Thursday's Orthotic Discussion of the Week: Root Balanced Technique evaluated in a left Positive Cast

Dr Merton Root in the late 1960's developed many methods to stabilize feet. He developed a way to cast feet to achieve a reliable, reproducible foot. This cast, called a negative cast, was taken using plaster of paris splints and the foot was held in a certain way, and this became the Golden Standard of making orthotic devices. Once the cast was taken, the heel was placed straight 

Positive Casts showing Forefoot Deformities needing different Orthotic Design

Podiatrists will start with a cast of the foot and some examination findings (both static and dynamic) to design complex foot inserts which change function and better patient's lives. It typically starts with an impression cast of the patient's foot. This image shows 3 left feet, all taken with the same cast technique, showing 3 different foot types. The cast on the right is fairly stable and neutral positioned. The middle cast shows a foot that easily rolls to the outside and needs stabilization for supination. This demonstrates forefoot valgus. The left side cast shows a foot that easily rolls inward producing over pronation. This is called forefoot varus, and there are various corrections for this based on degree of deformity.