In 2002, I published a paper entitled Medial Column Foot Systems: An Innovative Tool for Improving Posture which described a previously unrecognized embryological foot type in which the 1st metatarsal is structurally elevated and inverted relative to the 2nd metatarsal. This foot structure is now known as Rothbarts Foot.
Dr. Janet Travell felt that the discovery of Rothbarts Foot was a major breakthrough in understanding the etiology of trigger points throughout the body.
Clinically, the 1st metatarsal and hallux are off the ground when the standing foot is placed in its anatomical neutral position (e.g., joint congruity), demonstrated using Pressure Plate Analysis. The distance between the 1st metatarsal and ground, is referred to as the primus metatarsus supinatus value (PMSv) and is quantified using microwedges. This method was proven to be a reliable measuring technique in a double blind study conducted by Cummings & Higbie (1997).
Pathomechanics of Rothbarts Foot
Rothbarts Foot is biomechanically dysfunctional, demarcated by its abnormal (mid-stance) pronation. Mid-stance pronation frequently shifts the posture forward, resulting in the:
I term this shift in posture BioImplosion which closely resembles the Common Compensatory Pattern originally described by Zink (1979). I suggest that the pathomechanics linked to the Rothbarts 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 Insoles
I developed proprioceptive insoles, now referred to as Rothbart Proprioceptive Insoles, to reverse postural distortions and the resulting musculoskeletal/visceral compensations. Proprioceptive insoles are not orthotics. The differences between the two are visibly apparent. Proprioceptive insoles apply a tactile stimulation to the bottom of the foot. Through this stimulation, a signal (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.
In a study done by Dr Allan Kalamir (Macquarie University, Australia) - abnormal pronation was linked to TMJ noise. Guaglio (et al) linked changes in the bite to changes in the foot stance. A statistical study (Rothbart, 2008) links abnormal foot motion to unleveling of the cranial bones.
Of importance to note: not
all abnormal foot mechanics originate in the feet. Sphenobasilar
torsions can alter foot mechanics (Descending Cranial Foot Model).
Sphenobasilar torsions can also produce a short leg syndrome (Descending
Functional Leg Length Discrepancy).
Orthotics function very differently from proprioceptive signals. 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, over time, 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.
Cummings GS, Higbie, EJ 1997 A weight bearing method for
determining forefoot posting for orthotic fabrication. Physiotherapy
Research International, Vol 2(1):42-50.
Daniels TR, Smith JW, Ross TI 1996. Varus Malalignment
of the Talar Neck. Its Effect on the Position of the Foot and on
Subtalar Motion. Journal Bone Joint Surgery; 78: 1559 - 1567.
Prof/Dr Brian A Rothbart Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot Structure and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Inventor and Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain
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