Current Pedorthics | January-February 2014 | Vol. 46, Issue 1 | Page 30

Posturology as a Treatment: Intrinsic Foot Muscles Instead of Rigid Orthotics? Nigg concluded that medial arch supports, placed in the rear part of the arch against the calcaneus, reduces the initial pronation, but placed more forward to the midfoot, the effect became much less. Still compared to barefoot running, he found more pronation when wearing shoes. Shoes. Nigg concluded that medial arch supports, placed in the rear part of the arch against the calcaneus, reduces the initial pronation, but placed more forward to the midfoot, the effect became much less. Still compared to barefoot running, he found more pronation when wearing shoes. Neurologic of the Plantar Foot The hairless skin of the foot sole has a great number and variety of neuro-receptors: Ruffini, Krause, Vater, Pacini, Meisner, free nerve endings, etc. They all have special functions, but many of them are also sensitive to pressure. We call them mechanoor baroreceptors. Kennedy et al identified a total of 104 mechanoreceptors in the hairless skin of the foot sole, active only when the foot was loaded. Yet, when the foot is in an unloaded position no discharge activity in any of the cutaneous receptors was found, especially in the absence of intentionally applied stimulation. These findings suggest that skin receptors of the foot sole behave differently from those receptors found on the hairless skin of the hand. This may reflect the role of foot sole skin receptors in standing balance and movement control. René Jaques Bourdiol, has published extensively about his theory, however only in French, and unfortunately, not meeting scientific standards of the scientific community. His most important book, Pied et Statique, hypothesises that a (cork) insert, 1 to 2 mm thin, placed under (for example) the medial arch, has a direct effect on the intrafusal nuclear chain and the bag spindle of the m.abductor hallucis. He called his therapy ‘proprioceptive’. In his opinion, the sensitivity of these γ-fibers increases to more sensitiveness of the 1-a afferent nerve. This then leads to a contraction of the m. abductor hallucis activated through the α – motor neuron at spine level. These nuclear bag and chain spindles are found within and parallel to the muscle fibers and are sensitive to stretching. Since 1978 this technique, known as podopostural therapy, has been successfully applied in more European countries. 28 Pedorthic Footcare Association www.pedorthics.org Observations When we consider the thickness of dermis and epidermis, plus an average tissue thickness of 1 cm under the foot, I can see why scientists are skeptical that a 1 to 2 mm thin piece of cork changes the position of the foot and consequently the posture, in spite of the empirical results. In my opinion, the only sensors that can be activated directly are therefore the mechanoreceptor