## Orthotic Research

Thirty years ago, I had to find a way to treat my own chronic plantar fasciitis, achilles tendonitis, retro-calcaneal bursitis, and knee pain. Additionally, I had an active podiatric practice with about 10 orthotic patients per month. It became obvious that an increase in angular correction in the wedged portions of orthotics significantly improved the ability of an orthotic to resolve chronic pain. Research efforts were directed toward defining, measuring, and quantifying the “critical angles” that define the wedged portions of orthotic devices.

Although significant controversy exists even today over the definition of a “functional” orthotic, the basis of my research is that a functional orthotic can change the angle of the support plane we stand and walk on. In fact, they change the angle of the horizontal surface from zero degrees to some orther positive (varus) angle. These angles can be expressed in degrees or trigonometric function and can, for the first time, be studied scientifically.

**The primary hypothesis suggests that these “specific angles” relate directly to the function of any orthotic device, and can be quantified in mathematical terms.**

- The first step was to define the location of the “specific angles” named years ago by researcher Nick Grumbine DPM.
- The next step was to define a consistent method of measurment.
- The third step was to test the hypothesis clinically.

Step 1. Determining where the “specific angles” were located was relatively easy after a review of the patent literature. More than 70 US patents document the critical points of placement for the 2 basic wedges that were described in the patent applications. One wedge was described to contour the plantar foot at the apex of the MLA (Medial Longitudinal Arch). Another wedge was described as being located directly under the weight bearing metatarsal heads These are the locations of the “specific angles” of function where the support surface of orthotics is related to the horizontal plane. These two basic wedges now had to be measured in scientific or mathematical terms.

Step 2. Define how the angle (ABC) is measured. It turns out that this is the part that has blocked hunderds of other researchers from seeing the angle that I now measure with ease. Because the basic contour of the foot in a frontal plane section through the apex of the Medial Longitudinal Arch, forms a hyperbolic curve, the angle measured depends on the section of the curve that is used for the measurement. A B C (P1,P2,P3). The Metatarsal Arch Wedge is easier to visulise and define. Functionally non-compressible mass placed under the first metatarsal is all that is required.

Step 3. Test Theta Clinically. For the first 20 years, I collected clinical data from patients from several podiatric practices, including my own.

- For more than 20 years I documented treatment with orthotics with one wedge in the MLA.
- Clinical and Internet documentation with one wedge under the First Metatarsal for 15 years.
- Over 12 years of clinical and internet testing of orthotics with two quantified wedges.

Ironically, my orthotics research was funded by my surgical practice, for the first 20 years. For the last 12 years, my research has been self-funded by the sale of research products to both new and a growing number of existing research patients. More than 6 thousand internet patients have documented case histories with our research grade Theta-Orthotics.

Digital Theta Orthotics: 14 years ago, I conceptualized a digital system that would replace the partly human model and partly mathematical system of Theta-Orthotics, which I have tested from 1990 to Oct 2011.

Although I still have many patients who have only used our earlier Total-Control system, these treatment products are no longer being fabricated.

This all digital system of quantifying Theta and forming optimal bio-mechanical contours with mathematical formulas is the only custom treatment product that I currently fabricate and test clinically.

Theta-Orthotics current research direction is clear: Document cases with our Digital Thetas, both on the internet and and in the clinic, and continue to help those who now depend on the benefits of Theta.