There are several flawed assumptions with MASS position. One is the concept that there is a single “optimal foot posture” for everybody. Examine elite runners like Haille Gebrselassie .
http://www.youtube.com/watch?v=EAW87NsiGuI
This functional range is about as far from the MASS position as it is possible to get, yet is equally obviously functioning extremely well. If MASS is optimal, why is this apex athlete functioning so well, so far from it. Would he function better with a MASS orthotic?
Secondly, and more profoundly, the MASS model takes NO consideration of the actual nature of the pathology. Would anyone seriously suggest that the maximally supinated postion is optimal for a foot with a strain in one of the lateral structures? An inversion sprain for example, is an inverted postion (MASS) the optimal postion for treatment of an inversion sprain?
It is worth noting that the two studies quoted for outcomes compared these insoles not to shaped pre fabricated orthoses, but to flat 3mm pieces of poron. Scarcly robust evidence that this position is superior to any other!
One of the comments which caught my eye was this
“So what is the ideal foot posture if it is unrelated to subtalar neutral?”
The answer, for me, is simple. There is NO single ideal foot posture for every individual with any pathology, in every circumstance. Sadly, life is rarely that simple. The concept of an ideal position for the foot is as illogical as the concept of an ideal position of the knee, or the hip. The most favourable position for an orthotic is subject specific, injury dependant and will depend on activity and footwear. The foot defies such attempts to simplify its function, as much as it may be profitable and marketable to do so!.
Click to expand...