When the boot buckles are closed, the contour of the boot should not twist the foot relative to the tibia/fibula. When buckled, the ankle should be in the middle of its inversion/eversion range. Ideally, the sole of the boot will now be perpendicular to the ‘column of support’; represented as an imaginary line from the load bearing surfaces of the hip joint, to the functional midline of the foot. This relationship may not be the functional ideal in all cases, however, and may be affected by previous damage to the knee joint, tibial breakage, or just plain old ‘misfortune in parentage’.
Static evaluation of cuff alignment can be complicated by differences in leg length, scoliosis, etc.
Dynamic cuff alignment may be approximated, by walking in a straight line and observing the ‘nature’ of sole strike.