Podcast: Dynamic Heel Regulator Genesis & What it is

by Dr Alex Jimenez | Back Pain, Health, Spine Care, Treatments, Video, Wellness

PODCAST: In this podcast, Dr. Alex Jimenez, a chiropractor in El Paso, presents UTEP’s Engineering Program and Dr. Sarkodie’s team, Juan Corona and Valeria Altamirano, to discuss the genesis of the new dynamic Foot Heel Regulator and what it is. Leg length discrepancy is a health issue characterized as a significant difference in the lengths of an individual’s legs which can ultimately cause a variety of other health issues, including low back pain and sciatica, among others. Juan Corona and Valeria Altamirano describe why they started their leg length regulator product and how they’re planning to bring it to the public to help people with this health issue improve the overall quality of their lives. – Podcast Insight

[00:00:02] Today, we’re going to be presenting an amazing young group of individuals where we’re going to be discussing really what’s special in El Paso. We’ve got a lot of talent here in this town. And one of the things that we’re gonna be talking about is the actual professionalism. And the science actually what the college engineering does. Dr. Natalicia is an amazing, dynamic principal who’s left a legacy of engineering in the school of UTEP. And one of the things that we have is we have an amazing desire for our youth to want to stay. Now, I’ve been here for 30 years and I’ve been practicing for quite a bit of a long time. And what I’ve noticed is that when I first came to El Paso in 1991, a lot of the young individuals wanted to leave. It was a very common desire that if you lived out here, you wanted to leave. You wanted to go to Washington State. Washington. Harvard. But you didn’t wanna come back. Today, we have a school that is recognized around the world. And the science department is one of the most amazing departments and well respected. And it’s always in the top 10 with M.I.T. and in schools that are very high in engineering values. So I’ve met a lot of the students out here over the years and specifically engineering students and the amazing minds that they have and how intelligent they are. It doesn’t stop to baffle me. It makes me very proud as an individual, as a parent, as a community individual to present certain talents. And today we’re gonna be presenting a group of individuals that have begun a new process, a new endeavor in their lives, and a new beginning. [00:01:38][96.4]

[00:01:39] This beginning is one that is full of mystery, wonder, and amazing science endeavors. [00:01:45][6.1]

[00:01:46] The program that we’re gonna be discussing focuses on leg length regulations or what they call the leg length regulator. That’s the idea. One, Dr. Sara Cody, Dr. Thomas Sarkoty, who is their teacher, is one of the lead individuals and the one that is spearheading this program. And now I have the privilege of having these two young individuals. I have Juan Corona and Valeria. And tell me how you pronounce your last name. Altamirano. OK, so she’s got a really strong voice, so she will have no problem with introductory. So today I want to do is I want to talk to you guys about these two individuals and specifically about the leg length regulator. This leg length regulator is a new dynamic that is their baby. These guys are master students. That means they’ve gone through a long level education and they are in pre Ph.D. programs, which if they choose to, they can become the future in this new design. So I want to present it to you guys. I’m going to talk first with Mrs. Valeria, and she’s going to go ahead and tell me a little bit about this program as she’s one of the leads. And then the second chair is Juan. I want to be able to go over these things and to discuss what it is that this new product that is being actually genesis or begun here in El Paso is about so Valeria talk to me. Hello, how are you doing? [00:03:13][87.3]

[00:03:14] I’m doing really well. Thank you for having me here. [00:03:16][2.2]

[00:03:17] So you guys have started a new product and it’s this leg length regulator. Tell me a little bit about what it is, because I think El Paso wants to know what we’re doing in the engineering department. What is it? [00:03:26][8.9]

[00:03:26] So the leg length regulator is a new device that we’re trying to develop. And it’s to focus on patients that have leg length discrepancy. And what that is, is when your lower limbs are of unequal size. So a lot of people don’t really know that they have this kind of illness until they notice that they have a lot of back pain. It’s hard for them to stand right. It’s hard for them to walk. And they just experience a lot of uneasiness when they’re doing things. So for a class project, we were assigned to do research and make a device that of our choosing. And Dr. Sarkody had mentioned if we wanted to look into leg length discrepancy. So I went ahead and looked into it and I noticed that a lot of people are affected by it, especially children and elderly patients. So we went ahead and decided, okay, let’s build something for this cause. And that’s how it came to be the leg length regulator. So what it does is we’re trying to use an LVDT, which is a linear variable differential transformer, and it uses that along with a PD controller and programed into an Arduino. And it’ll help regulate the amount of pressure that’s being put on to the foot to help lift it back up to where it’s supposed to be so that the patient doesn’t feel pain. That’s the main goal here, is for that to eliminate pain. And so that children and adults can go on with their everyday lives without having this issue. [00:05:05][98.8]

[00:05:06] This is very much amazing. I want to ask Juan in a second here specifically about the idea and how he’s also perceived the beginning of this idea. But as a practicing physician over the last 30 years, I can assure you that leg length discrepancy is a huge problem. It totally throws and alters body mechanics. And one of the things that I can assure you is that when I evaluate each one of my patients, I actually measure for leg length discrepancy, whether it’s just a qualitative look or even a quantitative approach through x rays or different linear methods by measuring femur, hips and knees, tibias and all the good nuts. But we can figure these things out and we can look at the effects. And I will tell you this, that having an altered foot mechanics really throws off the human locomotion, the ambulation of the foot. So I’d like to know a little bit about Juan. Juan. Tell me. And your last name is Corona. Right. And you’re an El Pasoan. And tell me a little bit about the story behind you and this project. [00:06:11][65.4]

[00:06:13] I have an undergrad in mechanical engineering. So I’ve always been interested in the biomechanics field. I volunteered in some labs before and I approached Dr. Sarkody as part of my job for him to be my thesis advisor for my project. And as Valeria mentioned, we were in one class where we were asked to find what kind of problem and come up with some kind of a solution in a case. In our case, it was this leg length regulator then we would, that was the class. Then we had another class, which was it was more like a workshop. It’s called ICorps. And basically what they do is tell you and teach you how to sell your product and to see if it’s actually needed for a different kind of population. So, what we want to do, as Valeria mentioned, come up with a device that regulates the different lengths in your legs and to help people reduce their pain, their back pain, their knee pain, and all these different biomechanical issues that come with having this discrepancy. [00:07:23][70.6]

[00:07:24] You know, one of the things when you said biomechanical discrepancies, I have to think back to the years when smoking was real bad. It’s been one of the killers of the Americas and people in families through the nineteen hundreds. [00:07:38][14.0]

[00:07:40] One of the things is the surgeon general really fought hard and the system fought hard to put these little emblems on to smoking packages, which was smoking is hazardous for your health. Right. And everyone knew it was common sense but they took years to produce this one sentence. Later on, they went off and they put another sentence in there, says it could be also deleterious to pregnant individuals. Right. So this took a long time. It literally it’s sad to believe that it actually took to the 80s to put that statement on. Now, one of the things that I noticed is, is that the surgeon general has recently, and we’re talking about the last decade, has determined that arthritis is a disorder of biomechanical imbalance. Right. So now we know that biomechanical imbalance is one of the major causes of arthritis. When the body’s out of calibration, the body actually forms a level of imbalance. And the body responds, it’s just like when you work out, everyone who works out with their hands. They eventually get calluses on their hands and fingers. This is a normal process. Well, that’s because the body is under stress. The tissues are stressed. The body responds. Well, guess what happens when the body’s out of mechanics? Well, the bones in a process that is delineated by wolf’s law, which is a process of which accelerated mobilization of the osteoblasts, which are they work together, the osteoclasts and osteoblasts you ultimately form arthritis in the direction where the load is imbalancely placed. This is the way the body protects you. So one of the things is that if your body’s out of whack or your foot is not put in the right position, you will actually cause early degenerative changes not only in your foot, ankle, hip, knee, and pretty much the spine in different areas. Right. One of the things that people don’t know is that when we have, let’s say, a person who’s got arthritis in their back and they got a bad hip. Where do you begin? Which one do you fix first? And the smartest and the most astute surgeons will realize that you’ve got to first fix the hip first, because how can you fix a spine with a base all misaligned. Right. It’s almost like you’re building a house on an even floor. So you’ve got to fix the pelvis in this situation. We’re fixing it from the ground up. Once we fix the issue from the ground up, we can actually place a situation where now the body’s in the proper mechanics and then we can deal with the back problem. It’s very hard to fix, a little back problem with a body that has a base that is offset. [00:10:05][145.4]

[00:10:06] So let me ask you this in terms of this new product because I’m really excited about this product for you guys as I’m a stand buyer in this really mumbo jumbo to me engineering process and all these linears and vectors that they kind of develop in the neato stuff that they do. I want them to tell us a little bit about what was their beginning, how did they do their research? How did you guys do your research? Either of you guys can answer, how did you do the research in terms of beginning the process? [00:10:32][26.2]

[00:10:38] So in order for us to… first Dr. Sarkody, he mentioned about this problem and he said that it was affecting some people, though, in order for us to double-check that we had to carry out some different kind of interviews with people that had. Well, we first interviewed different clinicians and patients that have this condition in order for us to see if it’s actually something that was present among the people here in El Paso. And it is actually pretty common. Very common. Yeah. So we started doing more research and then we started some reading some peer-reviewed articles, you know, to see what our main effects and why… And if I may. [00:11:18][39.9]

[00:11:18] … [00:12:58][0.0]

[00:12:58] Yeah, it has like 500 people in it. And everyone that’s in that group has been affected either by a family member or they personally have been affected by it. And so I messaged the group admin and I said, hey, I’m doing research. Can I join your group? I don’t have any relation to leg length discrepancy, but I’m trying to build a product to help patients that really need it. And she got back to me and she told me, yeah, definitely. Go ahead, like I’ll post it and see if people are interested. And so, yeah, I was able to get in and I got interviews and that’s kind of how I saw that a lot of patients are actually affected by it. And I didn’t know to what extreme until they were telling me their stories that they have to preorder their shoes, they have to send their shoes to a company to get them back. One little girl told me that she only has one pair of shoes because it’s the only one that works. So she’s sad because she can’t really be that little 12-year-old girl that wants to wear every single shoe out there. [00:14:05][66.8]

[00:14:06] Yes. Is that true? Is that true? I have women here watching in the background. Is it true? They all say yes. It’s very true. OK. You know what? Let me ask you particularly because now we’re entering the human component of actually leg length discrepancy. I don’t think anyone’s written the story about the humanity of it, or at least I don’t see them as much. But there is a humanity, a feeling, an empathy to it. What did you sense as you were hearing these stories from these individuals? [00:14:31][25.5]

[00:14:33] I was shocked because I didn’t know how bad it was for a person to go through this, because, I mean, you know, my legs are even. I would hope that they are. And it never occurred to me like, oh, I have to go by a different shoe because I need a wider heel to even out my body. And some patients told me that they are active, but it’s hard because when they want to work out, it causes more pain because of the back problem. And then they have to go to rehab and then they want hip surgeries so that they can fix everything. But then it happens again. And then some patients told me that they don’t have the funds to afford a hip surgery and just to go through all that struggle of trying to find something that’ll make them feel good about themselves and not stand out. But at the same time, make it work. Because that was one issue that I noticed. A lot of people do not like the extra heel insert because it’s so bulky and so big and so noticeable and people will stare and be like, why do you have a different shoe size? Like, it looks weird. So it makes them feel really uncomfortable and they don’t want to go out because of this. And so they just stick with regular shoes because they don’t want to be standing out and have people pointing like, hey, you have a problem and they rather take in the pain than fix it. So that really hurt me a lot. Knowing that there’s not something that can help them improve and be able to live their lives daily without having this in the back of their mind. [00:16:14][101.3]

[00:16:15] One of the things that you mentioned is and I don’t know if you guys are old enough to have. Well, probably not. But, you know, many people started realizing that the word why became the most important word, probably about a good decade ago. You guys were in middle school. The why that you have in order to do this project. What means a lot to me is that your compassion to it, it hurts you. What else did you feel? And I’m going to talk. I’m gonna ask Juan how he felt after he did his research. What did you feel when you did your research about the individuals and their plight to try to feel good? Valeria, go ahead. [00:16:54][38.9]

[00:16:54] Um, well, for me. What made me want to keep on going was asking them questions, like I asked them, what do you want? What is out in the market that you would buy? And they told me what it was. So with the information that they gave me, I started looking into different like redesigning our initial design so that it can fit their criteria so that it can help then and ask them questions about telemedicine. If a component was available, would you prefer that? And would you like to reduce the number of times you visit the doctors and they told me? Yes. And they were just really I was just basically trying to get what they wanted. So I can try to figure out how to put everything that they’re looking for into one design. [00:17:39][44.3]

[00:17:39] That’s amazing. Juan, what was the why that’s driving you in this project? Because you got to do you know, one of the things is, engineering is one thing? Right. Right. And that’s the math. That’s the lines, the physics, all the cool stuff that is, you know, the Oppenheimer stuff. For me, when we get to the humanity of it. How do you feel this project has empowered you? [00:18:01][21.6]

[00:18:23] And of course I’ve had some knee pain or back pain or my foot hurt sometimes after running. Depends on how much you run and everything. How often. And then it’s I think it’s pretty easy for a person to not relate. For example, I think when people say that they just have two legs with differing lengths, you might not think how much it affects them and how much it impacts their life. And really like in a more personal way, like, for example, someone that likes a certain sport. If they walk, how much they cause in order for them to get a different shoe that is able to help them reduce all these pain. So I think all these pretty small issues when it translates to their experience. I think that’s the thing that impacted me the most. Because you might not know how much this condition is actually affecting their life until you ask them and they tell you. You know, many people that have these types of conditions are prevented of doing some activity that they might like. In my case, it would be running. And I don’t know what I would do if I were not able to run, you know, because there’s a difference between not doing something because you don’t want to then not doing something because you can’t. That’s a big, big difference. Yeah. So like that you get taken away that choice. I think that’s something that really impacted me. So that’s why we really want to keep working on this device to improve it and to make it accessible because there are solutions right now, but there might not be as accessible and affordable for different people. [00:19:59][95.3]

[00:19:59] … [00:24:30][78.6]

[00:24:31] And no matter what kind of individual, the human foot was designed to last 100 years at least. OK, so there’s nothing in our lives that lasts 100 years. Nothing. No car, no computer, no house without constant maintenance. [00:24:43][11.8]

[00:24:43] So imagine the majesty of the foot dynamics. This thing was created for all has like a bunch of bones, all with an arc on it. Two trends, late forces. The whole thing is covered in curves so that it dissipates forces and translates energy and dissipates energy in the most amazing way. One of the things that the feet does have is that as you strike the foot, the first hip is called the heel strike. [00:25:08][24.8]

[00:25:08] The heel strike is the moment at which your heel strikes it. At that point, the whole body has to adapt to the opposite. The contralateral, the mechanics, the muscles on the opposite side of the body engage. They know that you have struck the floor. You know this because when you ever missed the heel strike on the stairs, you look like some sort of crazed animal trying to figure out where that foot’s going to land. Right. Your body jumps. So from the heel strike. So as the body goes forward, then it goes to the foot, the stance phase, the stance phases the next phase on the final phase, which is probably the next phase, not the final phase, which is basically the toe-off or the toe land and the toe-off the first metatarsal, which is the big toe. It actually translates to energy, but it was being guided by the heel strike. So all this matters. Okay. Now, based on how the body translates that energy and that foot, we can actually see what actually occurs to the body. Now, guess who’s adjusting to this foot? Heel stands and toe-off stage, the low back is the knees are the cushion mechanism. The meniscus is, the mortise joint in the ankle. These things are all adapting. The beautiful thing of the tibia and the fibula also adapting. So in this magical motion thing. Yeah. You know what? Sadly to say, but we could talk the story when we were young kids, that toe bone connected to the ankle bone, the ankle bone connected to the hip bone all the way to the neck bone, and we sing that song, but it’s very true. So this design is very important to me as an individual to look forward to what it has now. Let’s get into the dynamics and the science of it. Okay, what did you guys do? And by the way. I can only get into it as far as they want to get into it because it’s very unique and it’s very still in the developmental stage. What were the things that you were considering in designing the product? [00:26:51][103.3]

[00:26:56] Yes. So when we were in the design process, I actually drew up some sketches and I sent them out and said, hey, does this look okay? And we all came to an agreement to do kind of like a shoe insert because we saw that the shoe insert was available. And then the addition heel part of the shoes, so we all said like, OK? We want to get rid of the whole oh. It looks weird kind of aspect. So our first initial design was focus on the shoe insert. And then we started looking into different material, like for foam that’ll help do the adjustment. And then I looked into different electrical components because my background is in electrical engineering. So I went ahead. [00:27:45][48.8]

[00:27:45] … [00:32:17][34.2]

[00:32:37] Yes. So I did do research on it about what the program is. And it’s ICorps. And what they do is they help engineers or anyone in the science field to build different technology that could be needed out in the world. And you present what you have to this group and they determine if, kind of like, if you’re worthy or not to have to bring your idea to life because a lot of people, what I’ve learned from the regional ICorps program was that a lot of people think that they have a million-dollar idea. But when they present it and they do research and they do customer discovery, they start to realize that maybe no one really needs it. They just thought it was a cool idea. [00:33:24][46.3]

[00:33:25] Yeah. So there’s stages. And so you said there’s regional and there’s what is there national. OK, there’s regional. National. [00:33:30][5.3]

[00:33:32] Yes. So when we went out and at first I was like, I don’t know, like to be honest, I told myself, I don’t know if there’s an actual need for this kind of thing. So it was cool having to go out and find people that have this type of issue. And I’m glad that I did because now I know a lot of people do have this issue and they don’t realize that they have this issue till they’re about the mid 20s, higher 30s, and it’s kind of too late for them to figure out, like what to do and help adjust their posture and fix it. Compared to kids who are born with it, they have to deal with all this and then go through different appointments to help fix it. And then they can qualify for surgery, which can take time. So when I saw that, I realized that what we’re trying to do and what we’re trying to make, it has an impact and can help all these people so they don’t have to be like, OK. [00:34:31][58.5]

[00:34:31] I have limited options. What can I do? Either hip surgery or get a shoe that’s going to make me stand out. And so this device that we’re trying to develop shows that it can go above and beyond and help a ton of people. [00:34:46][14.5]

[00:34:47] Let me ask you this Juan. Obviously, this is first a great product, but then you’re going to throw your baby out to competition. Right. So tell me how you feel about that and how ready are you and what are the things that you’re gonna be doing to get ready for this competition? [00:35:03][16.4]

[00:35:04] Um, so, yeah, um, basically as Valeria mentioned, the ICorps program they teach us if our idea is actually, if there’s actually a need for people to get it and if people are willing to pay for a device, essentially know if we’re actually able to commercialize it. So in this competition, we have different of course people and people have a different device and we all think there are devices that most needed one but we actually have to prove that people need it and that it’s actually going to help their lives. So I think in the original part, we already, that part is already finished. But we’re looking to go for the nationals. I’m pretty sure it’s going to be tough. I mean, I’m pretty sure that like not everyone gets it gets there, but we are very confident. And how much is the device needed and how much these people would get their life improved if they actually get us through it? [00:36:05][61.4]

[00:36:06] I think we have it in our thoughts. And as you guys develop this, you guys are thinking of like which was your avatar, who really wants the product. I would assure you this, that as a parent if I see my son having an issue, I’m the avatar, I’m the dad because you’re selling the product to me because I’m the one that’s going to identify my little boy. My little girl has an issue. Right. [00:36:30][23.8]

[00:36:30] So I got to tell you, the way you package this stuff in the way you’re explaining it to me excites me to be able to help my son, my daughter in whatever situation is. So that’s very exciting to see. Now, in terms of getting it on with the competition, let’s talk about getting it on with the competition because we’re gonna get it on. Right. So as we do the process, have you guys thought that process out in and how we’re going to present that at the regional? I think first it had to go to regional correct or has it been not we’re not past regionals or we are past regionals. [00:37:03][32.2]

[00:37:21] I have, um, I saw that it was a seven-week program and they told us that the first four days are heavy because you have to go to seminars and it can be from 8:00 in the morning all the way to 6:00 in the afternoon. So you need a lot of time. And then another thing that they told me was if we do want to do this for the regional, we had to contact 25 or conduct 25 interviews. And at the national level, you have to do 100 interviews. So it’s four times greater than what it is at regional. [00:37:59][38.1]

[00:38:16] And then we can also use LinkedIn to go for more of the doctors and people that actually focus and specialize in like leg length discrepancy. But it’s good to know for the customer segment of who’s actually going to be purchasing this because that’s where our money is going to be coming from. Yes. You know, it’s gonna be a lot of work, but we’re committed. And I’ve already looked at my schedule and I’m like, OK, this day is gonna be dedicated just to do this and things like that. And I’ve been pushing things around so that way I have the time to do what is needed and to get it done efficiently and successfully. [00:38:56][39.6]

[00:38:57] You know, full disclosure, I’ve been invited to be part of the mentor program along with Dr. Sarkody in different responsibilities. I look forward to working with these individuals and knowing the entire team to be able to bring the product to whatever it is that it’s supposed to be. It’s already written. But we’ve got to make it happen. Right. So we’ve got to propel this product. So I was brought in by Juan. He found me out. I was you know, I was bouncing around and I think Kenna also bumped in and we kind of crisscrossed and we got e-mails and they told me about this product. I thought it was an awesome idea because I have seen the effects. I can tell you that if I had an option like this, it would be unbelievable or a great choice for individuals that have from scoliosis to back problems to hip problems. Because we live in a world where when I started practicing, there was no such thing as the Internet. Now, as far as whether it is and did indicate that it’s a fast thing, my daughter, she was able to do things, you know, do a whole project by just getting on social media and doing things in minutes. That took me years to do. The people out there are highly educated. And now with the Internet and the resources that they’re out there, this is gonna be a big thing. I do believe. I believe in their vision. I believe in their why. [00:40:18][81.4]

[00:40:20] … [00:45:45][68.6]

[00:45:50] Well, you know, I can see you’re holding your cards to your vest there. Well, I tell you, I’m very impressed with you guys I’m fans of you guys. And I look forward to having you guys back into doing the podcast and discussing different avenues. Now, each one of these we did a lot of general talking. We didn’t get too deep into the subject matter for that. And that is by design. By the way, until we are able to really present this product, we won’t want to give the competition any of the ideas. Because then you guys, you know, you see the leg length regulator 2 and you’re gonna be really upset. Right. So as we do this kind of ideas today, we’re gonna be filling in some of the videos in the background. That’s gonna be just basic and generic. But I look forward to assisting you guys. And in the ability to push you guys out there and make it happen, because we’re gonna get it on right. Guys, we’re gonna get it on. We’re gonna get it. We’re going to take on these I.T. technical individuals and we’re going to bring it home because we have a stronger why. Right. And that’s what I want to make sure that as we encompass these new dynamics, I look forward to seeing my cohort, Dr. Sarkodie, in this process. And we’re gonna be bringing him into the next podcast and discussing, you know, the insights, the genesis in this product, and the reasons why the developmental process from his point of view, what he sees into his design, along with his personal experiences in moving biomechanical dynamic apparatuses that he has had. Because as I understand, Dr. Sarkodie has had a vast amount of experience in body and mechanical dynamics, specifically when we’re dealing with gait dynamics. [00:47:31][101.0]

[00:47:33] So UTEP, you know, has brought in a lot of great order around the world and is attracting great scientists from around the world. And what we need to do is we need to support our teams and our individuals. So. Enough said and we look forward to seeing you guys into the future. So God bless. And again, we had Juan Corona and Valeria Altamirano. [00:47:54][21.8]

[00:47:55] All right. Sounds good. All right. Thank you so much, guys. [00:48:00][5.2]

[00:48:01] Thank you. [00:48:01][0.0]

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