MEDIPIE Method

Understand function before deciding on treatment

The MEDIPIE Method connects history, examination, loading and movement with an individual clinical decision. Only when there is a clear indication do we move on to design, fabrication, fitting and follow-up.

Since 2003Assess · Integrate · Decide · Treat when indicated.

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Juan Bautista Calero in the MEDIPIE biomechanics room

Starting point

We do not start with an orthosis. We start by understanding how each patient functions.

We begin with the reason for your visit and relate symptoms, mobility, loading, walking or running, footwear, activity and goals. The foot is assessed as part of the whole picture, not as an automatic explanation for everything happening at the knee, hip, pelvis or back.

We do not look for one isolated measure to explain everything. Footprints and technology provide useful information, but decisions come from integrating findings and considering whether there is a relevant and modifiable factor.

Understanding the whole picture helps us decide whether to observe, advise, coordinate or treat.

From assessment to decision

A continuous process, with a decision before treatment

The MEDIPIE Method is not a fixed recipe. Each stage contributes information that helps us understand the problem and decide the next step. Only when we identify a specific clinical objective do we consider treatment; if a foot orthosis is indicated, it is designed, fabricated, fitted and reviewed within the same process.

Clinical room used for a complete biomechanical assessment — 01Understand the problem

Patient during biomechanical movement analysis — 02Examine and observe

Equipment in the MEDIPIE biomechanics room — 03Integrate and decide

MEDIPIE's in-house foot orthosis workshop — 04Design when indicated

Direct fitting of a foot orthosis to the patient's foot — 05Fit directly

Personal care and follow-up at MEDIPIE — 06Review and adjust

We start by listening to what is happening, when it began and when it appears. We review symptoms, progress, activity, footwear, limitations, goals and previous treatment. We do not assume everything comes from foot function: first we need the whole context.
We select the tests that can genuinely add useful information. We may assess mobility, loading, walking, running or the movement linked to the problem. Footprints, video and measurement systems provide data, but do not replace clinical examination or form a diagnosis by themselves.
We relate what the patient tells us to what we observe. We look for relevant, potentially modifiable factors and distinguish them from findings that do not require treatment. Then we decide whether to observe, advise, modify a habit, coordinate with another professional or treat.
When a foot orthosis is indicated, the clinical objective is translated into concrete design decisions. We define shape, geometry, stiffness, resins, support and relief areas according to the foot, activity and footwear. In-house fabrication keeps the process under clinical control.
The orthosis is fitted directly to the foot and checked in the patient's real footwear. We assess contact, stability, comfort and available space and make adjustments before delivery. Personalisation does not end with taking a measurement or making a shape.
Treatment does not end on the day of delivery. We review adaptation, tolerance, functional response and wear. When needed, materials or specific areas can be modified so the orthosis continues to serve the intended objective.

After integrating the findings

The assessment can lead to different decisions

Not every finding needs treatment and not every treatment needs a foot orthosis.

Explain and observe

Understand the problem, monitor how it develops or avoid intervention when there is no reasonable treatment objective.

Adjust or coordinate

Review loading, activity or footwear, or seek input from another professional when the case requires it.

Orthotic treatment

Consider an orthosis or adaptation only when there is an indication and an assessable clinical objective.

Design built around an objective

When we treat, every design decision has a reason

The orthosis is not the starting point. First we understand the problem and define what function we hope to support, unload or modify. Only then do we select the characteristics intended to meet that objective.

Shape, materials, stiffness, support and relief areas are not chosen from a standard recipe. They depend on the objective, footwear, activity and expected tolerance of each patient.

If an orthosis is not indicated, the assessment can still guide other recommendations or referral to another professional when appropriate.

01
Understand what is happening
How the patient functions and which factors may be limiting that function.
02
Define what treatment should achieve
Turn the problem into a specific biomechanical objective.
03
Build from that objective
Design the orthosis, select materials and control its fabrication.
04
Check and evolve
Fit, observe the response and adjust according to real-life use.

When an orthosis is indicated

In-house fabrication and direct fitting to the foot

We do not send the orthosis to an external laboratory. We define the design, work with the materials and carry out the fitting at MEDIPIE so that the fit can be checked on the foot and inside the footwear.

MEDIPIE in-house foot orthosis workshop — In-house fabricationGeometry, resins, stiffness and materials defined around the patient's objective.

Direct fitting technique for a foot orthosis — Direct fittingShaped to the foot without an intermediate mould and checked in the patient's real footwear.

The value of follow-up

Delivery is not the end of treatment

A foot orthosis has to work in real life. That is why we follow its use over time, considering the patient's progress, adaptation, material behaviour and wear.

Treatment can be reviewed, adjusted and continue to evolve after the initial fitting.

01Initial fitting
We check fit, footwear and the planned introduction period.
02Real-life use
Day-to-day experience shows how the treatment is responding.
03Systematic review
We review progress, tolerance, function and wear.
04Adjustments and evolution
Changes are made when the case and response require them.

A method evolving since 2003

More than two decades learning from individual cases

The MEDIPIE Method has developed through clinical experience, training, useful technology, evolving materials and continued follow-up of patients.

The same clinical responsibility connects assessment, design, fabrication, fitting and review. This continuity helps preserve the context of the case and supports coherent decisions throughout the process.

Juan Bautista Calero MárquezPodiatrist, registration no. 115 in the Region of Murcia · Clinical lead at MEDIPIE

Juan Bautista Calero, clinical lead at MEDIPIE

Biomechanical assessment

The first step is understanding what you need

Tell us the reason for your visit, your limitations and any previous treatment. The assessment helps us decide what approach may make sense in your case.

Clinical content reviewed by Juan Bautista Calero Márquez, podiatrist registered no. 115 in the Region of Murcia.

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