Forefoot Posting: Structural Balance or Kinetic Intervention?
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Forefoot Posting: Structural Balance or Kinetic Intervention?
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Traditional foot orthosis prescription has long relied on a kinematic model, which measures static foot geometry—such as forefoot varus and valgus—to predict and correct dynamic motion through angular posting. However, contemporary research challenges this paradigm, showing that static structural measurements fail to reliably predict dynamic compensation, and that forefoot posts produce remarkably small angular corrections to foot posture that do not match the prescribed degree values. Furthermore, orthoses can alter kinetics, modifying force distribution and external joint moments even when motion changes are minimal or null. This divergence highlights a potential clinical risk, as medial forefoot posting prescribed to reduce rearfoot pronation inadvertently increases mechanical stress on pathological tissues like the plantar fascia. Consequently, the presenters argue for a paradigm shift from balancing static geometry to directly manipulating tissue loading, ensuring that orthotic interventions are evaluated based on their ability to improve specific mechanical forces rather than trying to alter joint positions and motion.