The Foot-Spine Connection and MASS Posture Orthotics

Medical research has linked medial longitudinal arch dysfunction throughout the musculoskeletal system including; plantar fasciitis¹, low back pain² and even to involve the cervical spine, resulting in Head Forward Posture³. While pronation is a necessary biomechanical process for the foot to absorb and control the body’s weight as the foot transitions through the midstance phase of the Gait Cycle. It also allows the foot to adapt to variations in terrain. Excessive pronation, lower the height of the medial longitudinal arch initiates a “Jenga Effect” or Pronation Distortion Syndrome forcing the musculoskeletal system to compensate, in turn affecting the biomechanics of the spine⁴.

There is no harder activity on the feet than running. Even the healthiest of feet may break down over time. A middle distance runner had been suffering from chronic bilateral hamstring tendinopathy. The pain prevented her from running and was affecting her daily activities. Her physical examination revealed she was bilaterally hyperpronating affecting her lower extremity biomechanics. She was casted for MASS Posture orthotics and following several months of chiropractic manipulation and physical therapy she returned to jogging. A year later, she finished her first marathon.

ReLEAF is a line of foot support products manufactured by Brilliant Health Solutions, including ReLEAF RX custom orthotics. It uses the principles of the MASS Posture Theory. The MASS acronym is the abbreviation for Maximum Arch Supination Stabilization. Maximum arch height is achieved through the Windlass Effect supinating the medial arch. The medial arch is then stabilized to control the force of the body’s weight being transferred through the medial longitudinal arch transitions through the midstance phase of the Gait Cycle.

The casting protocol for MASS custom orthotics is unique to the industry. Casting is the process of creating a precise impression of the patient’s foot that is used to fabricate the custom orthotic. First, the patient is seated and non-weight bearing to ensure no force compromises the height of the arch. The Windlass Effect is utilized to maximally elevate the arch prior to casting. This is biomechanically significant to properly aligning the talus, ensuring proper alignment of the lower extremity in the sagittal plane. This is necessary to eliminate pelvic rotation, which can contribute to a functional leg length discrepancy. Finally, the foot is maneuvered through the casting foam, replicating the gait cycle.

The manufacturing process for the custom orthotic is also unique. ReLEAF by Brilliant Health Solutions, located in Tennessee, uses advanced 3D imaging technology to digitally transfer the patient’s foot impression to the manufacturing plant. This greatly decreases turnaround time. High-precision CNC mills the block of Virgin HDPE to create an exact replica of your medial arch. Unlike traditional heat-molded processes, which suffer from inconsistent structural weaknesses and unpredictable thickness due to heating and stretching plastic over a mold. ReLEAF custom orthotics are computer guided to be sculpted to within one-tenth of a millimeter. This process also allows for minute adjustments during manufacturing without the need for re-casting. By leveraging this extreme milling precision, we can accurately control and micro-adjust the shell thickness to achieve the exact flexibility and weight-bearing support your patient requires, based on their body weight, forefoot flexibility, and activity level. The result is a highly predictable, personalized, and performance-driven orthotic.

References

1. Cornwall M, McPoil T. Plantar fasciitis: etiology and treatment. J Orthop Sports Phys Ther. 1999 Dec; 29(12):756-60.
2. Kendall, J.C., Bird, A.R. and Azari, M.F., 2014. Foot posture, leg length discrepancy and low back pain–Their relationship and clinical management using foot orthoses–An overview. The foot, 24(2), pp.75-80.
3. Ghasemi MS, Koohpayehzadeh J, Kadkhodaei H, Ehsani AA. The effect of foot hyperpronation on spine alignment in standing position. Medical Journal of the Islamic Republic of Iran. 2016;30:466.
4. Yazdani, F., Razeghi, M., Karimi, M.T., Bani, M.S. and Bahreinizad, H., 2019. Foot hyperpronation alters lumbopelvic muscle function during the stance phase of gait. Gait & posture, 74, pp.102-107.