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The ‘4’ dimensions of MASS4D®: prevention, pain-relief, posture and performance are primarily achieved through an improvement of foot movement, foot position and weight distribution. These factors are founded on our Integrated Multi-Axial Theory™.

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The combination of our unique theory application, calibration algorithms, material balance quality and craftsmanship creates a functional foot orthotic, that have multiple beneficial advantages for the patient/user during wear.

With a focus on foot biomechanics and the integrated nature of the human kinetic chain, our Integrated Multi-Axial Posture Theory™ is an important component of our orthotic design and manufacturing process. 

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The beneficial properties of our foot orthotics extend beyond the feet to include the whole musculoskeletal system. Developed by lower limb specialists at MASS4D®, the Integrated Multi-Axial Posture Theory™ is evidence-based.

Biomechanical Integration

The concept of biomechanical integration involves the consideration of the human body in its entire complexity wherein each individual articulation is a part of a well-connected chain with spheres of influence ranging from distal to proximal in relation to the problematic area.


The functional integration of the foot and ankle becomes an area of prime interest in this regard especially when examining the chain reaction it sets forth during the gait cycle.
Anatomical Planes of the Foot

Optimal Biomechanics

An effective foot orthotic needs to provide for constant postural adjustments and readjustments undertaken by the whole body on variable terrains and at variable speeds.




A high-calibre orthotic must enhance balance and posture of the body by performing a supportive function from the plantar surface of the foot proximally to the central nervous system, throughout all types of daily activities.

Our functional multi-axial supportive device, 
specifically caters to numerous biomechanical needs.

Kinetic Chain

MASS4D® orthotics are designed to provide for the functional needs of the feet by ensuring that the joints and muscles are able to work well within their normal range of motion. By regulating improper foot movement, the body remains in a more stable and balanced position.


Whether used on their own or as a part of an active rehabilitation programme, an overall improvement in the movement and balance of the body, can be felt within weeks of using the product.


This is achieved by establishing a foot posture that can help an individual remain as active as possible without the risk of developing common foot problems that can greatly affect their ability to walk.

The Kinetic Chain

Multi-Axial foot movement

The Integrated Multi-Axial Theory™ looks at a foot during mid-stance, with the heel, first and fifth metatarsals all on the ground to see the maximum supination available in closed chain posture.



- adequate supination at heel strike
- a forefoot makes full contact on the ground at mid-stance
- the majority of forefoot load is on the first metatarsal joint at heel lift
- the first metatarsal phalange joint is not limited in dorsiflexion

FRAME OF REFERENCE

Foot posture measurements and assessments using the integrated multi-axial principles allow for the inclusion of the complex arthokinetic movement within the foot.


If we accept that there is an optimal foot posture unique for each individual (however based on the same reference points) then it provides a more accurate frame of reference for treatment and outcome review. 

The Physiology of the Joints
Foot Motion

RESEARCH AND DEVELOPMENT

It is our duty to continue to challenge research and find the theories and methods that will best serve our patients.

Reference List:

  1. Coskun, G., Talu, B., Bek, N., Bayramlar, K. Y. (2016) Effects of Hallux Valgus Deformity on Rearfoot Position, Pain, Function and Quality of Life of Women. Journal of Physical Therapy Science: March 2016, Vol. 28, No. 3, pp. 781-787. DOI: 10.1589/jpts.28.781

  2. Petcu Daniel, Anca Colda (2012) Foot Functioning Paradigms. Proc. Rom. Acad.: January 20, 2012, Series B, Vol. 14, No. 3, pp. 212-217.

  3. Chuter, V. H. (2010) Relationships between Foot Type and Dynamic Rearfoot Frontal Plane Motion. Journal of Foot and Ankle Research: June 2010, Vol. 3, No. 9. DOI: 10.1186/1757-1146-3-9

  4. Keith Rome, Douglas Richie Jr., Anna Lucy Hatton (2010) Can Orthoses And Insoles Have An Impact On Postural Stability? PodiatryToday: October 2010, Vol. 23, Issue 10.

  5. Doug Richie Jr. (2009) How To Treat Hallux Rigidus In Runners. PodiatryToday: April 2009, Vol. 22, Issue 4.

  6. Lundgren P., Nester C., Liu A., Arndt A., Jones R., Stacoff A., Wolf P., Lundberg A. (2007) Invasive in vivo measurement of rear-, mid- and forefoot motion during walking. Gait Posture: 22 October 2007, doi:10.1016/j.gaitpost.2007.10.009

  7. Hodgson, B., Tis, L., et al. The Effect of 2 Different Custom-Molded Corrective Orthotics on Plantar Pressure. J. Sport Rehabil. 15: 33-44, 2006.

  8. Cobb, S., Tis, L., and Johnson J.: The Effect of 6 Weeks of Custom-molded Foot Orthosis Intervention on Postural Stability in Participants with 7 Degrees of Forefoot Varus. Clin. J. Sport. Med. 16:316–322, 2006.

  9. Glaser, E., Bursch D., and Currie S.: Theory, Practice Combine for Custom Orthoses. BioMechanics. 8(9):33-39, 2006.

  10. John Fleming, Shane Smith (2006) Basic Structure and Function of the Ankle and Foot. SCS Continuing Education: 2006.

  11. Hurkmans HL, Bussmann JB, Benda E, et al. Accuracy and repeatability of the Pedar Mobile system in long-term vertical force measurements. Gait Posture. 2006 Jan;23(1):118-25.

  12. Christopher J. Nester, Andrew F. Findlow, Anmin Liu, Erin Ward, Jay Cocheba (2005) Redefining Biomechanics Of The Foot And Ankle. PodiatryToday: October 2005, Vol. 18, No. 10. Retrieved from: http://www.podiatrytoday.com

  13. Christopher J. Nester, Andrew F. Findlow, Peter Bowker, Peter D. Bowden (2003) Transverse Plane Motion at the Ankle Joint. Foot & Ankle International: February 2003, Vol. 24, No. 2, pp. 164-168

  14. Hsiao H, Guan J, Weatherly M. Accuracy and precision of two in-shoe pressure measurement systems. Ergonomics. 2002 Jun 20:45(8):537-55.

  15. Barnett s, Cunningham JL, West S. A comparison of vertical force and temporal parameters produced by an in-shoe pressure measuring system and a force platform. Clinical Biomechanics. 2001(16 ):353-357.

  16. Huson, A.H.: Biomechanics of the tarsal mechanism: a key to the function of the normal human foot. J. Am. Podiatr. Med. Assoc. 90(1).:12-17, 2000.

  17. Landorf, K., Keenan, A.M.: Efficacy of foot orthoses. What does the literature tell us? J. Am. Podiatr. Med. Assoc., 90(3).:149-158, 2000.

  18. Randolph AL, Nelson M, Akkapeddi S et al, Reliability of measurements of pressures applied on the foot during walking by a computerised insole sensor system. Arch Phys Med Rehanil. 2000 May;81(5):573.

  19. Cornwall M.W., McPoil, T.G.: Three-Dimensional Movement of the foot during the stance phase of walking. J. Am. Podiatr. Med. Assoc., 89(2).: 56 – 66, 1999.

  20. Pfeffer, G., et al: Comparison of Custom and Prefabricated Orthoses in the Initial Treatment of Proximal Plantar Fasciitis. Foot & Ankle Int. 20(4):214-221, 1999.

  21. Payne, C.B.: The Past, Present, and Future of Podiatric Biomechanics. J. Am. Podiatr. Med. Assoc., 88(2): 53-63, 1998.

  22. Ahroni JH, Boyko EJ, Forsberg R. Reliability of F-scan in-shoe measurements of plantar pressure. Foot Ankle Int. 1998 Oct;19(10):668-73.

  23. Quesada P, Rash G, Jaroe N. Assessment of pedar and F-Scan revisited. Clin Biomech . 1997 Apr;12(3):S15.

  24. Valmassy RL. Clinical Biomechanics of the Lower Extremity. St. Louis: Mosby; 1996.

  25. Kernozek TW, LaMott EE, Dancisak MJ. Reliability of an in-shoe pressure measurement system during treadmill walking. Foot Ankle Int. 1996 Apr;17(4):20409.

  26. Mueller MJ, Strube MJ. Generalizability of in-shoe peak pressure measures using the F-scan system. Clinical Biomechanics. 1996 11 (3) :159-164.

  27. Michaud TC. Foot Orthoses and Other Forms of Conservative Foot Care. Baltimore: Williams & Wilkins; 1993.

  28. Rothbart BA, Estabrook L. Excessive pronation: a major biomechanical determinant in the development of chondromalacia and pelvic lists. J Manipulative Physiol Ther 1988 October;11(5):373-9.

  29. Van Langelaan EJ (1983) A kinematical analysis of the tarsal joints. An X-ray photogrammetric study. Acta. Orthop. Scand. 1983. 54: Suppl.204.

  30. Botte RR. An interpretation of the pronation syndrome and foot types of patients with low back pain. J Am Podiatry Assoc 1981 May;71(5):243-53.Friberg O. Clinical symptoms and biomechanics of lumbar spine and hip joint in leg length inequality. Spine 1983 September;8(6):643-5.

  31. Subotnick S. Case History of unilateral short leg with athletic overuse injury. J Am Podiatry Assoc 1980;5:255-6.

  32. Root, M.L., Orien, W.P., Weed J.H.: Normal and Abnormal Function of the Foot, Clinical Biomechanics Corp, Los Angeles, 1977.

  33. Hoppenfeld S. Physical Examination of the Spine and Extremities. Norwalk, CT: Appleton Century Crofts; 1976.

  34. Angeli, C. A. Biomechanical Design of Functional Foot Orthotics: An Innovative Technique Used As An Injury Prevention Tool. Retrieved from: http://www.bioingenieria.edu.ar/grupos/geic/biblioteca/Trabypres/T03TCEu01.pdf

  35. Arne Lundberg (1989) Kinematics of the ankle and foot: In vivo roentgen stereophotogrammetry, Acta Orthopaedica Scandinavica, 60:sup233, 1-26, doi:10.3109/17453678909154185

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