The Morgan’s Meat Pie Paradigm or Theory of foot orthotic prescribing was put forward in the lobby of Heythrop Park during the Biomechanics Summer School in 2000 in Oxfordshire, United Kingdom by the UK podiatrist Gary Morgan.
Legend has it that after attending a foot orthotic prescribing lecture by a well-known international foot orthotic laboratory on the way home, Gary Morgan stopped at a pie cart. He noticed that every pie was a meat pie, but you could have different fillers. Meat pie and peas; meat pie and carrots; etc. He then used this as an analogy that pretty much every foot custom orthotic prescription was the same, in that invariably the rearfoot post was 4 degrees, regardless of the deformity or pathomechanical entities that were diagnosed clinically. The basis of the analogy is that every foot orthotic was 4 degrees with different ‘fillers’, such as top covers or metatarsal domes.
Commentary:
- some involved in the foot orthotic manufacturing industry reacted negatively to the idea as it did not paint them in a good light
- other commentary focused on the amusing aspect of the analogy and that it was not far from being accurate
- concerned has been expressed about the similarity in shape between the more common custom foot orthotic designs and prefabricated foot orthotics. This similairty in shapes might explain why there is generally a lack of differences in outcomes in clinical trials between custom made and prefabricated foot orthoses. This analogy brings that into focus.
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