Shift from Root’s biomechanical model to Rothbart’s neurophysiological model

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Core shift

Root’s model treats the foot as a primarily structural-mechanical system, evaluating static alignment, classifying “deformities,” and inferring dynamic gait compensation from those static findings.

Rothbart’s model shifts the emphasis toward sensory input and postural control, arguing that foot structure affects posture and chronic pain through neurophysiological pathways rather than only through bone-and-joint alignment.

Root model

• The Root paradigm proposes that an ideal foot functions around subtalar neutral, with the forefoot-to-rearfoot relationship ideally perpendicular; deviations are labeled deformities. Clinical treatment under that model aims to realign the foot toward those presumed normal positions, often via orthoses.

Rothbart model

• Rothbart’s framework argues that a structurally abnormal foot can trigger postural distortion through altered afferent input, especially from the plantar surface, which then influences the whole-body postural system.

• Rothbart explicitly distinguishes the “BioMechanical Model” from the “Neurophysiological Model” and presents them as two different explanations for how a twisting foot relates to chronic musculoskeletal pain.

• In that framing, the clinical target is not simply alignment correction, but reducing the abnormal neurophysiological drive that contributes to posture and pain.

Clinical implications

• Under Root, orthoses are used mainly to reposition the foot toward a presumed ideal mechanical state.

• Under Rothbart, orthoses are intended to modify sensory input from the foot and thereby influence posture and pain pathways more globally

This is a major philosophical change because it moves the goal from correcting shape to altering control systems.

Rothbart BA 2026. Shift from Root's biomechanical model to Rothbart's neurophysiological model. IARPT, Conference Paper. June 27, 2026.