Hello and what's what

Hello I'm Dave Smith, podiatrist and biomechanist practicing in the UK. Been doing podiatry and biomechanics for 18 years at FootHouse Ltd Fokestone Kent and have an MSc in applied biomechanics from University of Strathclyde. A lot of my daily work is in podiatric MSK, as its called these days.

So what is MSK and where does biomechanics fit in? This is a question often asked. I give a citation here to my friend and colleague Robert Isaacs who neatly separates MSK and Biomechanics in his lectures that he gives around the country and abroad. Its quite simple really:

Podiatric MSK is the process of history, assessment, testing, diagnosis treatment, planning and ongoing care for mechanical problems of the musculosketal system forming the lower limbs and feet. These techiques and skills can be used to address pathological conditions, injuries, gait and activity disorders and sports performance.

Biomechanics is the system of mechanics used to treat or address the problem at hand once we've discovered what is the precise problem and then found to have a mechanical aetiology or it can be addresed using mechanical principles. For instance, an ankle sprain has a direct mechanical cause and can be treated using mechanical principles. Arthritis is not solely a mechanical cause but can be addresed using mechanical intervention.

Mechanics is defined for our purposes as: The study of forces and displacements on a body or mass and the effect on structure and function of a mechanical system.

Biomechanics is not always the whole solution to resolution of painful symptomatology and often it is combined with clinical, medical and manual therapies, as is clearly obvious in the previous two examples.

So what is my objective here?

I find it quite frustrating that Biomechanics, by my experience, appears to be poorly understood by many podiatrists in all countries of the world, although Australians seem to have a better grasp across the breadth of their podiatric community than most. This lack of understanding leads to poor communication between clinicians and poor communication leads to poor understanding of the principles trying to be made clear. This problem is especially highlighted in this age of blogs and social media and forums dedicated to discussing such topics and the difficulties and misunderstandings that arise.

I have, in the past,moaned and ranted on podiatry forums about this apparent lack and so I decided that I should help to be part of the solution. So, before anyone can communicate the subject they must first have grasp of its principles and application. This is what I hope to achieve through this blog! I'm gonna try and keep it as applied as is possible and not delving into difficult physics and mathematics. I might say simple but simple is a relative word and I am aware that the mere mention of physics, force, levers and moments can have some running for the door or breaking out in a sweat. However nothing worth achieving is ever easy and biomechanics does have some physical principles, concepts to get hold of, and theories that require the use of precise terminology to describe. It should be noted perhaps, that Oscar Wilde said "Its worth remembering that nothing worth learning could ever be taught" hopefully Biomechanics is worth learning and I can help improve understanding and communication in some part.

So, this is not where you come to learn or brush up on MSK, what I'm going to be doing here is to look solely at biomechanics in terms of Newtonian mechanics and how to apply it in the clinical setting. Although ultimately that should result in improved clinical outcomes my main objective is to improve understanding and communication throught out the profession.

My aim is to do one blog every two weeks, each one building on the last, and then answer questions in between. Maybe I won't be able to answer every individual question but will group questions into categories or pick out some particularly relevant or interesting ones.

Some points of order :

I don't want to see phrases like -Physics is beyond me - I can't get my head around biomechanics its too hard - biomechanics is just a theory you can't prove it works - I prefer the more simpler theories coz they make sense to me. This is negative thinking, be more. 

Ask questions, if you think they might be dim or not worthy then this is the place to ask so when you get out on the dance floor you can look cool.

I promise to be kind and patient, I want you to improve, that's why you're here and why I invited you to engage.

If you think I'm wrong that's OK too, make your case, with reasoned argument and logical procession of premise to conclusion and put me right.

However, if you think you have got a better system of intervention or paradigm, and its not mechanical, based in physics and Newtonian mechanics, good for you but I'm not interested. The point of this blog is not to debate the merits of various systems of interventions to treat lower limb pathology or improve active performance.

Personal attacks will be blocked and barred (if I can work out how to do that)