In order to better understand the advantages of using heel stabilisation as a method of correcting foot posture and joint alignment, it is essential to gain a deeper knowledge of the process of orthotic posting first.
Employed with the purpose of managing the pronation and supination of the foot, posting is a process which involves making modifications to the anatomy of the orthotic, by tilting certain aspects of the shell or insole to control motion and joint forces.
The goal is to improve the stability of the medial column by taking into account the plantar angles of the forefoot and heel, the intended level of control and the ranges of motion available.
This could be done either on the positive cast (intrinsic) or on the orthotic shell (extrinsic), which can be combined at the rearfoot and forefoot in different ways, to produce a countless number of orthotic designs.
More suitable for supporting a varus or valgus forefoot deformity, intrinsic posting does not entail the addition of any material to the outside of the shell which results in an orthotic that is less bulky.
Intrinsic forefoot posting incorporates changes to the forefoot of the positive cast, specifically to the distal one-third of the shell. This is done through the addition of plaster to the plantar surface of the metatarsalphalangeal (MTP) joints.
Although such an orthotic can be used with great ease, especially with tight footwear, it does not efficiently control the compensatory pronation commonly associated with foot conditions.
Another method used in this regard is intrinsic rearfoot casting. This involves the removal of plaster from the medial portion of the plantar heel of the positive cast thereby creating a flattened area in the heel cup of the shell.
While the increased supination that follows may correct the hyperpronation for a certain period of time, such a device fails to provide for the optimal positioning of the joints and the foot, which is necessary to facilitate the optimal functioning of the entire musculoskeletal system.
Extrinsic posting requires the addition of wedges to the outer shell of the orthotic device.
In the case of extrinsic rearfoot posting, material is applied to the calcaneal region of the shell to angle it either medially or laterally, and to control movement of the calcaneus during the stance phase of gait.
An extrinsic forefoot post, on the other hand, comprises of wedging the forefoot into its desired position. Such a method helps to effectively distribute ground-reactive forces but may not allow the metatarsal heads to reach the surface and could instead lead to constriction of the metatarsalphalangeal joints.
Studies have proven the superiority of mediolongitudinal-arch-supported orthotics such as the MASS4D® orthotic over forefoot- and rearfoot-posted orthotics**.
MASS4D® does advocate the use of lateral posting to aid in controlling excessive supination and calcaneus invention. It’s important to further emphasise that certain foot positions that are truly rigid in nature are managed with corrective posting techniques.
Heel stabilisation and the full contact 3-point base involving the calcaneus, the first and fifth MTP allow for decreased pressure on the lateral metatarsal heads and increased pressure under the first metatarsal head at toe-off, therefore making it a much more effective device in comparison.
Copyright 2016 MASS4D® All rights reserved.
Rehabilitation of Your Foot and Lower Back Conditions.
Long Lasting Wear
Strong Foot Support
Easy to use
Handmade MASS4D® Quality
Sign up for free recommended foot exercises, stretching, medical news and everything good for your feet
Please have a a look at our medical reviews and clinical articles on everything about lower biomechanics.
You should always seek the advice of a physician or other qualified healthcare provider with any questions regarding personal health or medical conditions.
The content, products and services offered herein, are here to educate consumers on healthcare and medical issues that may affect their daily lives. Nothing in the content, products or services should be considered, or used as a substitute for, medical advice, diagnosis or treatment. This site and its services do not constitute the practice of any medical, nursing or other professional healthcare advice, diagnosis or treatment.
The marks "MASS4D" and the MASS4D logo are trademarks. The content and design of MASS4D.com is protected by U.S. and international copyright laws. You may not copy, reproduce, republish, upload, post, display, transmit or frame any of these materials without prior written consent from MASS4D®.
The content, products or services on this site should not be considered or used as a substitute for medical advice, diagnosis or treatment and is not intended to provide individual medical advice. Included materials and conversations do not imply a personalised doctor-patient relationship.
Copyright and Intellectual property
MASS4D® is owned and operated by Scheibye General Trading LLC - Licence no: 853463
MASS4D® and Logo are registered trademarks of MASS4D Inc. All content, trademarks, artwork, and associated imagery are trademarks and/or copyright material of MASS4D® Inc.