Ep.36 Liam Russell: Blending Personal Training with Podiatry and Orthoses in Practice

Explore the fusion of personal training with podiatry and the profound impact it has on patient care, as we sit down with Liam Russell, a spirited podiatrist fresh from his inaugural year in the field. Liam's story unfolds, revealing how his unique blend of expertise has shaped his approach to podiatry, from the foundational confidence built through hands-on university experiences to his dedication to patient pacing and maintaining enthusiasm for the profession. As a podiatrist passionate about sports rehabilitation, his insights are invaluable for both novices and veterans of the field, showcasing the need for a personalized touch in patient treatment strategies.

Uncover the subtleties of orthotic therapy as we navigate through the philosophies and realities of clinical orthotic use. Moving past the often rigid academic teachings, this episode illuminates the spectrum of orthotic approaches, emphasizing the concept of assisting rather than dominating foot function. With Liam's expertise, we delve into the journey from educational theories to clinical practice, highlighting the importance of experience in evolving one's understanding of orthotic prescription. As a practitioner who values being hands-on with orthotic modifications and prioritizes continuous learning, Liam's narrative offers a relatable roadmap for those striving to refine their craft in orthotic therapy.

We wrap up with a deep dive into the innovation of materials and their application in orthotic development, particularly for the dynamic needs of runners. Drawing from my own experimentation and Liam's personal training background, we share our collaborative discoveries in this domain. From the flexibility of EVA and Polypro to the precision of 3D printing, this conversation champions the hands-on approach and the art of crafting support that complements the body's natural movement. Listeners will be inspired by our commitment to pushing boundaries and tailoring care, ensuring that their takeaways from this episode will not only inform their practice but also ignite their passion for podiatry.

Transcript

Speaker 1: 0:05

Hi there and welcome back to Simply the Best Podiatry, where we want to pass on simple tips to enhance your best practice. I am Jason Agosta and we are continuing our Voces in Clinical Practice episodes. I recently caught up with Liam Russell, a podiatrist here in Melbourne who has completed just over a year of practicing full-time now in his podiatry roles. Liam briefly discusses his personal training background tying in with podiatry and the significance of his six months of sitting in with a podiatrist during his final year at university. We discuss Liam's fundamental understanding of the use of orthoses, practice management and the blending of his strengthening background with his podiatry.

Speaker 1: 0:53

This is episode 36 and Liam Russell. Well, we have had that chat, though, about the attrition rate in podiatry being so massive within five years, and it's either people not doing something that they're really passionate about and they've worked that out or they've worked out that it's maybe not what they were expecting and it's harder than what they thought it was going to be. And then the last one is most probably being absolutely drilled, and we spoke about this in the episode with Fiona Allen which is worth going back on that was titled Practitioner Management, where you just get absolutely hammered seeing a million patients in a day and after a few years you are a goner.

Speaker 2: 1:36

Yeah, and I think that's why I like that. That's sort of like what it is in Rosanna, but in Fitzroy it's like 45-minute appointments, like you take your time. It was like 20 patients and I was absolutely wrecked.

Speaker 1: 1:49

Yeah, like not very sustainable doing no, well, I can tell you now, after all this time and I've said this a million times on this show you just have to pace yourself. Yeah, and so, even at my stage now, like you know, 35 years ahead of you, you just have to pace yourself because, because that's the only way you can maintain your fascination and your passion, and I can see myself going for so much longer, despite everyone having that expectation of, like you know, when are you going to finish up? It's like what? It doesn't even come into the radar. So you've just completed one year since you graduated at university, correct? Has it been a good year? Tell me about your year.

Speaker 2: 2:28

Yeah, really good, I think I was. So I mean, if we go back when I was in fourth year, I was coming into a clinic every Friday and doing shadowing with a podiatrist. You're great. So I was doing that for six hours on a Friday, probably for six months before I graduated. Good move. I sort of felt even like my first few days I wasn't nervous, like I was pretty confident, going Like I sort of knew what to do. Like my very first biomechanics case was like extensor digitorum longus tendinopathy. But I've seen people I knew what to do. I wasn't like, oh shit, what, what is this? Yeah, yeah, yeah. I think that like grounding that six months probably really helped starting off. Um, so I couldn't recommend that enough absolutely, that's fantastic then worked here, um.

Speaker 2: 3:21

I mean, it's been a bit of a whirlwind year. We tn, we started a clinic in richmond um didn't work out, and then I that's why I had monday, tuesdays free and then spoke to soath and glenn um and ended up in fitzroy I think it was june, so I've been in there for six months too, so sure, and then, as like, I think my real passion lies dealing with like athletes, like you do a lot of sports rehab, a lot of sports medicine, like a lot of that. I think that's probably my passion. Sure, yeah.

Speaker 1: 3:56

And what about your background prior to this? What have you been sort of interested in and fascinated with?

Speaker 2: 4:01

I was a personal trainer for three years. So I finished high school, went straight into uni, um in my first year I studied um what while I was at my first year? A surgery in four in personal training yes, um completed that. And then so throughout my whole um like degree, I was doing like pt and like movement and all that stuff and same thing. I think that really helped, like analysing the body with very, very similar clientele and I'll probably speak about it as well. Like doing muscular assessments, strength testing assessments, all that type of stuff. But it all sort of tied in really nicely into this year. It all sort of it's pretty cool. Like at the time I was like you know, is it worth it? Is it worth it? I get to this year and it's all just tied together really nicely doing all that extra work, all those extra hours, like now, as I said, I feel like I've got a fair few tools. Probably I feel more further ahead than a lot of other people, probably first year out too fantastic.

Speaker 1: 5:00

that's good. Well, we have spoken about this on the show, about mentoring and the importance it, so it sounds like you've taken that on and put yourself in and been really committed to doing it for six months, which is what some of the other people and some of the people you know have done that with me, like Soph and many others, spent ages and ages just coming in and it's a lot of time, so it's a fair commitment.

Speaker 2: 5:22

Yeah, it is. Yeah, but I think, as I said, it was worth it because, like the the first few months I didn't feel out of depth or nervous, or I'm sure I do start would go oh shit like. And then it also meant I could see like I was prescribing orthotics from day dot as well, whereas like a lot of other clinics with their new grad programs, they sort of you start with your generals and you sort of you'll see like a plan of fashion or you see this, whereas for me, because I had all that grounding, it was just like which is good for me, they were just like good luck and if you need help, ask us and we'll troubleshoot along the way. But there's no sort of like babying. But also from my development, I think that's been awesome.

Speaker 1: 6:03

Yeah, fantastic mate, that's really cool, really good. Not for everyone you would have. By the time this gets up, you would have heard the chat I had with Matt Mollica, yep, and what this series is about is sort of talking very openly about the use of orthoses in our. You know from a clinical sense, yep, and I mean obviously you know from a clinical sense, yep, and I mean obviously you're one year out of college versus, like some of us who are a little bit down the track.

Speaker 2: 6:36

I'm really really intrigued and this is why I appreciate you coming on so much as to your thought process and sort of philosophy of the use of orthoses clinically, being one year out of college well, I think that for me, my understanding, I think the fundamental understanding, is that they're they're an external support, we know that, but they, from my understanding, we're mechanically changing the lever arms moment arms of surrounding tissues and muscles within the foot, um, and I find if, if we do this correctly, right, we're reducing force and pressures, um, on certain areas and then we can move or redistribute that further up, further down, sure, what as well?

Speaker 2: 7:20

I think something that stuck with me was thinking of orthotics as a spotter at the gym. I know that may sound silly, yeah, yeah, but when you're doing your last few reps, let's think about like a bench press or something like I'm still doing the work, I'm still physically moving the bar, but the spotter is there to guide me or assist me into a better position. And I think, with a well-prescribed orthoticotic, that's exactly what we wanted to do. We wanted to put us into a better position, but not do all the work for us as well.

Speaker 1: 7:49

so we're still working yeah, fantastic, a great message and great, that's a great ideology of it, because we need to keep the movement happening, don't we?

Speaker 2: 7:58

yeah yeah, that's perfect analogy, the spotter yeah, the spotter, but I think that I think a lot of that. I think from uni what we were sort of taught was we it was a black and white prescription method of an almost. If someone's 70 kilos, you prescribe them this or if, if this person has this, you've got to go down this rigid type shell. But I've actually seen a lot of the times if you do prescribe that really rigid orthoses with too much correction, patients can't tolerate it very well at all. Yeah, I think from this first year, prescribing if like a polyprope device, about 2.5 mil, 2.7 mil, I find that's a sweet spot. Obviously that's not correct, but I've found something that's flexible enough but still gives some support. Yeah, it does work. Work instead of locking that foot into one plane and just hoping for the best.

Speaker 1: 8:51

Well, that's another. You've just reminded me again of another episode we had in the show where John Osborne interviewed Anna Verena Bowing about, you know, the locking of the foot, and she's a biomechanist and she was saying, oh no, the concept of locking the foot is this it doesn't work and it's not right because the foot needs to be mobile. It's actually another one worth going back and listening to for the listeners. Can I just go back to what you just said about, um, the approach to orthosis, or what you learned was very black and white. What do you mean? Like it was like very definite scenarios yeah, so I remember.

Speaker 2: 9:27

I looked, I had it in front of me it was like a um like a word document and it sort of said if someone was 70 kilos, has plainness, we prescribe um like a four and a half mil shell um, with this amount of correction, um, and then it was sort of the same as if someone had a very cavest foot type you get your arch contour and then you give them this amount of correction. And it was sort of you either go that path or you go this path.

Speaker 1: 9:58

Yeah, so I sort of boxed it for you or categorised it for you in very simple terms.

Speaker 2: 10:03

Yeah, and I remember our cohort was just, everyone was like well what do we do? Yeah, yeah. We've all been there, we've all done it, yeah, and even in the literature there's not an awful lot of you know to tell you what to do or much guidance. So it sort of really is up to anecdotal, totally To experience as well, on what we need as prescribers, what we do as practitioners.

Speaker 1: 10:28

So what you're saying is I mean, everyone needs a starting point. So what you taught was a great starting point just to grow from, which is what you have to do in every other aspect as well. Yep, but I'm just listening to you thinking that what you just said is indicative of being just confused, Like when you said the whole group was thinking what do I do with this? Was it just like a level of confusion during and after graduation?

Speaker 2: 10:59

Yeah, and I think and it's not the uni's fault it's just because we don't see that volume of patients to prescribe allosis for.

Speaker 1: 11:06

Yeah, that was my next question.

Speaker 2: 11:09

Yeah, because a lot of the patients that we would see in the internal clinic were more of that general nail or that like older population yeah, the general foot care stuff yeah.

Speaker 2: 11:20

Yeah, you weren't seeing those people coming in with tip post issues, xenopathies, forefoot issues, like we didn't really see that until we went on our private placement and I think it's different now. But we did a two-week block compared to 18 weeks of public placement. Yeah, and if you're unlucky and you just had a private clinic that just did generals, I suppose you didn't really have much exposure as well to orthosis.

Speaker 2: 11:47

Yeah, okay, so you sort of get to the end of the line and you're like well, I haven't prescribed much, haven't seen much, and you've only got that like flow chart almost to go off. Hence why you'd probably say a lot of the cohort was quite confused.

Speaker 1: 12:01

Yeah, well, I mean, we've all spoken about that confusion, but that's okay. You need to start somewhere, you need to grow from it and you know, the most important thing is being a really good listener and also be a person who's teachable. That's the thing. To stay really open to it. And you, you will and I think I can say this fairly is that you will, one year out, grow your own style, your own sort of ideology around the use of devices and your approach to managing certain problems, and that's cool and that's perfectly fine. It doesn't have to be so rigid and sure, there might be things that are really consistent that we all do, but there'll be many things that you'll do your way, your style.

Speaker 1: 12:41

You know which is, I suppose, the great thing about practice practice isn't it? And clinically, you can put your um, you know, your spin on things. So it sounds like you didn't have much exposure of the use or manufacturing of orthoses. Did you have much hands-on? Yeah, we did one year or the last couple of years of uni and even this year. Have you had much hands-on experience of just modifications, recovering, posting, whatever it may be in regards to orthosis?

Speaker 2: 13:13

I think back, if we go back to the uni, we definitely did do that type of stuff like the posting, the recoverings, um, but I think it was in, I think it was in second year. So second or third year we were the COVID cohort, okay, yeah, so we did, but I think it was in third year. So I found I lost that like the art of doing that stuff. Yeah, okay, and seeing you come to fourth year and you're sort of doing a lot of the other stuff. So I didn't really do an awful lot of that at uni. You do that subject and that sort of bit. I think if I go into this year I haven't really done much recoverings. I know when they do come from our lab like I'll do all the grinding, the cutting, like all that type of stuff. But in terms of the actual making of the physical devices or adding additions myself, I mean I do a few like valgus, padding, met domes, that type of stuff, but nothing too crazy.

Speaker 1: 14:14

Yeah, yeah, yeah, okay. Yeah, that's all right, that's fair enough too, but you're getting your hands dirty Right on, yeah, yeah absolutely Like I'll probably grind most orthoses that come in as well.

Speaker 2: 14:25

Yeah, yeah, yeah, I think that's important.

Speaker 1: 14:27

Yeah, look, you know, trust me, if you haven't done that much, you know, through the uni years or whatever, because of whatever reasons, covid and things were just a bit different. It sounds like you've come out and just started doing a little bit of that and you'll just end up doing more and more too. You will I up doing more and more too. You will, I'm sure of it. Yeah, and plus it's. It seems that most podiatrists these days um are very aware, because of the great materials we have around us, that we can modify so much and do it really easily in our rooms yeah, I think this is having the confidence as well.

Speaker 2: 14:59

Yeah, you know, give it a grind or do what you need to do with it, because I know when you get accustomed you're sort of thinking gee, I hope I don't. Yeah, if I grind too much off, they're sending it back and the patient's like it's second. All right, give me a score out of 10.

Speaker 1: 15:15

This is a bit cheeky, but give me a score out of 10 of the level of confidence you have in dealing with orthoses. As far as, okay, number one is prescribing, give me a score out of 10 of your level of confidence, straight up Probably eight or nine.

Speaker 1: 15:29

Okay. And level of confidence, with modifications Six or seven, yeah Okay, unreal. And you sound like you're the sort of guy who's got to. You know you're quite confident within yourself because you've had that practical background of six months of sitting in with someone that you can impart a fair amount of knowledge to the patient. Am I right?

Speaker 2: 15:54

Yeah, spot on. I think that really helped me. I think we chatted just beforehand about this. It's just I saw six months of especially in this clinic as well. There's a lot of orthosis prescription, yeah, so seeing that every Friday like a bulk number of orthotics as well really helped me keep off the ground running. I think that's where that came from. From that Back in my day, I've seen it work really well with a really experienced practitioner. So the good bits from that into my own practice.

Speaker 1: 16:27

Perfect, I mentioned, you know, for all of us. You just have to stay teachable, yep spot on so important, yeah, so the second part of this is um, what are you actually using?

Speaker 2: 16:40

yeah. So for me, I mean it's it comes back to my history taking. So like simple things like activity levels, occupation, chronicity of pain are they athletes, are they really sedentary? And strength deficits as well. So I think I can paint a pretty good picture if I'm going to use an orthotic before I even look or touch a foot.

Speaker 2: 17:04

I think like a classic case, especially in the Fitzroy Clinic there's a lot of hospo workers and I always ask how many steps a day they're doing. A lot of them are doing 15,000, 20,000 steps. I was going to say it'd be 20 or so, wouldn't it? Yeah, heaps of steps and resting or something like that is not a real feasible option for them. So to have something under their foot, to just give them that support through those 20,000 steps if they can reduce it, we'll definitely speak about that as well.

Speaker 2: 17:35

So things like plantar fasciitis, tendinopathies within the foot, a lot of that type of stuff, forefoot issues I'm definitely using that for, but I think a big one too is I will always assess the strength deficits. I find a lot of times it's like if we look approximately up the chain, the hips really weak, the knees really weak, and then you the calf is, or the posterior compartment. In general they're really weak, so I'll prescribe the orthotic, but a lot of the times I'll get exercises as well, and I find that's a really good coupling instead of just giving the one thing to absolutely yeah, is this sort of the um extension of your pt background, though you're sort of implementing that as well.

Speaker 2: 18:16

Obviously I can see it and listening to you can hear it that you're still really passionate about that and passionate, fascinated with it and I think like and you probably see this as well, jason like a lot of people just aren't that strong too like they're like you, you'll get them to do single leg calf raises and they can just just reach four or five as well. So I think that's a that's a big thing for me is just trying to get them just even a little bit stronger, just to get that four or five reps just to 10, because that can make a big difference throughout the day as well yeah, absolutely.

Speaker 1: 18:46

So. What are you actually using, though? So that's your criteria and the things you're overseeing, so what would you actually be, uh, using?

Speaker 2: 18:55

you know, practically if so, I would. It depends as well custom versus non-custom so you use preforms a little bit.

Speaker 2: 19:04

Yeah, so we've got form thotics and there's also in my Rosanna Clinic stridosols. So we definitely have the conversation of pros and cons with the customs versus the prefabs. I do prefer to go down the custom route If that's a fine option with the patient. We always speak about that too. I use EVA or Polypro. Yeah, they're my main things, but I find having and this is just what I've found work supporting the medial, lateral and transverse arch of the foot as well, like almost like a contact point, really works well. Yeah, patients like finding that nice balance with those three areas of the foot sort of what I'll be prescribing, so do you use many preforms.

Speaker 2: 19:55

Yeah, I do In Fitzroy because we use form thotics. I find just having that support for that medial arch for, like your classic pes planus case, medial knee pain, that type of stuff works really well and then you can even add additions on that, and that's what I do a lot of the time too. But I just find if, like it's really chronic, they're in a lot of pain, like if they get an MRI and it comes back and you sort of you know those MRIs where you're reading your G-wiz, there's a lot going on and even their symptoms are quite bad. I find the custom is something I tend to lean more towards as well.

Speaker 1: 20:34

And, using the custom or the prescribed devices, you take plaster or you're scanning. I'm just scanning, scanning, yep.

Speaker 2: 20:42

I know how to do plaster.

Speaker 1: 20:43

And the polypropylene is the sort of material of choice.

Speaker 2: 20:47

Yeah, yeah, yeah, I find that's probably my go-to, and then EVA as well.

Speaker 1: 20:51

I find.

Speaker 2: 20:52

Okay, the full EVA works well. Yeah, sure, I go for more the beige or I can't remember the actual density more for kids. I find that works really nicely. Yeah, sure. Or on that heavier spectrum, the black EVA too. Yeah.

Speaker 1: 21:06

There's a lot to consider, isn't there? I'm just listening to you and I'm thinking, okay, there's all that criteria we consider when we meet someone and work out their history and what they're involved in or whatever it may be. Then we look at their mechanics, then we look at footwear, yeah, our understanding of materials. There's so much that goes into this. I think that's why it probably takes a bit of time to actually grasp it all yeah, spot on.

Speaker 1: 21:31

There's so much. Do you have a level of thought that, oh, is this right or wrong, or I'm a bit confused still, or whatever?

Speaker 2: 21:38

yeah, yeah, I hundred percent. I still like when, even when you're doing the prescription form, you sometimes think, yeah, I don't know if this is you. You know Right or wrong, yeah, but I think that's the beauty of it Like we don't actually know if this is right or wrong, I think it does come down to like results that you've sort of seen with this type of stuff and then sort of trying to tinker as well.

Speaker 1: 21:58

Experience side of it.

Speaker 2: 22:00

Yeah, yeah. I mean, I'm only one year down, so not that experienced, but I've definitely gotten some really good results with like this structure. Yeah, yeah, yeah, that's good.

Speaker 1: 22:09

But like we said, that's where you start from, that's how you grow and you know, you develop your own style and you know approach to it all. I can tell you now I know people who have been out 10, 15 years or so and they're still. They just lament over their prescription. They just lament over their prescription. They sit there and just stew over it and it's so stressful for them. Anyway, that's still interesting to hear.

Speaker 2: 22:31

No, it is. It's fascinating. We've got to do all that in the appointment that they're there. Run for it Exactly Not the easiest thing, is it?

Speaker 1: 22:40

No, it's not easy and there's a lot of confusion from where we start. But also, as I've mentioned on the show a few times, with this, these episodes, is, you know, the point of it was just really to get the podiatrists and people like yourself talking a little bit and sort of open it up, because we can sort of learn a fair bit from each other, and that's the point of the show is obviously, you know simple tips to enhance your, your practice.

Speaker 1: 23:04

so if we can do that great, I mean you know some people will totally disagree with us.

Speaker 1: 23:09

Yeah, and that's fine, and then others will go. Oh yeah, I'm doing the same thing, you know, and that's cool as well. But it's interesting listening to different people I mean, you're probably the one who's, I would say, have fewer or less time of experience that I've spoken to. Predominantly. I would say that overall, people have sort of got a similar sort of approach to things. Yeah, they're sort of in a ballpark, yeah, yeah, and I've said this, there's no right or no wrong. Yeah, and you are developing, you know, your own sort of style on your experiences. Yeah, yeah.

Speaker 2: 23:44

So it's interesting to speak to. Yeah. So it's interesting to speak to yeah With social media as well. Like you've got sort of that barefoot side as well, like orthotics aren't good, and then you've also got the other side where some people prescribe just too much as well. So there's out there, do we meet in the middle, do we go this way, or out there? So that can also make things very confusing too.

Speaker 1: 24:06

Yeah, it's an enormous spectrum, isn't it? It's huge.

Speaker 2: 24:08

It's a massive continuum oh, no, exactly.

Speaker 1: 24:11

but this is the point again of trying to get the podiatrist to speak, because very early on, matt mulligan and I were talking about how we never really, you know, hear the podiatrist talk that much. Yeah, and if this platform is one aspect of doing that, fantastic, and, as I said, there's no right or wrong, but if we can just open it up a little bit, I think it's a huge thing. Yeah.

Speaker 2: 24:35

What's your sort of approach? Are you similar to all of us?

Speaker 1: 24:45

Okay, so my approach is coming from a running background.

Speaker 1: 24:47

While I was at university and after that time, orthoses never sat right with me from a running point of view. They never sat right and I was always thinking about materials and the impact on us as we walked and ran. I was always thinking about muscular control and I was always thinking about impact, yeah. And so I just became fascinated with materials and the impact that materials would have on those three aspects. And, yeah, that just never sat right. And when I was working at Sports Medicine Centre for 12 and a half years at Olympic Park, I was always out the back toying with different products and materials. I was always trying to make my own stuff up, because the rigid materials that we had, or the materials we had for prescribed orthoses back then, was basically just one option. It was like four and a half mil, I think it was, or maybe six, yeah, I can't remember, but the hardest, most rigid you you know polypropylene you can get, and what we do know is that that influenced impact dramatically in runners. Yeah, studies we did on the force platform system, um, and then my thing was always about muscular control. What are we doing? Because I just had this vision of this splint in my shoe and I'd run in them, feel it, and I'd take them out and modify things. I was always mucking around with preformed insoles trying to get that right for people and myself, but the materials were so bad and I'm really really surprised that almost everyone on this show has mentioned that they're still using preforms that we've been using 35 and 40 years ago out of the like cheapest, poorest quality materials and they're still being used to this day. And that really intrigued me because there's so much out there around us now and so many options. Yeah, so my approach has been using preforms just to keep things as simple as possible, but a really big thing was doing preforms or trying to invoke small levels of change so I could learn whether I could help and, more importantly, learn whether the patient would be assisted, what their tolerance was. So, more importantly, how I could help and how the patient would tolerate any change, remembering that when we walk and run, the magnitude and repetition of forces is bloody huge. So again in my mind from a running background, thinking okay, I've got two to three times my body weight every single step I take. I'm taking 1,000 steps per K, running a million Ks in a week and I thought if I just tweak something, the smallest degree, shoe or orthotic, this has to have a profound effect on me. Yeah, and that was my mindset.

Speaker 1: 27:44

So I have been really big with offering small levels of change and then being able to modify either increase or decrease or add additions to get the support right, and it's a process and it's not a one-hit wonder ever. I think it's about eight, seven, it's either seven or eight out of ten people need adjustments or some modification. Oh, yeah, yeah, yeah, so I've sort of been stuck on the preform sort of route a fair bit over this time, decades and decades later. But the one frustrating thing was materials and more recently I sort of developed my own little preform Yep and I waited for the material to be exceptional, that I could change it 20 times up, 20 times down, and I wanted the contour to be perfect. Yeah, all based on if I'm running and I need support, I don't want to feel any pressure, which is bloody hard to create. Support but no pressure, it's like holy shit, how am I going to do this?

Speaker 1: 28:48

Yeah, but I had this vision of a contour that I wanted and I finally, finally have got it done and it's 3D printed, made out of a really good material. It's a super smooth contour and I can modify it as much as I want and it's sort of low to moderate levels of support. Yeah, and that's where I am and I would use that like many, many times through the week. I can't remember. I don't even know the numbers. To tell you the truth, I'm not very good with numbers in my rooms. Yeah, come on, it's hopeless. Yeah, good with numbers in my rooms a lot hopeless.

Speaker 1: 29:21

Yeah, never kept tabs on anything at the front end. Yeah, okay, again, very, very hands-on. And it's interesting, liam, talking to you about this because so many um, younger podiatrists have come in and their comments have been mate, why are you stuffing around with all this stuff? For why are you getting your hands dirty? And god, so much time put into this and like, and it was just like the skills you just learnt over, you know, years of mucking around? Yeah, so I sort of from the running background, that's where it all started, getting my hands dirty and building what I wanted, and I still do that now. But it's really interesting that sort of feedback as to why you're doing this and not just sending it off. Yeah, because you sort of get what you want and get it on the spot as well. Yeah, which?

Speaker 2: 30:02

is huge. I think that's probably the one thing I know. All professions change, I think, with our generations and probably the way we go through uni. I sort of feel like that may change over time, like how much we customise stuff unless we specifically go out our way. But we just don't do enough, I think, at uni yeah, but it's hard, though, isn't it?

Speaker 1: 30:22

because you're just getting a broad base of knowledge or education to springboard from yeah, you sort of get the seeds from uni but you've got to go. You know, flower them yourself almost absolutely, and this is where your pt background and that that you know things like that, say, my running background, your pt background and others will have a different background as well. That's where it feeds into it and you really can, you know, grow a fair bit over time I know, I know glenn from fitzroy.

Speaker 2: 30:48

He always says that he's like everyone sort of complains but he's like it's hard to. He's like we can't get 50 people come in with 50 different conditions and then like that's just not how it works yeah, yeah, yeah, I get that yeah right if it did, but it doesn't yeah, exactly, but I think that's the.

Speaker 1: 31:04

The critical thing you've mentioned today is about that. Six months you spent like one day or half a day with somebody who was willing enough to, you know, take you under their wing and give you that time, and we have spoken about that, I. I think in the early days, as far as professional development is, that you know people need to get out. Well, the students and new grads need to get out and source the people around them and use your resources. Use the people around you and you know that's such a critical thing. So, using the resources of people, but also think about the people you want to go and sit in with, yeah, of course, and the people who are successful or you know have done quite well with what they're doing. You know there's so much to learn from that.

Speaker 2: 31:50

And it doesn't really stop to be honest with you, because the last thing you want is just become rigid in your thinking.

Speaker 1: 31:55

Yeah, it doesn't stop because things keep moving, and that's the fantastic thing about our profession and Allied Health is that things just keep changing consistently.

Speaker 1: 32:03

Yeah, you know the evidence and knowledge out there and then like for us, what we're talking about today is, say, materials, materials have changed so much Some, really, you know, good advances and not so good. But I mean I was using a product from Germany called the Globotech for probably more than a decade. Yeah, and it was fantastic. It was the best thin insert I had and I'd modify it all the time. But materials have moved on from that as well. Yeah, and I was never happy, completely happy with the contour, but I could still be using it. Yeah, but materials have changed and I wanted a different contour, so I did my own little genie.

Speaker 2: 32:44

We've got cork in our clinic for our other form thotic that we use. I find the cork's pretty good, pretty good shock absorbing, and it moulds to the foot over the time as well. It's remarkable how many different products are out there.

Speaker 1: 32:58

I know, yeah, and you've got to work on that, yeah, yeah, work on what's what works and what doesn't, because you know, I think well, my own opinion I think most of the preforms out there are really bad materials, are really poor quality materials, they're not durable, they're bulky for shoe fitting and, more importantly, the actual molding is so set and so definite that it's really hard to change and really hard to get fitted right for so many people. But I really appreciate your time because and I was so keen to speak to you and just get your, you know, brief insight into where you are one year out of college and you've probably expressed a lot that would be relative to so many other people out there as well.

Speaker 2: 33:42

I think because I'm actually listening to the Andrew Wyand lateral ankle instability. Oh, okay, yeah. So when Soph said that I was listening on the way there, she's like, oh, have you heard of this? I was like, yeah, I was listening to it on the way there.

Speaker 1: 33:53

Oh good, yeah, Well, it's good to hear you're into your strengthening and that, because we've done plenty with that, with Matt Dillnott and just the most simple tips. But a huge effect on people, that's true, and you know, if anyone listening to those episodes just starts practising what we were discussing, it's like massive effect on you in a short period of time. But I really appreciate your insight into your background too, because that's a big part of your practice, clearly.

Speaker 2: 34:20

Yeah, yeah, I do.

Speaker 1: 34:22

But you know what we're talking about is just being open and there's no right or wrong. Just be really teachable yourself, but really open and listen and learn from others and what's out there, and that's the point of these episodes anyway. So hopefully we can impart that a little bit. Yeah, mate, I really appreciate your time coming on so generous of you and yeah, stoked to have you on the show and would love to get you on down the track sometime. That'd be awesome. You've got the best haircut and podiatry, from what I can see, so fantastic. You'll be well known for that now.

Speaker 2: 35:00

You've got the best haircut. Yeah, they love it. Thank you so much.

Speaker 1: 35:02

I appreciate it and I'll stay in contact as well. I really do pleasure, mate, much appreciated. See you soon. Thanks for listening to simply the best podiatry. More details of this episode can be found on the show notes, where you can also follow and support this show. These orthoses in clinical practice episodes are sponsored by Genie Orthoses. The webpage is thegenieau G-E-N-I -E. More details can be found at thegenieau and check the show notes. Stay tuned and I'll be back with you soon.