00:00:00 --> 00:00:01 And let's do this thing.
00:00:01 --> 00:00:03 David, Amanda, welcome to the podcast.
00:00:04 --> 00:00:05 Thank you for having us.
00:00:06 --> 00:00:06 Thank you.
00:00:06 --> 00:00:07 Excited.
00:00:08 --> 00:00:09 So you will be presenting in
00:00:10 --> 00:00:11 Orlando at the AOMT conference.
00:00:11 --> 00:00:13 So this is the prequel.
00:00:13 --> 00:00:14 This is the teaser.
00:00:14 --> 00:00:16 This is the movie trailer of
00:00:16 --> 00:00:18 what will be coming up when
00:00:18 --> 00:00:19 we get together in Florida.
00:00:20 --> 00:00:22 So my first hard-hitting question is,
00:00:22 --> 00:00:25 will you be presenting in
00:00:25 --> 00:00:26 Mickey Mouse ears?
00:00:26 --> 00:00:27 Are you going to be hitting Disney?
00:00:27 --> 00:00:28 That's the question everybody asks.
00:00:28 --> 00:00:29 Are you going to be hitting
00:00:29 --> 00:00:30 Disney beforehand?
00:00:30 --> 00:00:31 Amanda's already nodding.
00:00:33 --> 00:00:33 Of course.
00:00:34 --> 00:00:34 Yes.
00:00:34 --> 00:00:35 Or at least a Disney costume,
00:00:35 --> 00:00:36 maybe of some sort.
00:00:36 --> 00:00:38 Maybe not Mickey ears, but Disney costume.
00:00:38 --> 00:00:39 A little flavor.
00:00:40 --> 00:00:40 Yeah.
00:00:40 --> 00:00:41 I'm expecting that.
00:00:41 --> 00:00:42 I do not have the ears,
00:00:42 --> 00:00:44 but I will be wearing the slippers.
00:00:45 --> 00:00:45 That's all I'm looking for.
00:00:46 --> 00:00:48 All right.
00:00:48 --> 00:00:49 Let's get down to business.
00:00:50 --> 00:00:51 What are you presenting on?
00:00:51 --> 00:00:52 What do people get to learn
00:00:52 --> 00:00:54 from you when you'll be
00:00:54 --> 00:00:56 together on stage at the AM
00:00:56 --> 00:00:58 conference this October?
00:00:59 --> 00:00:59 Yeah,
00:00:59 --> 00:01:02 so we're actually continuing off of a
00:01:02 --> 00:01:03 series of presentations
00:01:03 --> 00:01:05 that we've given at prior AM conferences.
00:01:07 --> 00:01:08 You know, we've done the shank,
00:01:09 --> 00:01:09 if you will,
00:01:09 --> 00:01:10 and the tibialis posteriors
00:01:10 --> 00:01:14 roll on the hind foot, mid foot last year,
00:01:14 --> 00:01:15 talking a little bit more
00:01:15 --> 00:01:17 specific of hind foot and
00:01:17 --> 00:01:18 transverse tarsal joint.
00:01:18 --> 00:01:19 And then based on feedback,
00:01:20 --> 00:01:21 we're continuing down the
00:01:21 --> 00:01:22 mid foot to the medial and
00:01:22 --> 00:01:23 lateral columns.
00:01:24 --> 00:01:25 So it's a sequel is what you're saying,
00:01:25 --> 00:01:26 which just fits with the
00:01:27 --> 00:01:28 Universal Studios and the
00:01:28 --> 00:01:29 whole Florida mindset.
00:01:29 --> 00:01:29 That's great.
00:01:29 --> 00:01:30 All right.
00:01:30 --> 00:01:31 So let's dig into some
00:01:31 --> 00:01:32 specifics now that we
00:01:32 --> 00:01:33 understand where in the
00:01:33 --> 00:01:34 body we're located.
00:01:35 --> 00:01:36 Can you explain the
00:01:36 --> 00:01:37 importance of the
00:01:37 --> 00:01:38 interdependent relationship
00:01:38 --> 00:01:40 of motion among all the
00:01:40 --> 00:01:42 segments of the foot and ankle?
00:01:43 --> 00:01:44 We'll say in functional
00:01:44 --> 00:01:44 weight bearing because
00:01:44 --> 00:01:45 that's where we hope people
00:01:46 --> 00:01:46 are a lot of the time.
00:01:47 --> 00:01:49 yeah um that's a loaded
00:01:49 --> 00:01:52 question yeah right to
00:01:52 --> 00:01:55 start off with but uh yeah so
00:01:56 --> 00:01:58 The interdependent relationship, I think,
00:01:58 --> 00:02:01 is best summarized in, you know,
00:02:01 --> 00:02:02 the concept that we as
00:02:02 --> 00:02:03 physical therapists
00:02:03 --> 00:02:04 probably all know is the
00:02:04 --> 00:02:05 windlass mechanism.
00:02:05 --> 00:02:08 You know, great toe MTP extension,
00:02:08 --> 00:02:09 raising up the arch.
00:02:09 --> 00:02:11 Yes, it's by way of plantar fascia,
00:02:11 --> 00:02:12 hindfoot supination.
00:02:12 --> 00:02:14 But I think the outcome of
00:02:14 --> 00:02:16 that is perhaps even more important.
00:02:16 --> 00:02:17 And that puts the actual
00:02:17 --> 00:02:20 gastrocnemius and soleus on
00:02:20 --> 00:02:21 its best length tension
00:02:21 --> 00:02:22 relationship to produce
00:02:22 --> 00:02:24 force to actually propel us forward.
00:02:25 --> 00:02:26 Adding to that,
00:02:26 --> 00:02:27 I think knowing that the
00:02:27 --> 00:02:28 foot is a load-sharing system,
00:02:29 --> 00:02:30 So it's considered the
00:02:30 --> 00:02:32 longitudinal arch load sharing system.
00:02:32 --> 00:02:32 You know,
00:02:32 --> 00:02:34 obviously just everything is related.
00:02:35 --> 00:02:37 And you have to have that
00:02:37 --> 00:02:38 internal rotation of the
00:02:39 --> 00:02:40 shank to have that proper
00:02:41 --> 00:02:42 supination pronation of the
00:02:42 --> 00:02:44 hind foot and the
00:02:44 --> 00:02:45 subsequent elevation and
00:02:45 --> 00:02:47 depression of the midfoot
00:02:47 --> 00:02:49 for our function and weight bearing.
00:02:49 --> 00:02:50 The biggest factor to that
00:02:50 --> 00:02:51 is really just what is the
00:02:51 --> 00:02:52 ground reaction forces
00:02:52 --> 00:02:53 doing and what can the
00:02:53 --> 00:02:54 muscles actually produce
00:02:54 --> 00:02:55 for force against that.
00:02:56 --> 00:02:56 I mean,
00:02:57 --> 00:02:58 it seemed like he handled the
00:02:58 --> 00:02:59 knuckleball pretty well
00:02:59 --> 00:02:59 right off the bat.
00:02:59 --> 00:03:00 Okay.
00:03:01 --> 00:03:03 Moving on then, next pitch would be,
00:03:03 --> 00:03:05 there's a lot of segments in the foot.
00:03:05 --> 00:03:06 It might seem simple,
00:03:06 --> 00:03:07 but there's a lot of different parts,
00:03:08 --> 00:03:08 right?
00:03:09 --> 00:03:09 How do the different
00:03:09 --> 00:03:10 segments contribute to the
00:03:11 --> 00:03:12 overall function of the foot?
00:03:12 --> 00:03:13 If someone were to ask you that,
00:03:13 --> 00:03:15 let's say a new graduate PT,
00:03:15 --> 00:03:16 now they understand the basics,
00:03:16 --> 00:03:17 now they're moving on to a
00:03:17 --> 00:03:18 little more advanced concepts.
00:03:18 --> 00:03:19 How do those segments or how
00:03:19 --> 00:03:20 would you explain those
00:03:20 --> 00:03:21 segments contributing to
00:03:21 --> 00:03:23 the overall function of that foot?
00:03:23 --> 00:03:25 Yeah, great question.
00:03:25 --> 00:03:26 First question is how many?
00:03:26 --> 00:03:26 There's 10.
00:03:28 --> 00:03:29 If you really dive into the
00:03:29 --> 00:03:30 biomechanical descriptions,
00:03:30 --> 00:03:32 there's 10 segments of the
00:03:32 --> 00:03:34 actual hind foot, mid foot, forefoot,
00:03:35 --> 00:03:36 even then the toes included to it.
00:03:36 --> 00:03:37 And yeah,
00:03:37 --> 00:03:38 they all are working interdependently.
00:03:38 --> 00:03:41 I think what's perhaps even
00:03:41 --> 00:03:42 more important than just
00:03:42 --> 00:03:44 that is understanding all
00:03:44 --> 00:03:45 of the muscles that
00:03:45 --> 00:03:46 actually contribute to it.
00:03:46 --> 00:03:48 I mean, we're talking 19 intrinsic,
00:03:48 --> 00:03:49 12 extrinsic muscles.
00:03:50 --> 00:03:50 Um,
00:03:50 --> 00:03:51 and we're trying to have a good
00:03:51 --> 00:03:53 understanding of how are
00:03:53 --> 00:03:53 each of those muscles
00:03:53 --> 00:03:54 controlling those segments.
00:03:56 --> 00:03:57 All in a very small space as well.
00:03:58 --> 00:03:58 Very much.
00:03:59 --> 00:04:00 That's a lot to it.
00:04:01 --> 00:04:02 How about this one?
00:04:02 --> 00:04:03 Who wants to answer this?
00:04:03 --> 00:04:06 What role does the extrinsic musculature,
00:04:06 --> 00:04:07 you mentioned that a second,
00:04:07 --> 00:04:08 play in controlling the
00:04:08 --> 00:04:09 combined motion of the foot?
00:04:09 --> 00:04:11 That feels like a good continuation.
00:04:11 --> 00:04:12 We'll say foot and ankle
00:04:12 --> 00:04:13 because that also comes into play.
00:04:14 --> 00:04:14 Mm-hmm.
00:04:16 --> 00:04:19 So as far as that, yeah, I'll keep going.
00:04:19 --> 00:04:20 The extrinsics, you know,
00:04:20 --> 00:04:22 that's part of my area of
00:04:22 --> 00:04:23 particular interest and
00:04:23 --> 00:04:24 what I'm trying to do a
00:04:24 --> 00:04:26 little bit of investigation
00:04:26 --> 00:04:27 on more specifically.
00:04:27 --> 00:04:28 But there is recent
00:04:28 --> 00:04:29 literature that's
00:04:29 --> 00:04:30 indicating that the
00:04:30 --> 00:04:31 extrinsic musculature
00:04:31 --> 00:04:33 actually supports the quote
00:04:33 --> 00:04:35 unquote heart arch height.
00:04:35 --> 00:04:36 I argue that it's actually
00:04:37 --> 00:04:38 arch mobility more so than
00:04:38 --> 00:04:40 the actual intrinsic musculature.
00:04:40 --> 00:04:44 So having very good, you know, activation,
00:04:44 --> 00:04:44 strength,
00:04:44 --> 00:04:47 endurance of those muscles is just vital.
00:04:47 --> 00:04:49 All right.
00:04:49 --> 00:04:51 So we mentioned key kinetic
00:04:51 --> 00:04:52 principles a second ago,
00:04:52 --> 00:04:54 and I want to continue to play off this.
00:04:55 --> 00:04:55 Help us understand some of
00:04:56 --> 00:04:56 those key kinetic
00:04:56 --> 00:04:58 principles relevant to that
00:04:58 --> 00:05:00 foot and ankle segments
00:05:00 --> 00:05:01 that we just mentioned.
00:05:02 --> 00:05:04 Yeah, kinetic as far as the motion goes,
00:05:04 --> 00:05:05 you know,
00:05:05 --> 00:05:06 you can't have the proper
00:05:06 --> 00:05:08 pronation supination of
00:05:08 --> 00:05:09 anywhere within the foot
00:05:09 --> 00:05:10 without having the
00:05:10 --> 00:05:13 appropriate motion at the shank, right,
00:05:13 --> 00:05:14 internal, external.
00:05:14 --> 00:05:17 I think a good summary of the kinetics,
00:05:17 --> 00:05:18 the motion is, you know,
00:05:18 --> 00:05:20 for the students that are listening in.
00:05:20 --> 00:05:22 When we do our basic
00:05:22 --> 00:05:23 odiometry of plantar flexion,
00:05:24 --> 00:05:25 dorsiflexion of the ankle,
00:05:25 --> 00:05:26 we know that there's a
00:05:26 --> 00:05:28 total range of approximately 70 degrees.
00:05:29 --> 00:05:30 However, in fact,
00:05:30 --> 00:05:31 there's really only about
00:05:31 --> 00:05:35 45 to 47 degrees of that 70
00:05:35 --> 00:05:36 that is really happening at
00:05:36 --> 00:05:37 the talocrule.
00:05:38 --> 00:05:39 The rest of it is actually
00:05:39 --> 00:05:42 occurring minimally at subtalar joint,
00:05:42 --> 00:05:44 but the majority is
00:05:44 --> 00:05:45 actually talonavicular and
00:05:45 --> 00:05:48 some also at calcaneocuboid as well.
00:05:48 --> 00:05:49 You could include the
00:05:49 --> 00:05:50 forefoot transverse
00:05:51 --> 00:05:52 metatarsal joint in there as well.
00:05:52 --> 00:05:53 Point being,
00:05:54 --> 00:05:56 there's approximately 35% to
00:05:56 --> 00:05:59 37% of our plantar flexion, dorsiflexion,
00:05:59 --> 00:06:02 that is not at the talocruel that we,
00:06:02 --> 00:06:03 as entry level,
00:06:03 --> 00:06:04 are taking our measurements at.
00:06:05 --> 00:06:06 Understood.
00:06:06 --> 00:06:07 And I'm glad that was not on
00:06:07 --> 00:06:08 the MPTE because that would be right.
00:06:09 --> 00:06:10 All right,
00:06:10 --> 00:06:12 let's get down to what I like
00:06:12 --> 00:06:13 about conferences when they
00:06:13 --> 00:06:15 go into in terms of labs
00:06:15 --> 00:06:16 and techniques and hands on
00:06:16 --> 00:06:17 and observations.
00:06:18 --> 00:06:18 Talk about some of those
00:06:18 --> 00:06:19 specific techniques or
00:06:19 --> 00:06:20 approaches that will be
00:06:20 --> 00:06:21 covered in the lab
00:06:21 --> 00:06:22 presentations to help
00:06:22 --> 00:06:24 enhance that clinical practice.
00:06:27 --> 00:06:28 But I think just as what David described,
00:06:28 --> 00:06:30 we really go into taking
00:06:30 --> 00:06:31 that detail we talk about
00:06:31 --> 00:06:34 in how joints move and why
00:06:34 --> 00:06:35 it's important to look at
00:06:35 --> 00:06:37 multiple areas and break
00:06:37 --> 00:06:38 that down into the lab
00:06:38 --> 00:06:39 technique and look at very
00:06:39 --> 00:06:41 specific techniques that
00:06:42 --> 00:06:43 feel both quantity and
00:06:43 --> 00:06:45 quality of movement.
00:06:45 --> 00:06:46 And the way we've organized
00:06:46 --> 00:06:47 the lab sessions is there's
00:06:47 --> 00:06:50 time for active feedback from myself,
00:06:51 --> 00:06:53 David, Catherine Patla,
00:06:53 --> 00:06:54 who's our other colleague
00:06:54 --> 00:06:55 who's presenting with us,
00:06:56 --> 00:06:57 Because I think a lot of
00:06:57 --> 00:06:59 individuals move too fast
00:06:59 --> 00:07:00 and too quick through end
00:07:00 --> 00:07:02 range and actually feel
00:07:02 --> 00:07:03 things are stiff when in
00:07:03 --> 00:07:04 actuality they're not
00:07:05 --> 00:07:06 because they've blown
00:07:06 --> 00:07:06 through the end range and
00:07:06 --> 00:07:08 don't get to appreciate how
00:07:08 --> 00:07:09 the motion actually is.
00:07:09 --> 00:07:10 So we take that time to go
00:07:11 --> 00:07:12 back and forth and actually
00:07:12 --> 00:07:13 feel the motion together
00:07:13 --> 00:07:15 and provide feedback.
00:07:15 --> 00:07:16 And last time we were
00:07:16 --> 00:07:17 fortunate to have someone
00:07:17 --> 00:07:18 who had a problem in our
00:07:18 --> 00:07:20 session and we could do an assessment,
00:07:20 --> 00:07:20 treat,
00:07:20 --> 00:07:22 reassess and see tremendous
00:07:22 --> 00:07:23 improvements
00:07:23 --> 00:07:24 instantaneously with what we were doing.
00:07:25 --> 00:07:26 So we're hoping we can be
00:07:26 --> 00:07:27 lucky again this time too.
00:07:27 --> 00:07:28 How was that?
00:07:28 --> 00:07:30 Treating in front of your colleagues,
00:07:30 --> 00:07:31 like no pressure there, right?
00:07:32 --> 00:07:32 Yeah.
00:07:32 --> 00:07:33 Easy peasy.
00:07:33 --> 00:07:34 Yeah.
00:07:34 --> 00:07:36 So that's actually what
00:07:36 --> 00:07:37 inspired this year's
00:07:37 --> 00:07:38 discussion is that there
00:07:38 --> 00:07:40 was so much feedback
00:07:40 --> 00:07:41 requests that we could
00:07:41 --> 00:07:42 actually dive in further
00:07:42 --> 00:07:43 into our treatment
00:07:43 --> 00:07:44 approaches due to the
00:07:44 --> 00:07:47 success that we had seen in our session.
00:07:47 --> 00:07:48 That's great.
00:07:48 --> 00:07:48 And how, I mean,
00:07:49 --> 00:07:50 how is it presenting with Dr. Patla?
00:07:50 --> 00:07:51 I mean, no pressure there as well.
00:07:51 --> 00:07:53 We're talking about pressure situations.
00:07:53 --> 00:07:53 That can be kind of fun if
00:07:53 --> 00:07:54 you're on your team, right?
00:07:55 --> 00:07:55 Yeah, no, it's awesome.
00:07:56 --> 00:07:57 I think because we've both
00:07:57 --> 00:07:58 gone through the fellowship
00:07:58 --> 00:07:59 with Catherine for so many
00:07:59 --> 00:08:00 years and our colleagues,
00:08:01 --> 00:08:04 it's awesome to be on the stage with her.
00:08:04 --> 00:08:05 It's got to be great.
00:08:05 --> 00:08:06 All right.
00:08:06 --> 00:08:07 So let's talk about biases.
00:08:07 --> 00:08:09 I feel like that's a word
00:08:09 --> 00:08:10 that I don't know that I
00:08:10 --> 00:08:12 used it a ton before the last three,
00:08:12 --> 00:08:13 five years.
00:08:14 --> 00:08:15 What are some of the common
00:08:15 --> 00:08:16 biases clinicians might
00:08:16 --> 00:08:18 have in assessing foot and
00:08:18 --> 00:08:19 ankle function?
00:08:19 --> 00:08:21 We sort of alluded to one a second ago.
00:08:21 --> 00:08:23 And how can self-appraisal
00:08:23 --> 00:08:24 help identify these?
00:08:24 --> 00:08:26 Because we got to identify
00:08:26 --> 00:08:28 it before we can fix it or solve it.
00:08:28 --> 00:08:29 You got to know it's there.
00:08:29 --> 00:08:30 Yeah.
00:08:30 --> 00:08:31 And you first have to admit
00:08:31 --> 00:08:33 that there even is a potential bias.
00:08:33 --> 00:08:33 Right.
00:08:33 --> 00:08:34 And then you kind of walk
00:08:34 --> 00:08:35 through those steps.
00:08:35 --> 00:08:36 And so I think part of it is
00:08:36 --> 00:08:37 going back to one of our
00:08:37 --> 00:08:39 principles in that you must
00:08:39 --> 00:08:40 have normal joint function
00:08:40 --> 00:08:42 to have effective muscle
00:08:43 --> 00:08:43 function as well.
00:08:44 --> 00:08:45 And so we really take.
00:08:45 --> 00:08:46 Say that again.
00:08:46 --> 00:08:46 One more time.
00:08:47 --> 00:08:50 You must have effective joint mobility,
00:08:50 --> 00:08:51 quantity,
00:08:51 --> 00:08:53 quality in order to have proper
00:08:53 --> 00:08:54 muscle function.
00:08:54 --> 00:08:55 Okay, good.
00:08:55 --> 00:08:55 Okay.
00:08:56 --> 00:08:57 And so going, starting at that principle,
00:08:57 --> 00:08:59 we recognize the importance
00:08:59 --> 00:09:01 of looking at individual
00:09:01 --> 00:09:03 joint motion at the foot
00:09:04 --> 00:09:06 and ankle versus just gross
00:09:07 --> 00:09:09 osteokinematic assessment.
00:09:09 --> 00:09:10 I think that's the first
00:09:10 --> 00:09:13 bias that when people look at a foot,
00:09:14 --> 00:09:14 they,
00:09:15 --> 00:09:16 it's this nebulous and it's too
00:09:16 --> 00:09:17 complicated.
00:09:17 --> 00:09:18 There are too many joints
00:09:19 --> 00:09:20 and it becomes sloppy in
00:09:20 --> 00:09:22 the assessment and the treatment.
00:09:22 --> 00:09:23 And then they get frustrated
00:09:23 --> 00:09:24 that no one's getting better.
00:09:26 --> 00:09:28 And so you have to break it down and go,
00:09:28 --> 00:09:28 okay,
00:09:28 --> 00:09:30 what do I know and what don't I know
00:09:30 --> 00:09:32 and how can I get better at that?
00:09:32 --> 00:09:33 And the foot is one of those
00:09:33 --> 00:09:35 areas that I think can be
00:09:35 --> 00:09:36 particularly tricky if you
00:09:36 --> 00:09:38 don't understand the
00:09:38 --> 00:09:39 biomechanics well enough.
00:09:40 --> 00:09:41 All right,
00:09:41 --> 00:09:43 so you'll be providing an opportunity,
00:09:44 --> 00:09:45 and that's sort of what an
00:09:45 --> 00:09:46 AOPT conference has,
00:09:46 --> 00:09:47 which is there's a lot of hands-on.
00:09:47 --> 00:09:48 If there wasn't,
00:09:48 --> 00:09:49 it would feel a little weird.
00:09:49 --> 00:09:51 But what's the best way you
00:09:51 --> 00:09:52 might suggest for
00:09:52 --> 00:09:53 clinicians to apply the
00:09:53 --> 00:09:56 hands-on practice from your presentation,
00:09:56 --> 00:09:59 from a conference, when they get home,
00:10:00 --> 00:10:00 the neck, you know,
00:10:00 --> 00:10:02 we call it Monday morning applicable.
00:10:02 --> 00:10:03 Is there a suggestion like, hey,
00:10:03 --> 00:10:04 we want some carryover.
00:10:04 --> 00:10:06 We want to have the magic in the room,
00:10:06 --> 00:10:06 but then we want to be able
00:10:06 --> 00:10:07 to apply these things.
00:10:07 --> 00:10:08 We want to make them applicable.
00:10:08 --> 00:10:09 What would you suggest?
00:10:11 --> 00:10:14 Yeah, I think ideally in the session,
00:10:14 --> 00:10:15 being able to go back and
00:10:15 --> 00:10:17 forth with one of us, like I feel,
00:10:17 --> 00:10:18 you feel, I feel, you feel.
00:10:19 --> 00:10:20 And we compare right then
00:10:20 --> 00:10:22 and there and then doing it
00:10:22 --> 00:10:23 a couple of times.
00:10:23 --> 00:10:23 Right.
00:10:23 --> 00:10:25 This is a skill that you
00:10:25 --> 00:10:26 need to be using right away.
00:10:27 --> 00:10:28 But also what I like to do
00:10:28 --> 00:10:29 clinically is I do a
00:10:29 --> 00:10:30 functional assessment.
00:10:31 --> 00:10:32 Then I look at my osteokinematic,
00:10:33 --> 00:10:35 look at my joint mobility, treat,
00:10:35 --> 00:10:36 and go back and look at my
00:10:36 --> 00:10:36 function right away.
00:10:36 --> 00:10:38 So you know right then and
00:10:38 --> 00:10:40 there if something is working or not.
00:10:40 --> 00:10:41 And so I think that's a
00:10:41 --> 00:10:42 piece that people could take away.
00:10:42 --> 00:10:44 Day one is using that
00:10:44 --> 00:10:45 functional assessment,
00:10:46 --> 00:10:47 going and looking at the joint mobility,
00:10:48 --> 00:10:49 treat if there's a restriction,
00:10:49 --> 00:10:50 and go back and reassess.
00:10:50 --> 00:10:52 And if not, go back again and look again.
00:10:52 --> 00:10:55 So doing that continual assess, treat,
00:10:55 --> 00:10:57 reassess is a piece that I
00:10:57 --> 00:10:58 think is so critical.
00:10:59 --> 00:11:00 Do you want to add something, David?
00:11:00 --> 00:11:00 Yeah.
00:11:00 --> 00:11:02 And speaking clinically, I would say,
00:11:02 --> 00:11:02 you know,
00:11:02 --> 00:11:04 they have to just jump in to
00:11:04 --> 00:11:05 learn how to swim.
00:11:05 --> 00:11:05 Right.
00:11:05 --> 00:11:06 If you don't get into the water,
00:11:06 --> 00:11:08 you're never going to learn.
00:11:08 --> 00:11:11 So when it comes to the clinical approach,
00:11:11 --> 00:11:13 they have to just start investigating.
00:11:13 --> 00:11:13 They have to start putting
00:11:13 --> 00:11:14 their hands on and they
00:11:15 --> 00:11:16 have to feel many different emotions.
00:11:16 --> 00:11:18 feet types.
00:11:18 --> 00:11:19 Going back to the bias,
00:11:19 --> 00:11:20 I think one bias is
00:11:20 --> 00:11:22 presuming that arch height
00:11:22 --> 00:11:23 is related to risk of injury,
00:11:24 --> 00:11:26 but that's inconclusive in
00:11:26 --> 00:11:26 the literature.
00:11:28 --> 00:11:29 Mobility is arguably more
00:11:29 --> 00:11:31 important and they have to
00:11:31 --> 00:11:32 get their hands on
00:11:32 --> 00:11:32 different feets because
00:11:33 --> 00:11:33 there's different types of
00:11:33 --> 00:11:35 mobility for different
00:11:35 --> 00:11:36 sizes of feet related to
00:11:37 --> 00:11:38 different amounts of ground
00:11:38 --> 00:11:39 reaction force for specific
00:11:40 --> 00:11:41 demands of functional activity in sport.
00:11:43 --> 00:11:44 So you just got to start touching,
00:11:44 --> 00:11:45 touching, touching in my opinion.
00:11:46 --> 00:11:47 I now know what the promo
00:11:47 --> 00:11:48 will be for the episode.
00:11:48 --> 00:11:49 It'll be touch as many feet
00:11:49 --> 00:11:50 as possible from day one.
00:11:50 --> 00:11:51 Yes, yes, yes.
00:11:52 --> 00:11:53 And shoes off immediately
00:11:53 --> 00:11:54 when you first come in the room.
00:11:54 --> 00:11:57 That'll air the puppies out a little bit.
00:11:57 --> 00:11:59 But also, too, when we think about,
00:11:59 --> 00:12:03 I think especially at an AOMT level,
00:12:04 --> 00:12:05 we feel confident in our
00:12:05 --> 00:12:07 manual therapy skills,
00:12:07 --> 00:12:08 in our hands-on skills,
00:12:08 --> 00:12:09 our manipulation skills.
00:12:10 --> 00:12:10 But taking...
00:12:14 --> 00:12:15 time in the clinic to work
00:12:15 --> 00:12:18 with your to get feedback
00:12:18 --> 00:12:20 on your techniques and
00:12:20 --> 00:12:21 maybe spending a lunchtime
00:12:21 --> 00:12:22 on a friday hey let's run
00:12:22 --> 00:12:23 through some techniques and
00:12:23 --> 00:12:24 let's see if it feel the
00:12:24 --> 00:12:25 same as that I did at the
00:12:25 --> 00:12:26 conference that we had or
00:12:26 --> 00:12:27 let me show you some cool
00:12:27 --> 00:12:28 techniques let's talk
00:12:28 --> 00:12:29 through what we're doing
00:12:29 --> 00:12:30 but taking time to hone
00:12:30 --> 00:12:32 your craft outside of the
00:12:32 --> 00:12:33 time with the patient
00:12:34 --> 00:12:35 that's smart all right so
00:12:35 --> 00:12:35 I'm gonna I'm gonna make
00:12:35 --> 00:12:37 you pick only one
00:12:37 --> 00:12:40 What is each of your one key
00:12:40 --> 00:12:41 takeaway for clinicians
00:12:42 --> 00:12:42 that they'll be able to
00:12:43 --> 00:12:45 walk away from after your presentation?
00:12:45 --> 00:12:46 So this is, again,
00:12:46 --> 00:12:47 the teaser before the
00:12:47 --> 00:12:49 teaser regarding your topic.
00:12:49 --> 00:12:50 What do you got, Amanda?
00:12:50 --> 00:12:51 What do you think people
00:12:51 --> 00:12:52 will be able to walk away
00:12:52 --> 00:12:53 with and be armed with?
00:12:55 --> 00:12:56 Is that pun intended?
00:12:56 --> 00:12:57 I'm literally trying to
00:12:57 --> 00:12:58 think of a foot pun and I
00:12:58 --> 00:12:59 couldn't before it came out of my mouth.
00:13:00 --> 00:13:00 Yeah, you got it.
00:13:02 --> 00:13:04 I think being more confident
00:13:04 --> 00:13:07 in their ability to assess
00:13:07 --> 00:13:08 specific joint motion.
00:13:09 --> 00:13:10 I think that's one thing we
00:13:10 --> 00:13:11 started last time,
00:13:11 --> 00:13:12 and we're going to be able
00:13:12 --> 00:13:13 to capitalize more on that this time.
00:13:14 --> 00:13:15 All right, David, same question.
00:13:15 --> 00:13:16 Yeah, I would say two things.
00:13:16 --> 00:13:18 I would say try to remain as
00:13:18 --> 00:13:19 objective as possible.
00:13:20 --> 00:13:23 And then number two is to ask for help,
00:13:23 --> 00:13:23 right?
00:13:24 --> 00:13:25 Seek, you know,
00:13:25 --> 00:13:26 reaffirmation from your
00:13:26 --> 00:13:29 colleagues like Amanda had highlighted.
00:13:29 --> 00:13:30 And I think that also speaks
00:13:30 --> 00:13:32 to the self-appraisal component too.
00:13:33 --> 00:13:33 Perfect.
00:13:34 --> 00:13:36 Looking forward to,
00:13:36 --> 00:13:37 I think October is a good
00:13:37 --> 00:13:38 time to head south.
00:13:38 --> 00:13:40 It's not too shabby to go to Orlando.
00:13:40 --> 00:13:42 So this is the prelude to
00:13:43 --> 00:13:44 one of many presentations
00:13:44 --> 00:13:45 going on at the AOMT
00:13:45 --> 00:13:46 conference this October.
00:13:46 --> 00:13:48 For more information about the event,
00:13:48 --> 00:13:50 check out aomt.org.
00:13:50 --> 00:13:51 David, Amanda, looking forward to it.
00:13:51 --> 00:13:52 Thanks for the time sharing
00:13:53 --> 00:13:54 what you'll be presenting on this year.
00:13:55 --> 00:13:55 Thank you, Jimmy.