Have you observed a link between how the foot function and the development of scoliotic curves in children?
Read the thread on the Podiatry forum - Adolescent Ideopathic Scoliosis linked to abnormal Pronation.
https://podiatryarena.com/index.php?threads/adolescent-ideopathic-scliosis-linked-to-abnormal-pronation.112913/
Adolescent Ideopathic Scliosis linked to Abnormal Pronation | Podiatry Arena
We have not specifically observed or attempted to seek a correlation between abnormal foot pronation and AIS. However, there have been multiple studies - including one recently published by us - that have explored the difference in gait patterns in scoliosis patients as compared to healthy controls. As far as a 'pronation drive' is concerned, I believe it is being used in the context of abnormal foot function leading to pelvic instability which 'causes' scoliosis. This is very much a 'chicken or egg' conundrum - and I don't think there is reasonable scientific evidence to establish whether abnormalities in the lower limbs and pelvis cause scoliosis or vice versa, i.e, the asymmetric body weight distribution due to a three-dimensional spinal curvature causing abnormal lower limb, or more specifically, foot function.
Our work on gait analysis in scoliosis was published in a leading Spine journal last year:
Garg B, Gupta M, Mehta N, Malhotra R. Influence of Etiology and Onset of Deformity on Spatiotemporal, Kinematic, Kinetic and Electromyography Gait Variables in Patients with Scoliosis–A Prospective, Comparative Study. Spine. 2020 Nov 5.
Both clinically and in my study I have seen a consistant link between the PreClinical Clubfoot Deformity, the unleveling of the pelvis and increased spinal curvatures.
To me the chicken or egg conundrum was resolved once we understood the link between the PreClinical Clubfoot Deformity causing gravity drive pronation, which unlevels the pelvis, which results in increased spinal curvatures.
Appreciated your observations.
Do these cases eventually develop a 'clinical' foot deformity? Is it certain that we are talking about classical 'idiopathic' scoliosis cases, and not 'neuromuscular' scoliosis seen in specific conditions? We do have a state-of-the-art Gait and Locomotion Lab in our institute. Would be glad to listen to a testable hypothesis on this subject.
The PreClinical Clubfoot Deformity is a congenital foot deformity present at birth (much like the more severe Clubfoot Deformity) (Rothbart, 2002)
This is my hypothesis on AIS:
I believe the PreClinical Clubfoot Deformity is a major biomechanical determinant in the development of AIS. I have seen this link both clinically and in my research over the past 50 years. I encourage you to investigate this foot to spine link and either confirm or refute it.
Rothbart BA, 2002. Medial Column Foot Systems: An Innovative Tool for Improving Posture. Journal of Bodywork and Movement Therapies (6)1:37-46
Rothbart BA 2010. The Primus Metatarsus Supinatus (Rothbarts) Foot and the PreClinical Clubfoot Deformity.Podiatry Review, Vol. 67(1)
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 2006. Relationship of Functional Leg-Length Discrepancy to Abnormal Pronation. Journal American Podiatric Medical Association;96(6):499-507
Rothbart BA 2013. Preliminary Study: Adolescent Idiopathic Scoliosis Linked to Abnormal Foot Pronation. Podiatry Review Vol 72, No 2:8-11.
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