Medicine: Gait Laboratory

The University of Rochester last week announced that its gait analyst. Orthopedist Russell Plato Schwartz, will build a race track on a farm which he has just bought overlooking the Genesee River. There Dr. Schwartz will walk, trot, single-step, lope and gallop horses on whose backs will be strapped an electric recording device which Dr. Schwartz calls an electrobasograph. This will show by means of wires attached to the hoofs, details of locomotion which the fastest cinema cameras have failed to catch. Eventually Dr. Schwartz “hopes to determine precisely what makes a good race horse.”

The horse track will be the second field extension of a laboratory to study locomotion which Dr. Schwartz has conducted in the University of Rochester Medical School since 1926. His studies of foot problems as old as Xenophon’s forced inarch across Asia Minor are original enough to have earned him a gold medal from the American Academy of Orthopedic Surgeons and a bronze medal from the American Medical Association. And practical enough for a Rochester shoe manufacturer, Armstrong & Co.. to spend $150,000 on: 1) support of Dr. Schwartz’s gait laboratory; 2) maintenance of an extension gait laboratory in its own factory; 3) manufacture of what Dr. Schwartz calls “balance-in-motion” shoes which “compel the wearer to walk naturally.” When properly fitted, “they correct flat feet, obliterate bunions and callouses, alleviate sacroiliac pain, and actually, in certain cases, cure mental derangements by removing strains from the muscles and tendons of locomotion.”

The principle of “balance-in-motion” is relatively simple. By means of electrobasographs Dr. Schwartz determined that in natural walking the big toe propels the body forward, the heel and outer margin of the middle feet merely bear weight. The heel strikes the ground first, stays there 0.4 sec. Then, 0.15 sec. after the beginning of the heel’s impact, the middle foot begins a 0.4-sec. roll upon the ground. Just as the heel lifts clear, the big toe comes down for a 0.2-sec. contact. The instant the toe of one foot is ready to leave the ground, the heel of the other foot comes down to begin a cycle on that side.

Flat feet, according to Dr. Schwartz, are usually due to malalignment of the heel bone with the tibia (larger of the two long bones in the lower leg). Side swing of the heel throws all the muscles and tendons of the foot out of balance. “Since the tendons act as slings for the 26 bones of the foot,” reasons Dr. Schwartz, “those bones then have a tendency to slip out of their anatomical arrangement.”

To rearrange and brace the whole weakened structure he designed a shoe with a high, stiff, snug counter. This keeps the heel directly under the tibia, puts the heel in a straight line with the base and tip of the big toe, warps the instep into a springy arch. Shoes, according to Dr. Schwartz, must have heels to help throw the body forward while walking. Men’s heels should be supported eight eighths of an inch-from the ground, women’s fourteen eighths, says he.

Whether Dr. Schwartz’s “balance-in-motion” shoes are better than the 200 special “doctor” shoes on the market, or whether the University of Rochester sounds more important to shoe buyers than Antioch College which also sponsors a special shoe, last week was too early to tell. Dr. Schwartz’s good friend, William Washburn, general manager of Armstrong & Co. and president of Amherst’s Class of 1911 ever since he graduated, has sold only 250,000 pairs of “balance-in-motion” shoes. His target is an annual market of 412,000,000 pairs (two-thirds women’s), worth $600,000,000.

Dr. Schwartz is a slim, wiry sentimentalist of 43, whose latest exploit was a trip to the Island of Kos in the eastern Mediterranean. There last summer he collected a slice of the plane tree under which, local Italians told him, Hippocrates (460-400 B.C.) taught, and chunks of marble from the hot baths in which Hippocrates’ patients probably bathed. One chunk of that marble now is imbedded in the wall of a corridor of the University of Rochester Medical School.

Dr. Schwartz got into medicine with unusual indirectness. Son of a romantic, bookish Portland, Ind. photographer who doted on the name of Plato, Russell Plato Schwartz became an automobile mechanic after leaving high school. A North Dakota uncle persuaded him to sell shrubs and trees to farmers of the Great Plains. Mooning in country hotels and sod houses, Plato Schwartz decided to become a Dakota schoolteacher, take up a homestead and raise sheep. With this in mind he went to Valparaiso University where he earned his way to a B.S. degree by scrubbing floors and washing windows. Then he decided to become a dentist because he liked their office tools and machines. The old Schwartz family doctor told him that “if you’re going to put in time becoming a dentist, you’re a damn fool not to put in a little more and become a doctor.”

No fool, Plato Schwartz attended the University of Indiana medical school, working in all-night restaurants for his food and pocket money. The week he graduated (1920) he put on overalls, wrapped his only suit in paper, hopped a cattle train for Boston. There he barged in on Harvard’s quick-tempered Brain Surgeon Harvey Gushing who detests impudent young men, announced that he wanted Dr. Cushing’s help in getting an intern appointment under Boston’s able Orthopedist Robert W. Lovett. Dr. Gushing studied the tense applicant, sent him to Dr. Lovett with a note: “I think this young man will make good.”

-Shoemakers measure heel heights by eighths of an inch.