Current Pedorthics | January-February 2014 | Vol. 46, Issue 1 | Page 29

Posturology as a Treatment: Intrinsic Foot Muscles Instead of Rigid Orthotics? By Peter W.B. Oomens I n 1952, J.B.Baron, an ophthalmologist suggested a link between human sight and posture, thus creating a new field of study called posturology. This discipline takes into consideration the integral study of human posture and other body systems interacting together. Since 1976 when French neurologist René Jaques Bourdiol introduced an orthotics therapy using posturology as a base, a new neuromodular postural treatment known today as podopostural therapy, is taught to physicians, physical therapists and podoorthesiologists in and around Europe. For 25 years as a podopostural therapist, I have treated patients suffering from (chronic) low back pain and other, posture related, disorders. Podopostural therapy helps change the human posture by balancing the feet. Practicing therapists are able to provide a patient with a personally made pair of very thin insoles, where he glues pieces of cork of 1 to 2 mm thin. This therapy is based on the findings of Dr. René Jacques Bourdiol, a French neurologist († 2004) mentioned previously, who assumed a direct triggering of the intrafusal fibers of the intrinsic (plantar) foot muscles when applied by therapy. The effectiveness of this type of treatment is within discussion and it is my belief that excitation of the pressure sensitive mechanoreceptors of the hairless skin of the foot sole, during gait and stance, activates the related (plantar) intrinsic foot muscles (IFM). Challenging a Theory In 1995, I published in the NTIG (Dutch Journal of Integral Medicine, 1995; 11(2), 108-112), a research theory that suggested in a loaded human foot, at least in the length, we find a so called ‘force closure’ construction of the foot joints. This closure is maintained primarily through the intrinsic foot muscles and secondly muscles, supported by strong plantar ligaments, such as the aponeurosis plantaris and lig. calcaneonaviculare. These ligaments are unique to humans and not with other mammals. Living near the beach I have observed thousands of foot imprints in the sand, from both children and adults, and the more I studied them, the more I found something surprising. With 12% of the Dutch population having flat feet (pes planovalgus), I never could observe this foot joint construction from their footprints. On the contrary, all sand imprints I studied were less deep where I expected them to be; the deepest, under the medial arch. This offered me a different approach to researching this observation to find some kind of explanation for this phenomenon. The closest answer I was able to offer is that barefoot pronation is physiological and selfcorrecting. Is there a difference between barefoot walking and walking with shoes? Between walking with or without orthotic devices? In 1986, Benno Nigg published Biomechanics of Running Current Pedorthics January/February 2014 27