I’ve just cleared out my book shelves. It’s the end of an era for me. I’ve just been awarded my PhD, and as a result, it’s time to move on and clear out all those papers and books I’ve been holding onto.
On one shelf I found BSS conference attendee handout folders, the oldest going back to 2000. That year we enjoyed the presentations and company of Drs Dananberg, Kirby, Olson and Phillips. A “golden era” of BSS. New theories were being proposed on foot function, and the big names attached to these theories were being flown from the USA to the UK. Needing no real excuse to stop house-work, I read through the papers included in the handouts. Many were covered with my handwritten enthusiastic notes. I loved this stuff. I wrote papers on it, unifying the theories into a more clinically friendly approach. But reading them again, I feel less comfortable. There’s no sturdy best practice approach here. No evidence base. Have I changed, or has the profession…or both?
At BSS 2021 I had the pleasure to chair and participate in a round table debate upon charismatic authority with Dr. Simon Spooner, Prof Cathy Bowen, Dr Stewart Miller and Lawrence Bevan. We argued, with support and interaction from the audience, that charismatic authority has dominated the field of MSK practice within podiatry for years. Podiatrists were following and using theories of foot function because of the assertion of specialist knowledge and practice being instilled within the theory leader’s authority (charismatic authority) (Bacon and Borthwick, 2013), rather than a firm evidence base.
Was this type of practice wrong? Probably not in 2000, when there was no real evidence base available and some of the theories were relatively new. But things have changed. Sacket (1996) describes evidence-based practice (EBP) as the integration of individual clinical expertise with the best available external clinical evidence from systematic research. And it is this method of practice we should all be striving for.
BSS is adapting and reinventing itself, building on the reputation and knowledge shared by those founding and groundbreaking lecturers and weekends at Heythrop house in Oxford. It is embracing the new EBP generation and phase of MSK podiatry. A new golden era. To become the conference of research, evidence and clinical application for Podiatric Biomechanics, putting proposed theories and methods under the scrutiny of research and the establishment of evidence base. To openly discuss and recognize evidence gaps and how we work clinically where they exist.
The new BSS in 2023 will include:
- A range of keynote clinical and academic speakers
- An open invitation session for clinicians and academics to present research, clinical practice approaches and theories with keynote panel and audience discussion.
- Improved workshops with more practical hands-on learning of techniques and approaches
- Poster Presentations to help disseminate research and ideas
- A Gala Dinner (Black Tie) with casino entertainment
The topic of BSS 2023 is the arthritic foot and ankle, an area where great EBP strides have been made but more is required. I have the privilege of chairing BSS 2023, and I really hope I see you there.
Dr Paul Harradine PhD MSc FRCPodM FFPM RCPS(Glasg) CertEd