09/15/2017
Hello Internet, Brian here!
Today let’s talk about foot drop and prefabricated carbon AFOs. This pathology turns up a lot in stroke victims (cerebrovascular accident is the technical term). Basically the muscles that pull your foot and toes up when you swing your leg forward no longer want to listen to your brain, so you wind up dragging your foot and tripping on a regular basis.
Traditionally this was fixed the way most everything else was fixed. Double metal uprights riveted to a shoe. The classic that’s been around since the ‘40s only recently supplanted by the rise of thermoformable plastics. These aren’t much better. To effectively hold up the foot you have to prevent it from moving past neutral. Instead of your toes pushing downward to propel you forward you have to just lift your leg and plant it forward. This results in moving too quickly to foot-flat and it will eventually cause you knee pain. There are ways around that involving shoe sole changes (Does anyone remember Sketchers ShapeUps?) but now-a-days we’ve got something a little bit springier.
Carbon AFOs are ankle foot orthoses made out of – well – carbon. They are basically a flexible spring that allows your foot to flex naturally when you’re standing on it, and stores that energy you’re pushing into the brace when you bend it. The brace springs back into shape, pushing your foot up and holding your toes through swing. Literal spring in your step.
These aren’t for everyone. Prefabricated braces in general aren’t recommended if you have additional problems besides flail foot drop. Ankle instability or tone mean you’re going to need to do something custom. The techniques used in the prefabricated variety can be used, but you’re going to need more support than what something off the shelf can provide.
There are a few different brands of these. Personally I prefer Ottobock’s WalkOn series. They have the strut connection towards the inside of the arch. I prefer this because most patients collapse to the outside and if you put the strut there you wind up causing a problem with rubbing the outside of the ankle. Oh, if you’re wondering.
So TL;DR – Carbon AFOs are cool because they’re springy and don’t lock your ankle in a limited range. If you think you might need help keeping your toes from tripping you up, ask your local orthotist for a free consult (WT Hinnant for the lovely cities of Charlotte and Columbia – because every post has to have a shameless plug somewhere 😊)
