Your Feet Are Your, Foundation.
They Deserve More.

How can we make an informed decision about orthotics based on a single snapshot in time?

Sometimes the answer is straightforward. There are structural conditions, significant biomechanical deficits and clinical presentations where an orthotic intervention is clearly warranted early in the process.

But many cases are not that simple.

A foot that pronates excessively today does not necessarily represent a foot that must always function that way. What we observe during an initial assessment tells us how someone is functioning now. It does not automatically tell us what they are capable of.

We accept this principle almost everywhere else in the body. If someone is weak, we don’t assume they must remain weak. If range of motion is limited, we investigate whether it can be improved. Strength, mobility, coordination and body composition can all change.

Why should we assume the foot and ankle are different?

Anatomy matters. Structural limitations are real. But the foot and ankle are also remarkably complex and adaptive, with functional demands involving strength, mobility, stability, sensory feedback, motor control and the ability to manage and transfer force through the ground.

And if we’re considering a durable medical device designed to influence foot function for potentially several years, shouldn’t we first make a reasonable effort to distinguish between the factors that are modifiable and those that are not?

The Axis process is designed to distinguish between what we see and what we actually have to work with.

It begins by establishing objective and clinical baselines. Then identifying structural limitations alongside potentially modifiable variables. Where appropriate, an intervention is targeted towards the variables that can change. Then reassess the response and clinical presentation.

Sometimes that process leads to custom foot orthotics. Sometimes an existing pair performs exactly as intended. And sometimes the assessment demonstrates that an orthotic intervention isn’t necessary at all.

The objective is not to arrive at a predetermined intervention. It’s to understand the fundamental factors influencing foot and ankle function, identify what can meaningfully change, and make decisions through biomechanical testing, targeted intervention and sequential reassessment.