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Your Back Pain May be Worse after Having Back Surgery

rothbartsfoot@yahoo.com (rothbart) — Fri, 12 Feb 2010 11:25:00 GMT

Are you thinking about undergoing the knife to eliminate your back pain? Before you make such an important decision which will affect the rest of your life, it’s important to read the experiences of other back pain sufferers who have had this invasive surgery.

Below are four posts, taken from the Spine Health Forum, of people whose pain is worse after their back surgery:

Martyjo

Here I’m again posting. 15 months post L3-S1 fusion with iliac bone graft. I just can't get past the pain and spasms. I thought I'd be walking around and enjoying life. Instead, I have to take pain pills just to do normal daily living tasks.

Straker

I myself am still in considerable pain post operation {18 months now}. My first operation in 1996 was a laminectomy L4/L5. My second operation was in 2007, a bilateral discectomy S1 and redo of L4/L5 laminectomy to release scar tissue from my first back surgery.

sun2

I am three years post anterior double fusion L3-SI. I am in the same boat. I also need medications just to do normal things.

Meydey321

I went through a fusion on L5-S1 10 months ago and it was my second back surgery. The first time around was a bust since I suffered a recurrent herniation among other problems. These two surgeries were supposed to make me feel a whole lot better and get me on my feet again. It didn't go that way in either case!

The failure rate for back surgery is deplorable. In fact, in many cases the surgery actually makes the pain worse then before the surgery was done.

Why do back surgeries fail?

The answer lies in first understanding the cause of the back pain. In almost all cases, the herniation (a pathology in the spinal discs) and resulting back pain is caused by an underlying problem. And surprising enough, frequently that underlying problem is the way your feet function when you walk.

A direct link has been documented between back pain and bad posture resulting from foot twist (abnormal foot motion). When the posture is improved by eliminating the foot twist, the back pain quickly dissipates, without the need for surgery.

Rothbart Proprioceptive Therapy has been proven to be a very effective therapy that eliminates back pain by reprogramming the cerebellum (brain) to automatically improve posture.

Professor/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

Therapies That Only Manage Chronic Pain - Drugs

rothbartsfoot@yahoo.com (rothbart) — Wed, 03 Feb 2010 10:17:00 GMT

Pain medication is one of the top 10 treatments traditionally used to treat chronic muscle and joint pain.

This has had some pretty devastating effects for chronic pain sufferers. For example, lately the news has been flooded with untimely celebrity deaths as a result of taking prescriptive pain medication(s). But, this problem does not lie merely with the rich and famous. In fact, taking prescriptive painkillers has become more common than street drug abuse.

The dangers of pain medication have been documented everywhere. Why is it that billions of people still reach for their pill bottle to suppress their pain?

One very good reason is that many pain sufferers have not yet found anything else that actually eliminates their pain and so they just live with pain management. In other words, the cause of their pain has not been found and effectively treated.

Let’s take a closer look at how pain medication works and its side effects. These two factors alone will hopefully convince you that it’s a better idea to find a therapy that actually addresses the source of your pain, thereby eliminating it for good.

What is pain medication?

Pain medication, commonly referred to as painkillers, include over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin and/or acetaminophen, anti-depressant drugs and prescription pain medications such as opioids, morphine and methadone.

How does pain medication work?

Non-prescriptive pain medication such as NSAIDs (Ibuprofen®, Motrin®, aspirin (Bayer® and acetaminophen (Advil®, Tylenol® inhibits the production of prostaglandins, which are hormone-like substances which increase sensitivity to pain.

Prescription anti-depressants such as the tricyclic drugs (Elavil®, Prozac®, Zoloft®, etc.) increase the level of serotonin (a neurotransmitter), which suppresses the pain circuit to the brain.

Opioids (codeine, Alfenta®, Subutex®, Stadol®, etc.) are chemical substances that have a morphine-like action in the body.

* Please note that all of the above suppress pain in one way or another. But none of the above addresses the reason why you have pain in the first place. It stands to reason, that if the drug doesn’t address and effectively treat the cause, you will have to continue to take it for the rest of your life – pain management.

What are the side effects?

Painkillers must be taken continuously to be effective and have many documented side effects. The side effects of non-prescription pain medications includes: ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea, diarrhea, constipation, heartburn and unexplained weight gain. They can increase bleeding after an injury and cause ulcerations in the stomach. They reduce blood flow to the kidneys and can impair or cause acute kidney failure. Heart attacks, high blood pressure and heart failure have also been associated with the use of these non-prescription drugs.

The side effects of prescription anti-depressants include: liver dysfunction (jaundice), confusion, muscle rigidity and heart and kidney failure leading to death.

The well-known side effects of chronic opioid therapy include dependence or addiction, aberrant drug behaviors and respiratory depression (which can lead to death). It is important to note that over one million Americans are currently addicted to opioids.

To make matters worse, additional drugs are often prescribed to handle the side effects of the above medications. It is not uncommon for patients to take 10 to 15 different drugs a day for this very reason. The cumulative effect of taking so many drugs over a period of time is unknown.

When looking at the facts, it’s pretty obvious why painkillers are not the preferable way to treat your muscle and joint pain. Yes, they suppress your pain as long as you take them, but because they don’t treat the source of your chronic pain problem, they must be taken continually for the rest of your life. Besides being a very expensive habit, you could easily become another victim of (legal) drug addiction.

To find out the potential source of your chronic pain, go to the Rothbarts Questionnaire page.

To read about healthy alternatives to pain medication, go to Non Drug Alternatives for Resolving Chronic Pain.

Professor/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

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

Non Drug Alternatives for Resolving Chronic Pain

rothbartsfoot@yahoo.com (rothbart) — Mon, 25 Jan 2010 18:32:00 GMT

Millions of people worldwide suffer with chronic muscle and joint pain. After trying countless therapies and even surgery, all to no avail, people often turn to prescription painkillers to eliminate their suffering.

Each year, pharmaceutical companies spend billions in promoting pain medication as a ‘solution’ for managing chronic pain. This propaganda (often based on false or misleading claims) is partly responsible for the multitude of persons using pain medication long-term in order to manage their pain.

Unfortunately, many prescriptive painkillers are addictive and lethal. As a result, the use of prescriptive drugs, such as opioids, has become an epidemic. In fact more people are killed by prescription opioids than all those killed by heroin and cocaine combined.

Many people reach for their pill bottle with little thought or awareness of what it might do to their health. But the side effects of using pain medication over a prolonged period of time cannot be ignored, as they can be worse than the pain itself. Such side effects include liver dysfunction, fueling of existing cancer malignancies and respiratory depression (which can lead to death).

Sometimes we have to take medication as there may be no other way to get short term relief from the agony of chronic muscle and joint pain. But pain medication only interrupts the pain signal to the brain so that the pain is not felt and relief lasts only as long as one continues to take the pain killers. Don’t confuse this temporary relief with healing.

There are natural options to prescription pain medication which will not only reduce or even eliminate pain, but also promote healing throughout the body and enhance your health for the rest of your life. Some of these are:

1. Cleansing your digestive tract

Pain medications cause a toxic digestive tract by suppressing the contraction of the stomach muscles. This causes constipation, and as a result small amounts of toxins and waste begin to accumulate along the lining of your intestines. If the toxins penetrate the lining of the stomach and enter the blood stream, they will circulate throughout the body, deposit into your joints and cause pain. With a good cleansing program you can heal your digestive tract and break up the accumulated toxins.

2. Cleansing your liver

The liver’s job is to remove toxins from the body. Help it do its job by drinking plenty of pure water with fresh lemon juice added, which will flush away pain inducing toxins.

3. Eating ‘live’ foods

Reducing your intake of meat and animal products and eating a plant-based, ‘living’ foods diet will help eliminate toxins in your muscles, joints, tissues and nerves.

4. Getting enough sleep

While you sleep, the body carries on important functions to restore and maintain wellness. Your body simply cannot get well if it is deprived of sleep, due to pain.
There are many non-drug solutions that promote a good night’s sleep, thereby giving pain relief. A few of them are:

Eating your largest meal early in the day and your lightest meal early in the evening.

Using sleep inducing, pure therapeutic grade essential oils in the bath, dabbed on the body or massaged into the feet before bedtime.

Closing your eyes and ‘feeling’ a pleasant experience, such as walking on the beach and feeling warm sand under your feet and the sun on your head. This will calm down an overactive mind.

Following the above recommendations, one through four; will help you reduce or get off pain medication and greatly improve your overall health. But in addition, there is another step that is crucial to successfully eliminating your muscle and joint pain, once and for all. You must:

5. Address and effectively treat the source of your pain.

Lately, there has been much written about treating the source of chronic muscle and joint pain and there are numerous therapies that claim to do so. But the truth is; if the source of chronic muscle and joint pain was being addressed and effectively treated, there wouldn’t be so many people worldwide still suffering!

A previously unknown, yet very common source of chronic muscle and joint pain is in the feet.

Many people are born with an abnormal foot structure (that is frequently undiagnosed) that creates bad posture and predisposes them to a lifetime of muscle and joint pain. If you have this foot structure, this source must be addressed and effectively treated in order to permanently eliminate your chronic pain. How to identify this foot structure and the method that I have developed to effectively treat it; is fully explained in my book, Forever Free From Chronic Pain.

My wish for you is that 2010 be a New Year of health and happiness. A good first step toward making this a reality is to make a commitment to reducing pain medication or disposing of it altogether. In its place, use healthful alternatives such as a natural health regimen to clean out and rejuvenate your body. For permanent pain elimination; look for the source of your pain. It may be in your feet.

Resolution of Chronic Knee Pain

rothbartsfoot@yahoo.com (rothbart) — Tue, 19 Jan 2010 11:01:00 GMT

In 1993, a three year study was completed at the Bellevue Foot and Ankle Center in Bellevue, Washington, on 128 patients who suffered with chronic knee pain.

Prior to this study, these patients had been treated with various therapies including physical therapy, osteopathic and/or chiropractic manipulation, anti-inflammatory medications and in some cases, surgery. All of these patients were to some degree disappointed with the therapies they had received and were committed to permanently eliminating their knee pain.

I ran an initial evaluation, testing and analysis on each patient and found that all 128 patients all had foot twist and bad posture. A therapy (which later evolved into what is now known as Rothbart Proprioceptive Therapy) was then initiated to permanently improve their posture.

One year after therapy was completed, the patients completed a questionnaire. The results were:

78 patients reported that their chronic knee pain lessened 70% or more

14 reported that their knee pain lessened by 50-60%

8 reported that their knee pain lessened 10 to 40%

25 reported a definite decrease in their knee pain, but percentage of improvement was given

1 reported no change in their knee pain

2 reported an increase in their knee pain

Objective Outcomes (what I noted):

Of the 92 patients who reported a decrease in their level of knee pain of 50% or greater, all had a dramatic improvement in their posture.

Of the 8 patients who reported a decrease in their level of knee pain of 10 – 40%, all had a slight improvement in their posture.

The 1 patient who reported no lessening in her level of knee pain, no improvement in her posture was noted.

Of the 2 patients who reported an increase in their level of knee pain, all 2 demonstrated a deterioration in their posture.

Conclusion

A direct correlation was observed between bad posture and chronic knee pain. When the therapy improved the posture, the chronic knee pain diminished. However, when the posture did not improve, or deteriorated, the knee pain either remained the same or increased.

This study suggests that a viable, effective way to eliminate or dramatically reduce chronic knee pain is by permanently improving posture.

Reference:

Rothbart BA, Yerratt M. 1994. An Innovative Mechanical Approach to Treating Chronic Knee Pain: A BioImplosition Model. The Pain Practitioner (formerly American Journal of Pain Management), 4(3): 13-18.

The Foot can Create Muscle and Joint Pain in the Entire Body

rothbartsfoot@yahoo.com (rothbart) — Sat, 09 Jan 2010 10:27:00 GMT

An estimated 80% of the world population has one of the two inherited, abnormal foot structures that Professor Rothbart has discovered. These foot structures are known as the Rothbarts Foot and the PreClinical Clubfoot Deformity.

These common, abnormal foot structures create multiple effects in the body; which over time, can affect some or all of your weight-bearing joints and muscles (such as the neck, back, hips, knees and ankles) and cause pain.

If you have tried everything to eliminate your muscle and joint pain, but nothing has permanently resolved your problem, there is a good possibility that you have a Rothbarts Foot or PreClinical Clubfoot Deformity, and no one has identified and correctly treated your foot structure (the probable source of your pain).

How the feet can lead to pain throughout the body:

1. All feet have mechanical receptors on the bottom, which are stimulated through touch, as in standing or walking. This stimulation produces a signal which is sent to the brain.

If the foot structure is normal, correct signals are sent to the brain. The brain acts on these correct signals by maintaining good posture.

If the foot structure is abnormal (such as in a Rothbarts Foot or PreClinical Clubfoot Deformity), distorted signals are sent to the brain. The brain acts on these distorted signals by maintaining bad posture.

2. Posture affects the health of all the weight-bearing joints and muscles in your body (e.g., the neck, back, hips, knees and ankles). If you have bad posture, your joints become misaligned. This can lead to joint and muscle inflammation, which results in pain throughout the body.

3. If your bad posture is not permanently corrected, your muscle and joint pain can become severe and chronic.

If you have a Rothbarts Foot or PreClinical Clubfoot Deformity, the only way to permanently correct your posture (and thus eliminate your chronic pain), is by correcting (normalizing) the distorted signals coming from your feet.

After many years in research, I developed a therapy which does just that! Rothbart Proprioceptive Therapy corrects the distorted signals coming from the Rothbarts Foot and PreClinical Clubfoot Deformity. The brain receives these corrected signals and automatically improves your posture.

Through a series of postural corrections, your posture becomes straighter and straighter, allowing the weight-bearing joints to re-align into their proper position. As a result, the chronic inflammation in your joints and muscles can now heal and so the musculoskeletal pain in your entire body is eliminated for good.

For more in-depth information on the contents of this article, read my book, Forever Free From Chronic Pain.

Professor/Dr.Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot 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

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

Scoliosis - Rothbart Proprioceptive Therapy vs Surgical Intervention

rothbartsfoot@yahoo.com (rothbart) — Mon, 04 Jan 2010 13:31:00 GMT

The most progressive spinal (scoliotic) curve is the right thoracic curve. Its growth velocity is the fastest at skeletal ages 12-13, but frequently continues moderately after the age of 16 (Yrjones,20006).

Rothbart Proprioceptive Therapy has proven to be very effective in reversing scoliotic curves in adolescents.

Case # 1 – Right Thoracic Scoliotic Curve – 13 year old male

The parents of a 13 year old boy brought their son to see their family doctor, concerned over the progressive worsening of the son’s scoliosis. The doctor suggested a back brace. The brace was uncomfortable and difficult for the boy to use in school, so the parents decided to seek the advice of an orthopedist.

The orthopedist took two sets of Xrays (a year apart) of the boy’s spine. The first set of Xrays showed a right thoracic curve of 17 degrees. One year later, when the second set of Xrays was taken; the right thoracic curve had increased to 31 degrees.

The orthopedist explained that right thoracic curves are the most unstable type of scoliotic curves. When patients in their pre-teens and early pubescence have a right thoracic curve, this requires immediate attention. The orthopedist strongly advised surgical intervention (fixation of the thoracic vertebra) before the thoracic curve deteriorated even further.

Before subjecting their son to such an invasive and painful surgery, the parents decided to seek a third opinion and brought their boy to see me at my office in Rome.

After initially examining the boy, I determined that he had a Rothbarts Foot. I then tested him using proprioceptive stimulation under his feet in order to determine if any changes would occur in his thoracic curve. I noted that the boy’s posture looked straighter, his shoulders were more level and his head was more centered over his spine (See Right Thoracic Curve below).

Right Thoracic Curve. Before proprioceptive stimulation vs immediately after proprioceptive stimulation

Based on this immediate improvement in the boy’s posture using proprioceptive stimulation, I determined that his Rothbarts Foot was the cause of his right thoracic curve. Rothbart Proprioceptive Therapy was then initiated in order to stabilize the patient’s right thoracic curve.

Results

Using Rothbart Proprioceptive Therapy, the progression of the thoracic curve was not only stabilized, but also reversed. There was no longer any need for bracing or surgical intervention.

Reference

Yrjonen T, Ylikoski M 2006. Effect of growth velocity on the progression of adolescent idiopathic scoliosis in boys. Journal Pediatric Orthopaedics; 15(5):311-315.

Case 2 – Right Thoracic/thoracolumbar Scoliotic Curve – 15 year old female

The parents of a 15 year old girl were concerned over the visual appearance of their daughter’s back and that it might be getting worse and brought her to see an orthopedist.

The orthopedist’s initial exam and evaluation revealed a well compensated (stable) right thoracic colubar double curve. Initial Xrays taken at the hospital revealed a right thoracic curve of 32 degrees and a left thoracolumbar curve of 28 degrees (See Xray A below).

Xray A Xray B Xray C

The orthopedist diagnosed the girl as having adolescent idiopathic (cause unknown) scoliosis. He told the parents that the right thoracic curves are most unstable around the time of the beginning of menstruation and that these curves are prone to worsening if not surgically stabilized. Based on the orthopedist’s recommendation, the parents consented to the surgery.

Immediately after the surgery was done, Xrays demonstrated that the right thoracic curve had not changed, but that the left thorocolumbar curve had been decreased (by the surgery) from 28 degrees to 22 degrees (See Xray B above).

Six months after the surgery, the parents brought their daughter to see the orthopedist, anxious over the cosmetic appearance of their daughter’s back, which appeared to be worse than it was before the surgery. The orthopedist advised the parents not to be concerned; that the ‘appearance’ of worsening was only a temporary situation and the appearance of the girl’s back would improve as she completed her growth.

One year after the surgery, the appearance of their daughter’s back was still deteriorating. The parent’s concern continued to escalate. They sought another opinion and were referred to a radiologist for another set of Xrays.

The radiology report stated that the right thoracic curve was 52 degrees (a 20 degree increase compared to before the surgery was done). The left thoracolumbar curve had lost its surgical correction and was now measuring 28 degrees (the same as prior to the surgery) (See Xray C above).

Results

Prior to the surgery, the 15 year old female had a stable (not worsening) double curve pattern. One year post surgically, the spinal curves were unbalanced, unstable and getting worse. The girl’s cosmetic appearance had deteriorated (See Photos below).

What these two case studies suggest

When the cause of the abnormal spinal curve is determined and then correctly treated, as in Case 1, the spine is stabilized.

When the cause is not determined and not correctly treated, as in Case 2, the spine becomes unstable and the curves further deteriorate.

Reference

Weiss HR 2007. Adolescent Idiopathic Scoliosis - case report of a patient with clinical deterioration after surgery. Patient Safety in Surgery Journal, 1(7) Online at www.pssjournal.com/content/1/1/7

Professor/Dr.Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot 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

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

Resolution of Chronic Low Back Pain

rothbartsfoot@yahoo.com (rothbart) — Thu, 24 Dec 2009 16:23:00 GMT

In 1994, I completed a four year study at the Bellevue Foot and Ankle Center in Bellevue, Washington, on 208 patients who suffered with chronic low back pain. This study, which I published in the American Journal of Pain Management (1995), is described below.

Prior to this study, these patients had been treated with various therapies including physical therapy, osteopathic and/or chiropractic manipulation, anti-inflammatory medications and in some cases, surgery. All of these patients were to some degree disappointed with the therapies they had received and were committed to permanently eliminating their low back pain.

I ran an initial evaluation, testing and analysis on each patient and found that they all had foot twist and bad posture. A therapy (which later evolved into what is now known as Rothbart Proprioceptive Therapy) was then initiated to permanently improve their posture.

Of the 208 patients who started this therapy, 203 completed it. One year later, the 203 patients filled out a questionnaire rating the effectiveness of their therapy by how they now felt. The results were:

170 patients reported that their chronic low back pain lessened 50% or more

24 reported that their low back pain lessened 10 to 40%

6 reported no change in their low back pain

3 reported an increase in their low back pain

Objective Outcomes (what I noted):

Of the 170 patients who reported a decrease in their level of low back pain of 50% or greater, all had a dramatic improvement in their posture.

Of the 24 patients who reported a decrease in their level of low back pain of 10 – 40%, all had a slight improvement in their posture.

Of the 6 patients who reported no lessening in their level of low back pain, no improvement in their posture was noted.

Of the 3 patients who reported an increase in their level of low back pain, all three demonstrated a deterioration in their posture.

Conclusion

A direct correlation was observed between bad posture and chronic low back pain. When the therapy improved the posture, the chronic low back pain diminished. However, when the posture did not improve or deteriorated, the low back pain either remained the same or increased.

This study suggests that a viable, effective way to eliminate or dramatically reduce chronic low back pain is by permanently improving posture.

Reference:

Rothbart BA, Liley P, Hansen, el al 1995. Resolving Chronic Low Back Pain. The Foot Connection. The Pain Practitioner (formerly American Journal of Pain Management) 5(3): 84-89

Professor/Dr. Brian A Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot 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

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

Using Proprioceptive Stimulation to Improve Level of Performance in Sports

rothbartsfoot@yahoo.com (rothbart) — Tue, 15 Dec 2009 12:07:00 GMT

Using Proprioceptive Stimulation to Improve Linear Mechanics and Level of Performance in Competitive Sports
Level of performance in all sports, to a large degree, depends on the mechanical efficiency and linearity of movement. By this we mean the joints in the human body must function around their anatomical neutral position in order to generate maximum power and postural stability.

A good example of this principle is observed in power lifting (See photo below). The power lifter is concerned with (1) establishing a solid foot to ground position (e.g., "the sweet spot" where the foot functions around its anatomical neutral position) and (2) preventing any torsion or twisting in his legs, hips or shoulders while lifting (e.g., linearity of movement). If either of these two principles is compromised, the weight lifters level of performance dramatically suffers.

Courtesy of Gorilla Pack Power Lifting Club
in Johnstown, N.Y. Mike Miller, 6'5", 385 lbs.

Several years ago, at a workshop for power lifters at Gold's Gym in St. Petersburg Florida, I noticed one particular athlete having great difficulty with his lifts. First, he would spend several minutes before each lift trying to find “the sweet spot” between his feet and the ground, where he felt most stable. Then as he started to lift, I saw that he had great difficulty keeping his right shoulder from rotating forward as he power lifted 500 lbs (the maximum amount he could lift). I also noted a counter clockwise torsion in his thoracic spine as his feet abnormally twisted (pronated).

Basically, this athlete was having problems because his feet were twisting as he lifted the weights. This resulted in torsional mechanics. With the athlete’s permission, I placed a specific proprioceptive insole under his feet, which would decrease his foot twist, which in turn, would take the athlete from torsional mechanics into linear mechanics. He then repeated his power lift of 500 lbs.

The Result: (1) He found his "sweet spot" within several seconds (instead of minutes) (2) I saw a more linear motion in his mechanics, e.g. his right shoulder was not as forward, as he lifted. His foot alignment improved (e.g., less pronation), and (3) he lifted 500 lbs with considerably less effort.

The athlete then immediately increased his lifting weight to 525 lbs and was able to power lift this weight for the first time in his life!

What does this show?

Torsional Mechanics = fatigue, weakness and loss of endurance.

Linear Mechanics = power, strength and endurance.

The use of the correct proprioceptive insole takes the athlete from torsional to linear mechanics.

This is just one example of using proprioceptive stimulation to improve linear mechanics and resulting performance.

Professor/Dr. Brian A Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot 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

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

A forward head position can lead to central nervous system (CNS) dysfunction

rothbartsfoot@yahoo.com (rothbart) — Sat, 05 Dec 2009 08:13:00 GMT

Investigators at Northwestern University's School of Medicine (Baliki et al 2008) discovered an alteration in brain function in people suffering from chronic pain. They feel that this alteration in brain (CNS) function may explain how chronic pain can trigger such symptoms as insomnia, depression, anxiety and/or mental sluggishness.

Baliki et al further explained that the front region of the brain, in a person suffering from chronic pain, is consistently active. This, they suggest, will prematurely wear out the neurons, altering their connections to one another. They believe this may lead not only to the symptoms above, but also to permanent brain damage.

Based on nearly 40 years of clinical research, what I have suggested is that focal areas of hyperactivity within the cerebral cortex (CNS) may result from ischemia (decreased blood flow) due to a positional compression of the carotid arteries on either side of the neck.

Compressing these carotid arteries can diminish the flow of blood to the brain much like a kink in a water hose can diminish the flow of water through the water hose (Rothbart 2009. Forward head position can lead to debilitating symptoms within the brain). Diminished blood flow can lead to cellular death in the brain. The end result are symptoms such as insomnia, depression, anxiety and/or mental sluggishness and finally, permanent brain damage.

The question is, what causes a positional compression of the carotid arteries? My research suggests that this compression can result from a forward head position (See Diagrams below). The impact a forward head position has on the blood flow to the brain is clinically observable by taking the carotid pulses:

When the head is in a forward position, the carotid pulses are weaker

When the head is over the spine, the carotid pulses are stronger

A forward head position is part of apostural distortional pattern caused by an abnormal embryological footstructure, now known as the Rothbarts Foot.

Forward Head Position (adapted from Ventura Publications). This forward head position is frequently part of a postural distortional pattern resulting from a Rothbarts Foot

Rear View of the Head and Neck. The red arrows point to the carotid arteries. When the head is in a forward position, the carotid arteries are more susceptible to being compressed. This compression can dramatically decrease the blood flow to the brain.

All feet have mechanical receptors on their plantar surfaces, which send signals from the feet to the brain. The brains responds by adjusting the posture. But the Rothbarts Foot sends distorted signals to the brain. The brain responds by distorting the posture. Part of this postural distortion is a forward head position, which is seen in most chronic musculoskeletal pain patients.

This forward head position can be effectively reversed using a type of therapy that now bears my name (e.g., Rothbart Proprioceptive Therapy). Rothbart Proprioceptive Therapy provides a stimulation underneath the feet. This stimulation sends a corrected signal to the brain. The brain, in turn, automatically corrects the posture and brings the forward head back over the spine. When this takes place, the compression on the carotid arteries is diminished. This allows the blood to flow more freely to the brain. The brain cannow function optimally.

In summation, I suggest that:

when the head is forward over the spine, the brain may not be receiving sufficient blood flow and oxygen due to compression of the carotid arteries. If this compression is severe enough, it can result in cerebral ischemia (CNS dysfunction). Clinically what we see is disturbed sleeping patterns, increased anxiety and mental sluggishness.

when the head is in its correct position over the spine and the brain is receiving sufficient blood flow and oxygen, brain function improves. Clinically, what we see is improvement in sleeping, anxiety abating, mental alacrity improving and a greater sense of wellbeing.

References

     Baliki MN, Geha PY, Apkarian V, et. Al. 2008. Beyond Feeling: Chronic Pain Hurts the Brain, Disrupting the Default-Mode Network Dynamics. Journal Neuroscience. 28(6):1398-1403.
     Rothbart BA 2009. A forward head position can lead to debilitating symptoms in the brain. Heal Yourself Magazine, July 25
     Rothbart BA 2009. Chronic Pain Changes How the Brain Functions. Research Blog, August.

Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot 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

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

The Four Postural Distortional Patterns

rothbartsfoot@yahoo.com (rothbart) — Sat, 05 Dec 2009 08:06:00 GMT

In 1988, I published a paper in the Journal of Manipulative and Physiological Therapeutics in which I linked foot twist (pronation) to torsional changes within the knees and pelvis. This study was based on 97 chronic pain patients in whom I correlated oblique patella (knee) tracking patterns and dysfunctional positioning of the pelvis to foot twist.

In 1994 and 1995 I published two papers in the American Journal of Pain Management in which I linked a distortion in posture (referred to as BioImplosion) to foot twist. The results of these two clinical studies, which involved nearly 300 patients, also supported my theory that poor posture was one of the major causes in the development of chronic knee pain (1994) and chronic low back pain (1995). (Foot twist leads to poor posture, poor posture leads to chronic pain in the knees and low back)

However, the cause of foot twist still remained a mystery until 2002, when I published a paper in the Journal of Bodywork and Movement Therapies in which I described two previously unknown embryological foot structures that resulted in foot twist: the Rothbarts Foot and the PreClinical Clubfoot Deformity.

Since 2002, I have been classifying the various postural distortional patterns that can result from either the Rothbarts Foot or the PreClinical Clubfoot Deformity. Four distinct patterns became apparent:

Flatback Postural Pattern
Kyphotic Postural Pattern
Lordotic Postural Pattern
Swayback Postural Pattern

Interesting enough, the Kyphotic and Lordotic Postural Patterns are most frequently seen in patients with the Rothbarts Foot. Whereas the Flatback and Swayback Postural Patterns are more frequently seen in patients with the PreClinical Clubfoot Deformity.

The classification of these four postural distortional patterns are based on the:

Position of the innominates on the sagittal plane,
Curves in the lower and upper back
Position of the head relative to the cervical spine

Below is a brief description of each of the four postural distortional patterns and the Normal or Ideal Pattern.

(1) - Flatback Postural Pattern

Flatback Postural Pattern is Characterized by:

Posteriorly positioned innominates
Decrease in the sacral (lower back) curve
Slight Increase in the thoracic (upper back) curve (convex backwards)
Forward head position

(2) - Kyphotic Postural Pattern

Kyphotic Postural Pattern is Characterized by:

Anteriorly positioned innominates
Increase in the sacral (lower back) curve (convex forwards)
Increase in the thoracic (upper back) curve (convex backwards)
Forward head position

(3) - Lordotic Postural Pattern

Lordotic Postural Pattern is Characterizied by:

Anteriorly positioned innominates
Increase in the sacral (lower back) curve (convex forward)
Normal thoracic (upper back) curve
Head in neutral position (auricle over outer ankle bone)

(4) - Swayback Postural Pattern

Swayback Postural Pattern is Characterized by:

Posteriorly positioned innominates
Decrease in the sacral (lower back) curve (flatten)
Increase in the thoracic (upper back) curve (convex backwards)
Head forward position

The Ideal (Normal) Postural Pattern

Ideal Postural Pattern is Characterized by:

Innominates in neutral position
Normal sacral (lower back) curve (slight convex forward)
Normal thoracic (upper back) curve (slight convex backward)
Head in neutral position (auricle over outer ankle bone)

References:

   Rothbart BA, Esterbrook L, 1988. Excessive Pronation: A Major Biomechanical Determinant in the Development of Chondromalacia and Pelvic Lists. Journal Manipulative Physiologic Therapeutics 11(5): 373-379.
   Rothbart BA, Yerratt M. 1994 An Innovative Mechanical Approach to Treating Chronic Knee Pain: A BioImplosion Model. The Pain Practitioner (formerly American Journal of Pain Management) 4(3): 13-18.
   Rothbart BA, Liley P, Hansen, el al 1995. Resolving Chronic Low Back Pain. The Foot Connection. The Pain Practitioner (formerly American Journal of Pain Management) 5(3): 84-89
   Rothbart BA, 2002. Medial Column Foot Systems: An Innovative Tool for Improving Posture. Journal of Bodywork and Movement Therapies (6)1:37-46
   Cordova N, Cordova PV 2009. Posture Confidence

Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

A special thanks to Natalie and Philip Cordova for granting me permission to use the above photographs that were published in their e-book: Posture Confidence. Their e-book contains a wealth of information on postural exercises; highly recommended.

Plantar Fasciitis - What is it and How do you treat it

rothbartsfoot@yahoo.com (rothbart) — Wed, 18 Nov 2009 18:16:00 GMT

Plantar Fasciitis is an inflammation of the plantar aponeurosis, a thick fascia located underneath the foot than spans from the heel bone (medial and lateral calcaneal tubercles) to the toes (plantar tubercles of the proximal phalanges) (See Figures 1 and 2 below).

Figure 1 - Plantar Aponeurosis (Long Plantar Ligament). A thick fascia that runs from the bottom of the heel bone to the toes.

Figure 2 - medial view of the foot demonstrating the insertion of the plantar aponeurosis into the heel bone.

Plantar Fasciitis is characterized by pain across the inside of the ankle (medial malleolus) and under surface of the heel bone (medial calcaneal tubercle) (See Figure 3 below). Plantar Fasciitis is the most common foot symptom seen in chronic pain patients.

Figure 3 - location of pain associated with Plantar Fasciitis; inside of the ankle and the under surface of the heel bone.

In 1971, I published a paper in the Journal American Podiatric Association that challenged the then current thought that Plantar Fasciitis was frequently due to a heel spur irritating the long plantar ligament. I suggested that Plantar Fasciitis (heel pain syndrome) was the result of excessive foot twist. My paper was based on my findings that:

Many of my patients with heel pain (Plantar Fasciitis) did not have heel spurs
Many of my patients with heel spurs did not have heel pain
All of my patients with heel pain had foot twist

In this paper, I described the step by step process in which foot twist can culminate in heel pain (Plantar Fasciitis):

Foot twist expands the foot (longer and wider)
As the foot becomes longer, the long plantar ligament is stretched
As the long plantar ligament is stretched, micro tears occur in the attachment of the ligament into the heel bone
These micro tears result produce an inflammatory reaction, culminating in heel pain

My research remained controversial for approximately 20 years until the early 1990s when other research teams came to the same conclusions.

However, the question that still needed to be answered was: what causes the foot to twist?

This question was answered in a paper I published in 2002 in the Journal Movement Bodyworks Therapy, in which I linked foot twist to two embryological foot structures, the Rothbarts Foot and the PreClinical Clubfoot Deformity. I theorized that these two foot structures force the foot to twist due to the incomplete osseous development of the calcaneal (heel) and/or talar bones.

Therapy

Traditionally, Plantar Fasciitis is treated with arch supports. The rationale of this therapy is to reduce the stretch on the long plantar ligament (plantar aponeurosis), thereby allowing the inflammation at its insertion points to heel (See Figure 4 below). However, a randomized trial published by Landorf et al (2006) concluded that this approach resulted in only “small reductions in pain for people with Plantar Fasciitis”. In my practice, I have found that arch supports frequently increase the pain in patients suffering from Plantar Fasciitis.

Figure 4 - Therapy using arch supports which actually increase the tension of the plantar aponeurosis, which in turn, predisposes this ligament to further micro tears.

Rothbart Proprioceptive Therapy

Rothbart Proprioceptive Therapy has proven to be very effective in eliminating heel pain associated with Plantar Fasciitis. The reason this therapy is so effective is that it treats the underlying cause of foot twist, which in turn, decreases the elongation of the long plantar ligament (and resulting inflammation of its insertion points as it is being torn away from the bone) (See Figure 5 below).

Figure 5 - Proprioceptive Therapy reduces foot twist, which in turn, decreases the tension on the long plantar ligament (plantar aponeurosis).

For more information on Rothbart Proprioceptive Therapy, go to: What is Rothbart Proprioceptive Therapy or Does Rothbart Proprioceptive therapy reduce foot twist? A technical presentation.

References

    Landorf KB, Keenan AM, Herbert RD, 2006. Effectiveness of Foot Orthoses to Treat Plantar Fasciitis. Archives Internal Medicine, 166:1305-1310.
    Rothbart BA 1971. Heel spur and heel spur syndrome. Journal American Podiatric Medical Association (JAPMA), 61(5):186-9.
    Rothbart BA, 2002. Medial Column Foot Systems: An Innovative Tool for Improving Posture. Journal of Bodywork and Movement Therapies (6)1:37-46


Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

Eliminating pain resulting from the Rothbarts Foot or the PreClinical Clubfoot Deformity

rothbartsfoot@yahoo.com (rothbart) — Mon, 16 Nov 2009 13:09:00 GMT

An estimated 80% of the world population has one of the two inherited foot structures which I discovered and treat. These foot structures are called the Primus Metatarsus Supinatis (known as Rothbarts Foot) and the PreClinical Clubfoot Deformity - a common cause of the flexible flat foot. Both of these foot structures can cause chronic musculoskeletal pain. However, the symptoms resulting from the PreClinical Clubfoot Deformity usually occur earlier in life and typically are more debilitating/disabling then the symptoms resulting from the Rothbarts Foot.

To understand how an abnormal foot structure creates muscle and joint pain, we must first look at the function of all feet. All feet have mechanical receptors on the bottom, which are stimulated through touch, as you stand or walk. This stimulation produces a signal which is sent to the brain. The brain acts on these signals to maintain the posture in an upright position.

If the foot structure is abnormal or faulty (such as in a Rothbarts Foot or PreClinical Clubfoot Deformity), distorted signals are sent to the brain and the brain responds by distorting the posture. Because posture affects the health of all the weight-bearing joints and muscles (such as the neck, back, hips, knees and ankles), if you have bad posture; this can lead to joint and muscle inflammation. The end result is pain.

If the source of your chronic muscle and joint pain is a Rothbarts Foot or Preclinical Clubfoot Deformity, the only way to eliminate your pain is by improving your posture. And the only way to permanently eliminatechronic pain that comes from the Rothbarts Foot or the PreClinicalClubfoot Deformity is to permanently improve your posture.

The only way to permanently improve your posture is by correcting the distorted signals being generated by your foot structure. In doing so, the brain now receives corrected signals and adjusts the posture to a straighter position. The approach I use to accomplish this is called Rothbart Proprioceptive Therapy.

As a result of Rothbart Proprioceptive Therapy, a global correction is made in your posture. That is, the weight bearing joints re-align into their correct position. This is done gradually so that your body can adjust to each postural correction. This gradual process of postural improvements allows the inflamed joints and muscles to heal naturally. The end result is the permanent elimination (or dramatic reduction) of muscle and joint pain throughout the body.

For more information on the Rothbarts Foot and the Preclinical Clubfoot Deformity, go to: What is the difference between the Rothbarts Foot and the PreClinical Clubfoot Deformity or What exactly is a Flatfoot? Are there different types? (Read the unabridged published paper)

Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

Knee Replacement Surgery - An Overused Intervention

rothbartsfoot@yahoo.com (rothbart) — Tue, 10 Nov 2009 15:47:00 GMT

The clinical history in a patient with arthritis of the knee is dominated by significant and disabling pain. The pain predominantly occurs while standing and walking. However, as the arthritis progresses, the pain may be constant and unrelieved by rest (e.g., night pain). In addition to pain, other symptoms include stiffness, swelling, locking of the knee joint, and weakness.

Osteodegenerative Arthritis of the knee is the most common reason that surgeons advise total knee replacement, in which all cartilage is removed from the knee joint and a metal or plastic implant is substituted. Approximately 130,000 knee replacement surgeries (femoral surface replacement) are performed every year in the United States.

However, in a paper published in 2005 (Squire et al), 37 knee joint replacements were reviewed. The surgical failure rate was reported at 40.5% (failure defined as patients requiring a 2nd surgery on the same knee).

Why the extraordinary high failure rate? The answer became apparent to me as a result of my research on foot function. In a landmark paper, An Innovative Mechanical Approach in Treating Chronic Knee Pain. A BioImplosion Model (Rothbart,1994); I linked degenerative knee joint disease to the feet.

I found that certain inherited foot structures force the feet to twist while standing or walking. This foot twist causes the knees to rotate inward (See Figure 1 below). This inward rotation results in a misalignment of the knee joint. The misalignment causes abnormal wear patterns (where the cartilage wears unevenly) in the knee joint (See Figure 2 below). This is similar to a car alignment problem which can lead to uneven wear patterns in the tires. The knee becomes inflamed and arthritic.

Unless X-ray findings demonstrate a destruction of the bone surfaces within the knee joint and not just a wearing down or thinning of the cartilaginous tissue, I believe that is is unwise to consider knee replacement surgery. The reason is because cartilaginous tissue does regenerate if the cause of its degeneration is determined and reversed. This negates the need for surgical intervention.

Once I understood that one of the primary causes of knee pathology was foot twist, I invented a therapy to eliminate the foot twist, which in turn, places the knee joints in a better alignment, protecting the knee cartilage from wearing down and promoting its regeneration. This therapy, called Rothbart Proprioceptive Therapy, has eliminated the need for a vast majority of knee replacements.

Figure 1 - note the valgus (inward)
rotation of the left knee, which is the
result of foot twist

Figure 2 - misaligned knee joint.
The red arrow points to the
loss of cartilage

Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

References

Squire M, Fehring T, Odum S, W.Griffin, Bohannon Mason J, 2005. Failure of Femoral Surface Replacemen for Femoral Head Avascular Necrosis. Journal of Arthroplasty, Volume 20, Issue null, Pages 108-114.

Rothbart BA, Yerratt M. 1994. An Innovative Mechanical Approach to Treating Chronic Knee Pain. A BioImplosion Model. The Pain Practitioner (formerly American Journal of Pain Management) 4(3):13-18.

Does Rothbart Proprioceptive therapy reduce foot twist? A technical presentation

rothbartsfoot@yahoo.com (rothbart) — Tue, 03 Nov 2009 13:12:00 GMT

Introduction: Rothbart Proprioceptive Therapy is based on the observation that foot twist during weight bearing (standing and walking), is directly linked to postural distortion patterns coming from the feet (e.g., RothbartsFoot or the PreClinical Clubfoot Deformity). By reducing foot twist (via central nervous system reprogramming), the postural distortional patterns (poor posture) are reversed, which in turn greatly reduces or eliminates chronic musculoskeletal (muscle and joint) pain.

Discussion: Computerized postural studies by this author over the past 15 years is consistent with the conclusion that Rothbart Proprioceptive Therapy is very effective in reversing postural distortions, foot to jaw. However, the question that begs to be answered: Is there visible evidence that Rothbart Proprioceptive Therapy reduces foot twist?

Procedure: Selective frames were extrapolated at midstance from computerized gait studies: with, versus without, Rothbart Proprioceptive Insoles (See Gait Analysis below). The white arrows point to the navicular tuberosity, the area in the foot where foot twist can readily be observed.

Gait Analysis - Note the bulging at the navicular tuberosity when the proprioceptive insoles are not worn (see white arrows)

Results: Foot twist is reduced when the correctly prescribed Rothbart Proprioceptive Insoles are worn in the shoes.

For more information on Rothbart Proprioceptive Therapy, read my book, Forever Free From Chronic Pain.

Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

What is the difference between the Rothbarts Foot and the PreClinical Clubfoot Deformity

rothbartsfoot@yahoo.com (rothbart) — Tue, 13 Oct 2009 23:30:00 GMT

Rothbart Proprioceptive Therapy has become widely known as a non-drug, non-surgical treatment which permanently eliminates chronic musculoskeletal pain. It is based on my discovery of two inherited foot structures which predispose many people to chronic muscle and joint pain.

The first of my discoveries is known as the Rothbarts Foot. I have written a book, Forever Free From Chronic Pain, describing in detail my discovery of this foot structure and the treatment I developed which effectively handles it.

The second embryological foot structure that I discovered is called the PreClinical Clubfoot Deformity. It is one of the major causes of a flexible flatfoot and the chronic muscle and joint pain that results from it.

Until recently, I have published very little information on the PreClinical Clubfoot Deformity. But after having examined thousands of patients, I have frequently found that those who have the severest pain and most debilitating symptoms do not have a Rothbarts Foot, but instead, the more severe foot structure, the PreClinical Clubfoot Deformity. Hence, I have realized the importance of publishing more information on this second and more disabling inherited foot structure.

Rothbarts Foot vs the PreClinical Clubfoot Deformity

Let’s look at the commonalities, the differences and how these foot structures are treated using Rothbart Proprioceptive Therapy.

Commonalities

In both the Rothbarts Foot and the PreClinical Clubfoot Deformity, the foot twists when you stand or walk.

Both foot structures produce postural distortions and resulting muscle and joint pain.

Both are treated and effectively handled using Rothbart Proprioceptive Therapy.

Differences

The Rothbarts Foot is the result of an incomplete development of the talar bone in the foot.
The PreClinical Clubfoot Deformity is the result of an incomplete development of the heel bone.

The muscle and joint pain resulting from the Rothbarts Foot usually does not appear until the fourth of fifth decade of life.
The muscle and joint pain resulting from the PreClinical Clubfoot Deformity can appear in children as young as five or six years of age, or may not develop until the second or third decade of life.

The muscle and joint pain associated with the Rothbarts Foot is painful, but rarely debilitating.
The muscle and joint pain associated with the PreClinical Clubfoot Deformity is typically debilitating and occasionally incapacitating.

Treatment

Using Rothbart Proprioceptive Therapy for treatment of the Rothbarts Foot usually takes 6-12 months to complete, but can be longer if bad posture is the result of not only the foot structure, but other problems as well (such as malocclusion, cranial issues or visual problems).

Treatment of the PreClinical Clubfoot Deformity usually takes 12-18 months to complete, but can be longer for the same reasons described above.

Though both foot structures are effectively treated using Rothbart Proprioceptive Therapy, the proprioceptive insoles used to reverse the postural distortions (and resulting muscle and joint pain) in the Rothbarts Foot are very different from the proprioceptive insoles used to treat the PreClinical Clubfoot Deformity.

One should only treat the Rothbarts Foot (using proprioceptive insoles made for the Rothbarts Foot) if you are sure it is actually a Rothbarts Foot.

You, the chronic pain sufferer, may have purchased one (or more) pairs of insoles from a company that sells two or three different strengths of prefabricated proprioceptive insoles, advertised to treat a Rothbarts Foot. You may even have been told that you have a Rothbarts Foot and prescribed these same prefabricated insoles by a well-meaning healthcare practitioner who is not properly trained in the use of my therapy. Yet in spite of best intentions, your pain symptoms may have returned

It is important to know when using these insoles, if your pain symptoms return (or have even increased), it could be because you are using the wrong strength of insole (See my research blog: The Consequences of Using an Incorrect Proprioceptive Insole - Joints) as there are many, many prescription strengths to treat the Rothbarts Foot. Or it could be because you don’t have a Rothbarts Foot! (See my research blog: The PreClinical Clubfoot Deformity should never be treated using a proprioceptive insole designed to treat the Rothbarts Foot)

How to treat the foot structure that the patient really has

When healthcare practitioners treat people who have chronic muscle and joint pain, they must first determine whether or not the patient has one of these two inherited foot structures. Healthcare providers trained at the International Academy of Rothbart Proprioceptive Therapy do this by reviewing the responses obtained in the Pre-Consultation Questionnaire and by asking specific questions during the Initial (Phone) Consultation.

If it is determined that the patient does indeed have one of the two inherited foot structures, the second step is to run a series of tests and proprietary analyses in order to determine which of the two foot structures is present. Running and interpreting these tests and analyses is the only way that one can determine which of the two foot structures a person has.

Training on the diagnosis and treatment of the Rothbarts Foot is available to healthcare practitioners and is covered in the Level I certification course at the International Academy of Rothbart Proprioceptive Therapy.

Training on the diagnosis and treatment of the PreClinical Clubfoot Deformity is available to healthcare practitioners and is covered in the Level III certification course at the International Academy of Rothbart Proprioceptive Therapy.

Reference

Rothbart BA 2009. What exactly is a Flatfoot? Are there different types? Podiatry Review, Vol 66(6):4-6.

Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot and PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain

Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain

The PreClinical Clubfoot Deformity (a flexible flatfoot) should never be treated using a proprioceptive insole designed to treat the Rothbarts Foot

rothbartsfoot@yahoo.com (rothbart) — Sun, 11 Oct 2009 12:31:00 GMT

In 2002, I published on two previously unknown embryological foot structures, the Primus Metatarsus Supinatus (known as Rothbarts Foot) and a source of the flexible flatfoot, the PreClinical Clubfoot Deformity (Medial Column Foot Systems. An Innovative Tool for Improving Posture. Journal of Bodyworks and Movement Therapy).

The Rothbarts Foot and the PreClinical Clubfoot Deformity share some common characteristics (See: What is the Difference Between a Rothbarts Foot and the PreClinical Clubfoot Deformity) and so healthcare practitioners may mistakenly believe that they are one and same foot structure. This results in treatment error, which leads to (at best) the patient not responding to therapy (or obtaining the results hoped for) or (at worst) the patient’s pain symptoms increasing.

Despite the commonalities shared by the Rothbarts Foot and the PreClinical Clubfoot Deformity, the PreClinical Clubfoot Deformity is notably a more severe foot structure because it is skeletally less developed. Hence, there is a vast difference in the way each foot structure is treated.

Specific prescriptive proprioceptive insoles are designed to treat a Rothbarts Foot. Other prescriptive proprioceptive insoles are designed to treat a PreClinical Clubfoot Deformity. Because you are dealing with two different foot structures, these insoles are not interchangeable from one foot structure to the other.

To insure that the pain sufferer is being correctly diagnosed and treated, the healthcare practitioner must have a sound knowledge on both the Rothbarts Foot and the PreClinical Clubfoot Deformity:

First, the practitioner must determine if the patient has an abnormal embryological foot structure. This is done through information obtained in the Pre-Consultation Questionnaire and the Initial Phone Consultation.

Second, they must identify which abnormal embryological foot structure the patient has (the Rothbarts Foot or the PreClinical Clubfoot Deformity). This is done by running and interpreting specific tests and computer analyses (learned only in certified training offered at the International Academy of Rothbart Proprioceptive Therapy).

Only after having established which foot structure the patient has, can one design and fabricate the correct proprioceptive insole that will result in permanent elimination of the patient's pain.

To see the results of using the wrong proprioceptive insole, go to: The Consequences of Using an Incorrect Proprioceptive Insole - Joints.

To learn how the PreClinical Clubfoot Deformity can be successfully treated, go to: The Flexible Flatfoot can be Successfully Treated using Rothbart Proprioceptive Therapy.

Reference

Rothbart BA, 2002. Medial Column Foot Systems: An Innovative Tool for Improving Posture. Journal of Bodywork and Movement Therapies (6)1:37-46

Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot and PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain

Sign Up Now to get a free charter from my book, Forever Free From Chronic Pain.