magnitudes and temporal patterns of external forces acting on the plantar foot to decrease the pathological loading forces acting on injured structures of the foot and lower extremity. Foot surgery and foot orthotics are both biomechanical forms of treatment, one internal, the other external.

   Yes, performing foot and ankle surgery, wound care, routine care, and padding and strapping are all biomechanical forms of treatment. However, no matter how you look at it, orthotics aren’t biomechanics. Until podiatrists fully comprehend this important and critical concept, our profession will never be able to mature into the scientifically-based medical profession that our patients all deserve.

   Dr. Kirby is an Adjunct Associate Professor within the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt University in Oakland, Calif. He is in private practice in Sacramento, Calif.

   Dr. McCord retired in December 2008 from practice at the Centralia Medical Center in Centralia, Wash.

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