4th congress of the international foot and ankle biomechanics community.

Too many times theories of how the human foot functions and therefore how mechanically inducted foot problems are treated have been presented as if they were facts. The dogmatic adherence that sometimes ensues from such an approach has frequently stifled the evolution of foot mechanics. This has been particularly apparent in the field of podiatry which has been dominated by the Root paradigm. Briefly, the Root paradigm proposes that the human foot functions ideally around the subtalar joint’s neutral position. Additionally, the forefoot to rearfoot frontal plane relationship ideally should be perpendicular. Furthermore, deviations from those ideal positions are termed deformities. [1,2] Biomechanical treatments according to Root are intended to re-align the foot so as to function around the neutral subtalar position and/or prevent frontal plane compensations from a deformed forefoot. In essence this paradigm is based on foot morphology. Several studies have raised doubts as to the validity of the Root paradigm. [3-8] This abstract is a review of several papers which raise those doubts and explores emerging paradigms of human foot function which align more with current research findings on foot function.[9-11] References 1. Root M, Orien W, Weed J: Biomechanical evaluation of the foot. Los Angeles: Clinical Biomechanics Corporation 1971. 2. Root M, Orien W, Weed J: Normal and Abnormal Function of the Foot. Los Angeles: Clinical Biomechanics Corporation 1977, 2. 3. McPoil TG, Cornwall MW: The relationship between subtalar joint neutral position and rearfoot motion during walking. Foot Ankle Int 1994, 15:141-45. 4. Payne CB: The past, present, and future of podiatric biomechanics. JAPMA 1998, 88(2):53-63. 5. Lee WE: Podiatric biomechanics. An historical appraisal and discussion of the Root model as a clinical system of approach in the present context of theoretical uncertainty. Clin Podiatr Med Surg 2001, 18(4):555-684. 6. Nigg BM, Nurse MA, Stefanyshyn DJ: Shoe inserts and orthotics for sport and physical activities. Medicine and Science in Sports and Exercise 1999, 31: S421-8. 7. Stacoff A, Reinschmidt C, Nigg BM, van den Bogert AJ, Lundberg A, Denoth J, Stussi E: Effects of foot orthoses on skeletal motion during running. Clinical Biomechanics 2000, 15:54-64. 8. Heiderscheit B, Hamill J, Tiberio D: A biomechanical perspective: do foot orthoses work? British Journal of Sports Medicine 2001, 35:4-5. 9. Kirby K, Fuller E: Subtalar Joint Equilibrium and Tissue Stress Approach to Biomechanical Therapy of the Foot and Lower Extremity. Lower Extremity Biomechanics: Theory and Practice Denver: Albert SF, Curran SA, 1 2013, 1:205-264, Bipedmed. 10. Whitney KA: Classification and Treatment of Congenital Sagittal Plane Deformity. Lower Extremity Biomechanics: Theory and Practice Denver: Albert SF, Curran SA, 1 2013, 1:265-288, Bipedmed. 11. Curran SA: Sagittal Plane Facilitation of Motion Model and Associated Foot Pathologies. Lower Extremity Biomechanics: Theory and Practice Denver: Albert SF, Curran SA, 1 2013, 1:289-315, Bipedmed.