BLOGS

By Doug Richie, DPM Posts about the decline in knowledge of biomechanics demonstrated by students applying for postgraduate residency training recently appeared on a podiatry online daily e-newsletter.1 Several practitioners surmised that students see surgery as a more lucrative part of podiatric practice than orthotics, and therefore have little interest in learning biomechanics. If that is true, students are clearly misguided in terms of their expectations for reimbursement for surgical procedures compared to that for evaluating and dispensing orthoses, particularly ankle-foot orthoses (AFOs) in clinical practice. For example, consider the reimbursement and time spent on repair [...]

By Doug Richie, DPM Is bone overload the main culprit with medial tibial stress syndrome? Does foot pronation play a role in the etiology? Are there any treatments that are consistently effective for this condition? Addressing these questions and much more, this author offers a thorough review of the literature on the common, albeit poorly understood, condition of medial tibial stress syndrome.  Although medial tibial stress syndrome (MTSS) is among the most common musculoskeletal injuries in sport, experts continue to debate the etiology of this injury today. As a result, there is no validation for [...]

By Doug Richie, DPM In my previous blog, I discussed the myth promoted by many authors of authoritative articles discussing plantar heel pain with a promise that “conservative treatment is successful 90 percent of the time.”1 These conservative measures usually include rest, stretching, physical therapy, shoe inserts, nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections.2-5 Most of these authorities do not provide a timeline or criteria for determining “successful” treatment for relief of plantar heel pain. Whether it is home-based or implemented by a clinician, conservative treatment of plantar heel pain does not have a 90 percent success [...]

By Doug Richie, DPM One of the biggest myths propagated about plantar heel pain is the perception that 90 percent of all patients will experience cure of their condition with conservative treatment. I just finished writing an upcoming cover story for Podiatry Today reviewing published studies of non-traditional treatments for chronic plantar heel pain. Upon reading over 100 articles on this subject, I was struck by the repetitive proclamation that “conservative treatment will resolve plantar heel pain in 90 percent of all cases.”1-13 This authoritative statement appears in many journals and has been published by multiple disciplines. The authors [...]