Does biomechanics have sufficient emphasis in podiatric education?

35% (65 votes)
65% (120 votes)
Total votes: 185


I have trained podiatric surgical residents for over 30 years and I find that students have less knowledge about biomechanics than their earlier peers.

What is the consequence of this? They don't have an understanding of the pathomechanics that produce many if not most of what we as podiatrists treat. Would it be a good idea to have open heart surgery by cardiac surgeon who knew nothing of how the normal heart worked? I think not.

How do you take the podiatric surgeon from the hesitant operator, cookbook surgeon to ultimately, the thinking innovative technician without biomechanics? Most students could not describe the determinants of gait nor tell me how hip arthritis contributed to a sub second keratoma.

Biomechanics is the core of our knowledge to most of the entities we treat. I think our training may be stopping at the cookbook surgeon level rather than progressing to the complete innovative podiatric surgeon.

Jared Frankel D.P.M.
Elmhurst, Illinois

Biomechanics is what sets us apart from the rest of the medical services community. By the way, when I say that, I am also talking about all us surgeons as well. The best surgical foot procedures consider the mechanics pre, during and post-surgery.

It has been a few decades since I was in podiatry college but I think my observations still hold true. There is plenty of theory (from whoever’s camp you come from) and not enough practical. The challenge (in my opinion) is how you teach the “art” without the knowledge of the theory and a large dose of EXPERIENCE within the short time allotted for a DPM degree.

Maybe the question should be more like “is enough emphasis placed on biomechanics in the residencies?”

I agree they all are taught the "Root" textbook but they do not retain practical biomechanics. Students see it like the Krebs Cycle and just memorize it for the test. I think they need to integrate biomechanics with surgery. If a surgeon, which all the new DPMs will be, cannot see how they are affecting the foot in 3 dimensions with a surgical treatment, they should not pick up the knife. I also agree they should all review Valmassy's 1st ray influence on biomechanics of the foot.

I agree with a lot that is written so far. The bottom line is that our students need more biomechanics whether surgically or conservatively.

As far as the different biomechanical theories out there, there is only one truth, and there are many ways to get there. No one has the perfect answer, but they think they do. We should train our students to be able to think. Then they can see the benefits of each theory and apply it all.

Remember what brought us up from chiropodists was sports medicine in the 1970s. The biomechanics is what made us what we are as a profession.

I feel you need a good knowledge of biomechanics for sports medicine, surgery, and of course orthotics. If you don't understand how the foot and ankle function mechanically, good luck.

Biomechanics is a big part of the practice of podiatry. However, biomechanics and the prescribing of orthotics with the incorporation of physical medicine and rehabilitation procedures make a much better podiatric orthopedic practice. I don't think this is taught sufficiently in school.

Interesting how all the comments see the "magic" of biomechanics. Our understanding of biomechanics as a profession and as all medical professions is lacking. We take and preach Root biomechanics which has ZERO evidence behind it.

I realize that all of you make a lot of money "treating" biomechanics and "relieve" money from millions of people. Show me a "normal" ROM or a perfect gait or any study that supports that abnormal biomechanics A is the cause of pathology B.

I am not all surgery, surgery, surgery. I am just the opposite. But I also know BS when I see it and I don't believe in Bigfoot either.

We can thank Residency Resources and accredidations which are only interested to graduate residents by the number of surgical cases they have done and not the amount of orthotics they have successfully casted and dispensed.

Most podiatric biomechanics is an unproven, anachronistic nod toward chiropody, shoe salesmanship and an insecurity in the economic viability of the medical and surgical side of podiatry.
It is favored by those that wanted a business with an impressive title without too much intellectual effort. These people should have become pedorthists,physical therapists or, maybe, engineers. Yes, there is some role in podiatry, but some biomechanics supporters have a religious fervor for "arch supports" to cure most maladies without medicines. Robert Bijak,DPM

Doug Richie Jr. DPM FACFAS's picture

It is clear that too many practitioners still percieve podiatric biomechanics as a science devoted to Root theory and foot orthoses. This clear misconception is the result of ignorance in our profession to teach the monumental changes which have occured in our understanding of lower extremity function as well as the surgical implications of these new insights. Instead, our orthopedic counterparts have paved the way with research into joint moments, lower limb kinematics, movement coupling and multi-segment foot modeling. How can we advocate teaching biomechanics in the schools when we have no conception of what this science is really about? Doug Richie D.P.M.

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