Question out of Curiousity

[pudge123]

I am a pre-dental student but I am also curious in other fields of healthcare. I was just wondering if anyone can tell me the relation of podiatry to sports medicine. Do pro sports hire foot docs? etc.. thanks a bunch

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[DPMrick]

I am a pre-dental student but I am also curious in other fields of healthcare. I was just wondering if anyone can tell me the relation of podiatry to sports medicine. Do pro sports hire foot docs? etc.. thanks a bunch

Not sure if pro sports hire podiatrist...I don't think they do though. But Pods do work on sports related injuries within the scope of their practice.

 

[MurrayButler]

When I interviewed at Temple, I met the DPM that was head of the clinical program there. Unfortunately I am unable to recall his name, but the point of this is up until the past few years he was the team podiatrist for both the Pittsburgh Steelers and the Pittsburgh Pirates. So I would say that this is definately something that occurs. I also know that some of the Barry students are allowed to work for the Atlanta Braves spring training camp and the Miami Heat (or at least the school told me that) and Temple does such things as cover the podiatry work for the Boston Marathon. So maybe that helps.

 

[krabmas]

Unfortunately the world of medicine has changed and Pods are not hired by pro teams anymore.

The NY Giants used to have a team podiatrist as did the NJ devils...

Now hospitals pay for the oppurtunity for their staff to be the Team hospital/ team doctors. That's right - the doctors pay the patient. This is because there is so much money to be made if the hospital or practice gets to advertise that they are the Team pod, or orthopedist.

Just think though - are those patients (athletes) getting the best care? or just the highest bidder?

There are plenty of oppurtunities to get involved in sports medicine as a pod though. The most common injury that comes into the office though is plantar fasciitis mostly due to imperfect feet overworking (very breif explaination).

At NYCPM as students we volunteer at triathalons, marathons, special olympics... At some events we do free foot screenings and at other events we do post-event injuries.

There may be oppurtunities at the college level for team podiatry or even high school.

The kind of podiatrist you become will depend on the nature of your patients. If you work near a high school or gym or active community you will have some sports injuries. If you work near a nursing home you'll be cutting lots of nails.

Alot depends on who you treat and how and what they tell their friends. If you treat a soccer player and he tells all his friends to come - then you can become a soccer pod along with treating other types of patients.

I'm sure there are people on this site that disagree with me... I am just trying to be helpful.

 

[manik]

Just think though - are those patients (athletes) getting the best care? or just the highest bidder?

Are you saying podiatrists are more qualified than orthopaedic surgeons in handling sports injuries?? Because as far as I know, most professional athletes are treated by the best orthopaedic surgeons in the country.

 

[PM2]

Are you saying podiatrists are more qualified than orthopaedic surgeons in handling sports injuries?? Because as far as I know, most professional athletes are treated by the best orthopaedic surgeons in the country.

It is true that those with money can have the best podiatrist for foot and ankle and orthopods for knee, hip, etc.

I'm sure you are aware that podiatrist know the foot and ankle geometry and anatomy better than the general orthopod.

August 1st is right around the corner. Back to the library.

 

[krabmas]

Are you saying podiatrists are more qualified than orthopaedic surgeons in handling sports injuries?? Because as far as I know, most professional athletes are treated by the best orthopaedic surgeons in the country.

Please re-read my post. That has nothing to do with what I wrote. All I said was that pods and orthos pay to treat the pro-athlete teams.

Just in case you missed that last point let me try again...

Almost no team employs doctors anymore - not just pods, and orthos... any doctor.

Maybe a hockey team might have a team dentist for the knocked out teeth

And many of the procedures we still use in surgery were developed by orthopedists - so I have no reason to say they are not as good.

 

[diabeticfootdr]

Are you saying podiatrists are more qualified than orthopaedic surgeons in handling sports injuries?? Because as far as I know, most professional athletes are treated by the best orthopaedic surgeons in the country.

I would say that it is true. There are many podiatric surgeons who are much better at handling foot and ankle injuries than orthopods.

We are foot and ankle specialist, and board certified in foot and ankle surgery. There is no board certification for orthopedics in foot and ankle surgery, and if you read Micheal Pinzur, MD (foot and ankle orthopedic surgeon) who is at Loyola - which is close to you - (I see you attend FU) --- in a recent editorial he wrote in Foot and Ankle International, he states that foot and ankle training in orthopedic residencies is lacking. So you do the math.

LCR

 

[manik]

Please re-read my post. That has nothing to do with what I wrote. All I said was that pods and orthos pay to treat the pro-athlete teams.

Just in case you missed that last point let me try again...

Almost no team employs doctors anymore - not just pods, and orthos... any doctor.

Maybe a hockey team might have a team dentist for the knocked out teeth

And many of the procedures we still use in surgery were developed by orthopedists - so I have no reason to say they are not as good.

hey krabmas,

sorry man, didn't mean to upset you but I just assumed you meant orthopaedic surgeons because I know a lot of hospitals don't have podiatrists on staff. I've also met the team physicians for the LA Lakers and the Philadelphia Eagles, all of which were prominent orthopaedic surgeons from university-based medical schools. I also know your belief that orthos pay athletes to treat them is a little misleading. In fact, many orthos are hesitant to treat pro-athletes because their malpractice premiums can double or even triple by treating these athletes. We're talking about athletes that have multi-million dollar paydays based on their physical capabilities. Any injury to them can be catastrophic to their careers. Any mistake an orthopaedic surgeon makes in treating them can be catastrophic to their careers also. With the already high premiums these surgeons pay, whether it be provided by the hospital or not, their premiums only become exponentially greater in treating the pro-athlete.

 

[PM2]

hey krabmas,

sorry man, didn't mean to upset you but I just assumed you meant orthopaedic surgeons because I know a lot of hospitals don't have podiatrists on staff. I've also met the team physicians for the LA Lakers and the Philadelphia Eagles, all of which were prominent orthopaedic surgeons from university-based medical schools. I also know your belief that orthos pay athletes to treat them is a little misleading. In fact, many orthos are hesitant to treat pro-athletes because their malpractice premiums can double or even triple by treating these athletes. We're talking about athletes that have multi-million dollar paydays based on their physical capabilities. Any injury to them can be catastrophic to their careers. Any mistake an orthopaedic surgeon makes in treating them can be catastrophic to their careers also. With the already high premiums these surgeons pay, whether it be provided by the hospital or not, their premiums only become exponentially greater in treating the pro-athlete.

Manik,

Do you know why many hospitals don't have Podiatrists on staff? Partly because the hospital may be small, partly because the hospitals may have "old school" orthopods that still haven't accepted podiatrists as ligit docs, and mostly because the hospital orthopods feel that there isn't enough foot and ankle trauma/surgerys to warrant a podiatrist to be on staff. As one doctor has told me, some orthopods don't want a podiatrist on staff because it will not reduce their "on-call" hours. Although ligit, it is not necessarily the best medical practice.

Another doctor, who is an emergency medicine physician, has told me that most othopods will refer them to a podiatrist when the foot is damaged seriously or if it looks serious. On one occasion, it was a fractured MT but the foot looked like a football. The orthopod didn't want to touch it. He admitted that he didn't know the anatomy well enough.

Have a good summer Manik. Does CMS start on August 1st?

 

[drbeesh]

Manik,

Do you know why many hospitals don't have Podiatrists on staff? Partly because the hospital may be small, partly because the hospitals may have "old school" orthopods that still haven't accepted podiatrists as ligit docs, and mostly because the hospital orthopods feel that there isn't enough foot and ankle trauma/surgerys to warrant a podiatrist to be on staff. As one doctor has told me, some orthopods don't want a podiatrist on staff because it will not reduce their "on-call" hours. Although ligit, it is not necessarily the best medical practice.

Another doctor, who is an emergency medicine physician, has told me that most othopods will refer them to a podiatrist when the foot is damaged seriously or if it looks serious. On one occasion, it was a fractured MT but the foot looked like a football. The orthopod didn't want to touch it. He admitted that he didn't know the anatomy well enough.

Have a good summer Manik. Does CMS start on August 1st?

I completely agree with wut your saying because I've shared similar experiences and positive feedback from other physicians when I volunteered at 2 separate externship rotations in the U.S.

As much as I respect podiatrists and their services, I can't help but notice a sense of insecurity when it comes to some podiatrists "need" to conduct surgeries in the hospital OR (keep in mind i'm talking about SOME not ALL). What I mean by this is that sometimes it appears as though the podiatrist needs to be in the OR to convince everyone else that he/she is a "real" or "legitimate" DR. So what if hospitals or a few ignorant Orthopods/other practioners don't recognize your surgical abilities? There are MANY MANY other important roles for podiatrists that extend beyond the OR. Why do we undermine the importance of caring for diabetic patients, working with children, biomechanics, orthotics, and soft-tissue surgery. In the province of Ontario, podiatrists are not allowed anywhere near the hospitals and they are restricted to in-office soft-tissue surgery, but I still had the greatest previlidge of shadowing a podiatrist in his private practice and he completely opened my eyes to the profession and the field. How many medical professions can combine the best of family practice, dermatology, orthopoedics, sports medicine, all in one. What I liked the most was the fact that we did not know what to expect from each patient who visited. Every case was different from the other but the only thing that they had in common was that ALL the patients left the office with PAIN RELIEF. This is what it's all about. It's not about how many hours you log in the OR or how your other colleagues look at you. Ladies and Gentlemen, I will share with you that podiatrist's advice..."you are podiatrists and foot & ankle specialists - this is a great honor - don't abuse it - respect your patient, and ALWAYS dedicate your time for his or her OVERALL wellbeing".

Good luck with all your studies...

cheers!

 

[PM2]

drbeesh,

In my humble opinion, a podiatrist who wants to practice Foot and Ankle Reconstructive surgery does not feel a "need" to be in a hospital OR to impress others. Rather, he or she probably feels a calling. Just as many surgeons feel that it was a calling for them to practice the act of surgery. Podiatry is growing in a very positive direction. As time progresses, orthopaedist are beginning to realize the surgical skills of foot and ankle surgeons which may be causing some "insecurity" on their behalf . Many podiatry schools have joined with medical school programs. This allows the entering podiatry and medical students to be very similar in scholastic ability. In our combined anatomy class, there was no significant statistical difference between the means of medical school students and podiatry students. In addition, the detail of our combined clinical anatomy didn't even compare to the detail of our lower extremity anatomy course. If you feel that I am being "insecure" by making such a comparison, I will feel as if I have missed my mark. Rather, it is not called insecurity but it is called a display of confidence with the support of factual data. I hope to use this confidence to educate orthopaedic surgeons about the importance of Foot and Ankle specialist. Especially in the care of patients who have a potential for serious problems (diabetics). In addition, most foot problems, example: mid foot/hind foot equinus, can cause some serious damage to the knee and hip. Equinus will eventually affect the knees of most patients. If the equinus is caught and managed quickly, the damage may be reduced. TPoTa insufficiency can also cause acquired adult flat foot and potential ankle collapse of the elderly. These are conditions that have been overlooked for many years.

You are correct that there are many other means that a podiatrist uses to address a multitude of patient problems. Among them are toe nail trimming, callus removal, orthotics, flat feet management, diabetic management, Hallux Valgus management, charcot foot, neuropathy, PVD, etc..... All of these are important. Not much different than an internal medicine doctor, emergency medicine doctor, family practice doctor, or most other MDs who use lab analysis to diagnose a patient. One difference is the current lack of automated equipment to allow podiatrist to make many of the pathological or traumatic diagnoses that he/she will she when practicing. Instead, the act of trimming the nails, trimming the callus, and etc allows the podiatrist to develop an understanding of the biomechanical nuance that may have caused the abnormal nail growth or callus. The nuance may be a simple as the size of a muscle in proportion to other muscles or the slightly altered angles in the foot, ankle, and tibia. An example of a potential problem: The superficial group of muscles called the soleus and gastrocnemius combine to form the tendocalcaneus from the aponeurosis of insertion of each. Furthermore, it seems that the tendocalcaneus fibers, from origin of insertion, spiral from medial to lateral so that the gastroc fibers insert on the lateral aspect of the upper 1/3 of posterior body of the calcaneus and the soleus fibers insert on the medial aspect of the upper 1/3 of the posterior body of the calcaneus. If the gastroc is disproportionate in size to the soleus, could this cause a biomechanical effect similar to varus equinus? If so, could this be causing that callus on the rigid/lateral portion of the longitudinal arch? How does it affect the required amount of dorsiflexion required when doing certain arthrodesis procedures? Will a lengthening of the tendon be required?

Personally, I think most podiatric students and most practicing podiatric surgeons will ask these questions. Just as other doctors are thinking as they examine a patient. Sorry for the long response. I just enjoy this stuff called podiatric medicine. I am only a PM2 though. 3 more years of school, and 3 years of residency. Maybe some additional education f I am lucky. I would like to learn some tricks from Dr. Paley and his group. A group that includes podiatrist.

 

[drbeesh]

drbeesh,

In my humble opinion, a podiatrist who wants to practice Foot and Ankle Reconstructive surgery does not feel a "need" to be in a hospital OR to impress others. Rather, he or she probably feels a calling. Just as many surgeons feel that it was a calling for them to practice the act of surgery. Podiatry is growing in a very positive direction. As time progresses, orthopaedist are beginning to realize the surgical skills of foot and ankle surgeons which may be causing some "insecurity" on their behalf . Many podiatry schools have joined with medical school programs. This allows the entering podiatry and medical students to be very similar in scholastic ability. In our combined anatomy class, there was no significant statistical difference between the means of medical school students and podiatry students. In addition, the detail of our combined clinical anatomy didn't even compare to the detail of our lower extremity anatomy course. If you feel that I am being "insecure" by making such a comparison, I will feel as if I have missed my mark. Rather, it is not called insecurity but it is called a display of confidence with the support of factual data. I hope to use this confidence to educate orthopaedic surgeons about the importance of Foot and Ankle specialist. Especially in the care of patients who have a potential for serious problems (diabetics). In addition, most foot problems, example: mid foot/hind foot equinus, can cause some serious damage to the knee and hip. Equinus will eventually affect the knees of most patients. If the equinus is caught and managed quickly, the damage may be reduced. TPoTa insufficiency can also cause acquired adult flat foot and potential ankle collapse of the elderly. These are conditions that have been overlooked for many years.

You are correct that there are many other means that a podiatrist uses to address a multitude of patient problems. Among them are toe nail trimming, callus removal, orthotics, flat feet management, diabetic management, Hallux Valgus management, charcot foot, neuropathy, PVD, etc..... All of these are important. Not much different than an internal medicine doctor, emergency medicine doctor, family practice doctor, or most other MDs who use lab analysis to diagnose a patient. One difference is the current lack of automated equipment to allow podiatrist to make many of the pathological or traumatic diagnoses that he/she will she when practicing. Instead, the act of trimming the nails, trimming the callus, and etc allows the podiatrist to develop an understanding of the biomechanical nuance that may have caused the abnormal nail growth or callus. The nuance may be a simple as the size of a muscle in proportion to other muscles or the slightly altered angles in the foot, ankle, and tibia. An example of a potential problem: The superficial group of muscles called the soleus and gastrocnemius combine to form the tendocalcaneus from the aponeurosis of insertion of each. Furthermore, it seems that the tendocalcaneus fibers, from origin of insertion, spiral from medial to lateral so that the gastroc fibers insert on the lateral aspect of the upper 1/3 of posterior body of the calcaneus and the soleus fibers insert on the medial aspect of the upper 1/3 of the posterior body of the calcaneus. If the gastroc is disproportionate in size to the soleus, could this cause a biomechanical effect similar to varus equinus? If so, could this be causing that callus on the rigid/lateral portion of the longitudinal arch? How does it affect the required amount of dorsiflexion required when doing certain arthrodesis procedures? Will a lengthening of the tendon be required?

Personally, I think most podiatric students and most practicing podiatric surgeons will ask these questions. Just as other doctors are thinking as they examine a patient. Sorry for the long response. I just enjoy this stuff called podiatric medicine. I am only a PM2 though. 3 more years of school, and 3 years of residency. Maybe some additional education f I am lucky. I would like to learn some tricks from Dr. Paley and his group. A group that includes podiatrist.

I enjoyed your response as well since I am a future podiatry student myself. Look, I think you misunderstood me or missed my point when I said, "SOME podiatrists"....i'm simply saying that surgery is one aspect of podiatry but not the FULL aspect....yes podiatrists are probably more qualified in dealing with foot and ankle surgery (the board certified ones at least) but i'm saying that there's so much more to that beyond the OR exposure. I'm just basing opinion on wut I observed....mind you i'm not a podiatrist....and i don't work with podiatrists every day....i appologize if i offended you by this comment but in no way do i mean to disrespect podiatrists....i'm a a very firm believer of the podiatrist's role and i experienced this first hand when i shadowed more than a few of them....

 

[PM2]

drbeesh,

You didn't offend me. Although MDs that I know have never accused me of being "insecure", they have stated that Podiatrists are long winded. One said he felt it was because podiatrist felt the need to prove themselves. I found this interesting since I know the MD and his wife personally and have spent time at their house and have gone out to dinner with them. On every occasion, all he and the other MDs did was talk about their form of practiced medicine. I do not blame them since work occupies such a large part of their life. I do think they were a little "long winded" though.

I gave a long response because I believe that some podiatrist feel a calling to a certain part of podiatry. I am not minimizing the current and major role of most podiatrist. A role which is not surgery with an exception for HVA. As you know, the act of cutting a patients toenails is very important to the patient. In most situations, the patient cannot feel their toes and can barely reach them, which usually leads to damaged toes. In diabetics, this can lead to a worst case scenario of amputation. I truly appreciate this role also. I have only shadowed 5 podiatrist. I will be shadowing another podiatrist for the first time in his office and then in the operating room of the hospital where he sits on the surgical board. In addition, I just discovered that I will be shadowing another set of podiatrist that do lots of rear foot reconstructive surgery. Although the latter few may do more surgery on average than the previous, I am predicting that they are also doing toenails, callus trimming, orthotics, etc...

Thanks for the discussion!

 

[drbeesh]

drbeesh,

You didn't offend me. Although MDs that I know have never accused me of being "insecure", they have stated that Podiatrists are long winded. One said he felt it was because podiatrist felt the need to prove themselves. I found this interesting since I know the MD and his wife personally and have spent time at their house and have gone out to dinner with them. On every occasion, all he and the other MDs did was talk about their form of practiced medicine. I do not blame them since work occupies such a large part of their life. I do think they were a little "long winded" though.

I gave a long response because I believe that some podiatrist feel a calling to a certain part of podiatry. I am not minimizing the current and major role of most podiatrist. A role which is not surgery with an exception for HVA. As you know, the act of cutting a patients toenails is very important to the patient. In most situations, the patient cannot feel their toes and can barely reach them, which usually leads to damaged toes. In diabetics, this can lead to a worst case scenario of amputation. I truly appreciate this role also. I have only shadowed 5 podiatrist. I will be shadowing another podiatrist for the first time in his office and then in the operating room of the hospital where he sits on the surgical board. In addition, I just discovered that I will be shadowing another set of podiatrist that do lots of rear foot reconstructive surgery. Although the latter few may do more surgery on average than the previous, I am predicting that they are also doing toenails, callus trimming, orthotics, etc...

Thanks for the discussion!

Well said...I hope you enjoy your exposure and experience with shadowing the podiatrists...Its always good to see someone passionate with what they do - surely your positive attitude will transpire on your patients and those you work with as well...

 

[PM2]

Thanks!

From your past posts, I see that you are/were interested in DO schools. I also assume you are interested in ortho.

You appear to be willing to learn from others. If this is true, I respect that trait tremendously. During my time in the army, time in college, time working in corporate America and time working for the government, I discovered the importance of learning from others. Everybody knows something that can benefit another. One who may be ignorant or less knowledgeable.

When I said "educate othro..", I sincerely hope you were not offended. Rather, I have learned that everybody brings something valuable to the table. A different way of thinking that can have drastic changes on a process or procedure. By working together, listening to each other, trouble shooting and problem solving, N minds is better than n minds in most cases. In some cases, there is only time for a quick, educated, and experienced decision of the most knowledgeable person. I am sure you are aware that this decision does not always come from the most senior or educated person.

Once again... Thanks for the conversation.

 

[drbeesh]

Thanks!

From your past posts, I see that you are/were interested in DO schools. I also assume you are interested in ortho.

You appear to be willing to learn from others. If this is true, I respect that trait tremendously. During my time in the army, time in college, time working in corporate America and time working for the government, I discovered the importance of learning from others. Everybody knows something that can benefit another. One who may be ignorant or less knowledgeable.

When I said "educate othro..", I sincerely hope you were not offended. Rather, I have learned that everybody brings something valuable to the table. A different way of thinking that can have drastic changes on a process or procedure. By working together, listening to each other, trouble shooting and problem solving, N minds is better than n minds in most cases. In some cases, there is only time for a quick, educated, and experienced decision of the most knowledgeable person. I am sure you are aware that this decision does not always come from the most senior or educated person.

Once again... Thanks for the conversation.

As a matter of fact, I was very serious about DO school and still the interest is there...But podiatry is still a strong option for me as well especially after the numerous positive experiences I had with the podiatrists I shadowed...luckily i have both options at hand and i can start either route this fall so the decision is definately a tough one...As I said before, I love the idea of praciting different scopes of medicine within one profession and getting instant gratification from the patient...this is something exclusive to podiatry...right now i'm in the process of decision making and reviewing all the options....i.e. cost, scholarships, what I want to do, etc. And, I definately agree that we need to learn from one another....podiatrists, pharmacists, MD's, DO's, RN, all other healthcare practitioners all need to be able to communicate and share their wealth of respective expertise for the well being of the patient....

interestingly, the one person who really emphasized this point to me was the podiatrist I shadowed in my province, he always stressed that "podiatrists treat and look after the well being of the patient as a whole...not just the feet/lower extremety"...so there is a responsibility to be actively communicating and working with other practitioners...Also, that our major problem in health care is the fact that we do not have enough "active listeners"...As scary as this sounds, but not too many people actually listen to what the patient says or what the other colleagues/health care professionals recommend. We really do need to have people working together and utilizing their experience and expertise for research, patient care, etc. - especially the research aspect!!

And thank u for the convo, i'm definately learning something new from all this

 

[PM2]

drbeesh,

Options are always good.

Funny you mentioned research because I was just discussing that with my wife. Our program offers an excellent research position for those who qualify and research is definiately needed to show the innovation and importance of podiatrist. I think I would enjoy research but it would have to be active research. I don't think I will be going for a PhD though. I am 36 and need to finish my schooling and residency before I get to old. With that said, I am sure you know that "active" can take on many meanings. To me, active would also include learning and using finite analysis to model the po biomechanics of complex surgical techniques. Granted, it has been a long time since I have used such complicated math, but it would be fun to incorporate it into podiatric medicine.

Have fun and good luck

 

[box29]

drbeesh,

Options are always good.

Funny you mentioned research because I was just discussing that with my wife. Our program offers an excellent research position for those who qualify and research is definiately needed to show the innovation and importance of podiatrist. I think I would enjoy research but it would have to be active research. I don't think I will be going for a PhD though. I am 36 and need to finish my schooling and residency before I get to old. With that said, I am sure you know that "active" can take on many meanings. To me, active would also include learning and using finite analysis to model the po biomechanics of complex surgical techniques. Granted, it has been a long time since I have used such complicated math, but it would be fun to incorporate it into podiatric medicine.

Have fun and good luck

I was a former podiatry student, at Scholl, not too long ago and I still have friends there (PM4). Anyhow, I am glad to see the discussions growing. I do have to add that lower extremity anatomy in med schools is rather quick and hardly as in-depth as the LEA course taught by Dr. Bareither. I am grateful to have had the experience I had at SCPM.

Something that had interested me was that now since I'm in DO school, I have learned several techniques of LE manipulation which was very interesting. I still have much to learn and I was surprised to see other points of view. I was reflecting back on my courses and realized that manipulation of the foot and ankle was not even mentioned as treatment modalities. Has there been any discussion of this whether in or out of class?

Just curious

 

[PM2]

I was a former podiatry student, at Scholl, not too long ago and I still have friends there (PM4). Anyhow, I am glad to see the discussions growing. I do have to add that lower extremity anatomy in med schools is rather quick and hardly as in-depth as the LEA course taught by Dr. Bareither. I am grateful to have had the experience I had at SCPM.

Something that had interested me was that now since I'm in DO school, I have learned several techniques of LE manipulation which was very interesting. I still have much to learn and I was surprised to see other points of view. I was reflecting back on my courses and realized that manipulation of the foot and ankle was not even mentioned as treatment modalities. Has there been any discussion of this whether in or out of class?

Just curious

Hello box29,

I am truly saddened by your decision to jump ship. Have to do what makes you happy though.

I assume you are referring to manipulation of joints and tissue.

No, we have not discussed the topic directly. As you know from Dr. Bareither's class, the two most common nerve entrapments in the foot are the medial calcaneal of the Tibial nerve of the sciatic nerve of the ventral divisions of the ventral rami L4 to S3, and the muscular branch to Abductor digiti minimi of the lateral plantar nerve of the tibial nerve which divides into the medial and lateral plantar nerves directly before the porta pedis. It is believed that the 3rd and 4th metatarsals may pinch the 3rd plantar common digital branch of the medial plantar nerve causing a sharp biting pain also (Morton's Neuroma (Morton didn't discover it though, an Italian anatomist discovered it and the Italians want credit.)

Now, stretching the foot is important for tendo calcaneus legthening and helping with mild plantar fascitis. Manipulation of the joints could be dangerous in some situations like charcot foot which is often missed in medical diagnosis.

If you have any suggestions, please educate me... I thought the above response might remind you of Dr Bareither's lab tests. Scholl students now take Clinical anatomy and other courses with medical students.

Having fun in DO school?

 

[diabeticfootdr]

I was reflecting back on my courses and realized that manipulation of the foot and ankle was not even mentioned as treatment modalities. Just curious

Osteopathic manipulation of the lower extremity (sacrum down) is taught to the DPM students at Des Moines University. --- as an alternative to surgery

LCR

 

[PM2]

Osteopathic manipulation of the lower extremity (sacrum down) is taught to the DPM students at Des Moines University. --- as an alternative to surgery

LCR

diabeticfootdr,

Not so quick We may learn more in years 2-4. Manipulation can mean many things. Orthotics, braces, etc. I believe every podiatrist learns these important concepts.

Although Rosalind Franklin University has a MD program instead of a DO program like Des Moines University, some of our classes, immunology, are taught by professors from the Chicago DO school. They may teach some of our other classes also. Just haven't been there yet. We also have some chiropractors associated with Scholl, but I am not sure what they may teach.

Have a nice day!

Good point though. It is nice that podiatrist are taught different diciplines.

 

[drbeesh]

I was a former podiatry student, at Scholl, not too long ago and I still have friends there (PM4). Anyhow, I am glad to see the discussions growing. I do have to add that lower extremity anatomy in med schools is rather quick and hardly as in-depth as the LEA course taught by Dr. Bareither. I am grateful to have had the experience I had at SCPM.

Something that had interested me was that now since I'm in DO school, I have learned several techniques of LE manipulation which was very interesting. I still have much to learn and I was surprised to see other points of view. I was reflecting back on my courses and realized that manipulation of the foot and ankle was not even mentioned as treatment modalities. Has there been any discussion of this whether in or out of class?

Just curious

Hey box29, I am curious to know if the LE manipulations taught in the DO schools are similar to the ones done by the chiropractors? I've been very previlidged to shadow a DO last year and I was lucky enough to see him do some back and lympthatic manipulations on his patients but I've never thought about the possibility of LE manipulations. Are there any publications about those techniques (LE)? I know there is a push from osteopathic physicians to publish in journals and get actively involved with research which is exactly what ALL medical professions should do, so if you have any publication or reference, please do share because I would be very interested to learn about that.

Thanks in advance.

 

[drbeesh]

drbeesh,

Options are always good.

Funny you mentioned research because I was just discussing that with my wife. Our program offers an excellent research position for those who qualify and research is definiately needed to show the innovation and importance of podiatrist. I think I would enjoy research but it would have to be active research. I don't think I will be going for a PhD though. I am 36 and need to finish my schooling and residency before I get to old. With that said, I am sure you know that "active" can take on many meanings. To me, active would also include learning and using finite analysis to model the po biomechanics of complex surgical techniques. Granted, it has been a long time since I have used such complicated math, but it would be fun to incorporate it into podiatric medicine.

Have fun and good luck

I see what you mean. Gearing towards a PhD is not for everyone but nevertheless it is always good and necessary to be "active" (by your definition) with research and get as much exposure possible especially before you enter your residency. Temple preaches a very strong biomechanics research with their GAIT analysis lab which is very good for their students adn profession as a whole because without research the profession can go extinct...not just podiatric medicine, but other medical diciplines as well...it is only more apparent in podiatry i guess because the profession is very small (only ~14,000 practicing podiatrists in the U.S.)...so as long as the research programs are strong and students get the research exposure at early stages then I think the profession will continue to progress in the positive direction and will continue to contribute to the overall health and well being of members of society.

 

[PM2]

I see what you mean.

drbeesh,

I have heard good things about the Gait lab at Temple. I have also heardgood things about the Temple Podiatry program in general.

I agree that research is important. In my first year at Scholl, I had the opportunity to meet some bright, hard working and gifted people. People who I think will be very beneficial to podiatric medicine. I am sure others have seen similar in their programs as well.

I don't know what my future holds but I will give it 110% and hope to gain acceptance to a good residency program.

 

[drbeesh]

drbeesh,

I have heard good things about the Gait lab at Temple. I have also heardgood things about the Temple Podiatry program in general.

I agree that research is important. In my first year at Scholl, I had the opportunity to meet some bright, hard working and gifted people. People who I think will be very beneficial to podiatric medicine. I am sure others have seen similar in their programs as well.

I don't know what my future holds but I will give it 110% and hope to gain acceptance to a good residency program.

Thats awesome man...I hope you land a good residency....btw speaking of residencies...i know the newer edition of podiatry residencies is the PM&S-36...i've heard a rumor that they will be launching a 4-yr podiatry residency as well...is this true? Or is it just a combined 1-yr of Primary podiatry residency and 3 years of the PM&S-36?

 

[PM2]

i've heard a rumor that they will be launching a 4-yr podiatry residency as well...is this true?

drbeesh,

I don't know, but I don't think so. According to my LE professor, who is a member of the resideny accreditation, there is no current push for a 4 year residency. Rather, they are trying to get the three year in more programs.

I think there are opportunities to do a fellowship after residency. Most programs offer fellowships in management of diabetic feet and limb salvage.

 

[dpmgrad]

There are currently two 4 years podiatric surgical residency programs. Both programs are located in Philadelphia. Both programs are currently listed as PSR-24+ (with 4 years commitment). These programs will be converting to PM&S-36 (with 4 years commitment). The two 4 years programs are Temple University Hospital Podiatric Surgical Residency Program (which currently accepts only TUSPM students) and University of Pennsylvania Medical Center - Presbyterian (which is open to stuents in all schools).

Thats awesome man...I hope you land a good residency....btw speaking of residencies...i know the newer edition of podiatry residencies is the PM&S-36...i've heard a rumor that they will be launching a 4-yr podiatry residency as well...is this true? Or is it just a combined 1-yr of Primary podiatry residency and 3 years of the PM&S-36?

 

[discusdan]

The Utah Jazz have a team podiatrist.

 

[krabmas]

Who pays whom