Postural Corrections using Proprioceptive Insoles (Photos - Pre and Post Stimulation)

Comments from Healthcare Professionals familiar with or using Professor Rothbart's Insoles

3 Factors that can distort Proprioceptive Signals:

• Unstable Shoes
• Incorrect Signals
• Polarity Reversals

Postural Distortional Patterns - Ascending vs Descending:  the pathomechanics associated with these two distinct patterns

Rothbart suggests that PMs is the end result of a failed or incomplete embryological unwinding of the talar head.  Independent research published by Daniels et al (1996) supports Prof Rothbart's theory.  Daniels et al reported a direct correlation between talar varum and forefoot varus defomities.

Clinically, the 1^st metatarsal and hallux are off the ground when the standing foot is placed in its anatomical neutral position (e.g., joint congruity)  This can be demonstrated using Pressure Plate Analysis.

The distance between the 1^st metatarsal and ground, is referred to as the PMs value and is quantified using microwedges (Cummings & Higbie, 1997). 

• Primus Metatarsus Supinatus (PMs) (aka Rothbarts foot structure) - PMs values between 10 and 30 millimeters
• PreClinical Clubfoot Deformity (PCFD) - PMs values between 30 and 55 millimeters

 
Biomechanics of the Primus Metatarsus Supinatus foot

Pms is biomechanically dysfunctional, demarcated by its abnormal (mid-stance) pronation.  Mid-stance pronation frequently shifts the posture forward:

• (1) the innominates rotate anteriorly which can unlevel the legs,
• (2) the pelvis tilts, which can distort the spinal curves (See animation below),
• (3) the shoulders protract,
• (4) the head moves forward relative to the cervical spine resulting in
• (5) a Class II occlusion. 

Rothbart terms this shift in posture BioImplosion which closely resembles the Common Compensatory Pattern originally described by Zink (1979).  Rothbart suggests that the pathomechanics linked to the PMs foot are a plausible etiology for the development of musculoskeletal pain (Dr Janet Travell's trigger points), as well as, scoliosis (AIS), dental imbalances, diabetic ulcers and plantar fasciitis.

Proprioceptive Signals:  Proprioceptive signals (insoles) were developed to reverse postural distortions and the resulting musculoskeletal/visceral compensations.  Proprioceptive signals are not orthotics.  The differences between the two are visibly apparent.  Proprioceptive signals apply a tactile stimulation to the bottom of the foot. Through this stimulation, a message is sent to the cerebellum, the balance center of the brain. Acting on this signal, the cerebellum initiates a postural correction affecting the entire body (See Figure below).  Dramatic change (improvement) in the face (reversing ptosis) and spine (Formetric Studies on Scoliosis) have been achieved using this technology.  A Case Study is presented that links chronic fascial pain to abnormal foot mechanics (Smith, 2006).

A published research study (2003) suggests that Proprioceptive Signals are very effective in shifting surface area and pressure readings towards homeostasis (Cuernavaca Study, Current Research). 

   Wikipedia Encyclopedia's definition of a proprioceptive stimulation orthotic (insole)

Malposition of the innominates (both anteriorly and posteriorly) can be corrected using Proprioceptive Signals.  Functional leg length discrepancies, driven by abnormal foot mechanics (e.g., Ascending Model) are attenuated and/or corrected using proprioceptive signals.

Dental PathoMechanics linked to Postural Distortions resulting from Foot PathoMechanics:  In a recent study by Dr Allan Kalamir (Macquarie University, Australia) - abnormal pronation was linked to TMJ noise.  Guaglio (et al) link changes in the bite to changes in the foot stance.  A statistical study (Rothbart JAPMA in press) links abnormal foot motion to unleveling of the cranial bones.  A case study is presented.

Orthotics function very differently from proprioceptive isignals.  Orthotics support the foot by incorporating (1) arch supports underneath the medial longitudinal arch, (2) metatarsal pads underneath the metatarsal heads, and (3) wedging underneath the heel and metatarsal heads.  Orthotics do not improve posture, and over time, can weaken the intrinsic muscles of the foot.  Fusco (et al 2001) has linked weak plantar muscles to the development chronic musculoskeletal pain, ankle to jaw.

• Zink GJ, Lawson WB 1979.  An Osteopathic Structural Examination and Functional Interpretation of the Soma.  Osteopathic Annals 7:12-19.
• Fusco MA, Fusco R, and Ambrosone M. 2001 Instrumental Evaluation of the Consequences on the Pelvis and on the Vertebral Column Caused by the Use of Various Orthotics, Performed by Means of the Posturographic Rug 3D VRS Formetric. KS ITALIA Studies’ and Research Center.

Three Minute Screening for the Primus Metatarsus Supinatus Foot type:

• Look for a Positive Knee Bend Test
• Look for a deep 1st webspace
• Look for an uneven heel wear pattern in the shoes
  
   
  Interpretation of Results:

• 1 out of 3 positive = 70-75% level of confidence, screening is positive for the PMs foot
• 2 out of 3 positive = 80-85% level of confidence, screening is positive for the PMs foot
• 3 out of 3 positive = 90-95% level of confidence, screening is positive for the PMs foot