AFO Recommendations

[live2ride]

I was in today to get my cycling brace repaired - rigid carbon fibre with an anterior (rather than posterior) shell and full foot plate designed specifically to fit in my SPD cycling shoes. While it was getting repaired I put the walking brace on and went for spin up the road to get lunch. I'd forgotten how much of a difference the fully rigid brace makes!! But I have 0/5 for all muscles below the knee so need the brace to soak up all the power I can put through from full quads (+ body weight when out of the saddle).

After reading this thread I asked about my walking brace (blue rocker) and whether I'd be better off with a rigid or jointed custom make brace. His opinion was that the blue-rocker probably still gives me the best option. He did suggest I see if I can get hold off a FES machine and see if I could get anything happening on my peroneals - if so them perhaps the 'walkaide' type approach might be OK but I would also have to get an ankle reconstruction if I went down that path to get enough stability (have ripped all the ligaments off at some point in the past). Think I'll just stick to what I have for the time being.

[springville girl]

i have a pair of AFO's that hinge at the ankle with a strong "gummie bear" type of material. They were made by J and K Orthotics in Pomona California.
They made a world of difference for me, my ankles are stabilized and it keeps my foot up. I can send a picture to anyone wanting to see what they look like. I think "Lance" at J and K is on the cutting edge when it comes to orthotics devices. I am broken at the L-2 (Cauda Equina) and now walk with the AFO's and a cane. It's been 5 and a half years since my injury. i started with KAFO"s at 4 months post injury. I had only slight hip flexors. After my knees began to lock out, i could graduate to the AFO"s and a cane. Only after trying for 2 years using nothing to see if my ankles or dorsi/plantar flexion would come back. It didn't. Or not so far anyway, who knows, maybe in 10 years!!!

[springville girl]

i read the link about this particular AFO. It looks great. Will have to see where they have them in the U.S. I liked the idea of not having to have such a big shoe to accomodate my AFO's. Although i am very happy with mine, they do take a much bigger shoe. I am going to do some homework on the SAFO's.

[jody]

springville girl, I have been told that new balance makes shoes just for mafo's. they have some dress shoe styles as well as athletic styles. I have not seen them, but have heard they are great.
I tried to write to Dr scholes for a couple of years suggesting they make shoes for people using mafo and kafo's, but got no reply.
I have injury about like yours, L5S1 cauda equina. I have spasticity that works againts the bracing, and actually put force on the knee straps of the rigid braces to balance. for that reason the softer braces were not going to work for me.

[agnes]

i read the link about this particular AFO. It looks great. Will have to see where they have them in the U.S. I liked the idea of not having to have such a big shoe to accomodate my AFO's. Although i am very happy with mine, they do take a much bigger shoe. I am going to do some homework on the SAFO's.

Yes Springville girl, I really recommend the SAFOs. They look better and can be used with a much greater variety of shoes, but most importantly, the material they are made of is like a very soft rubber (I guess silicone) and therefore it does not cause friction against the skin. Although they look higher in the picture on the website, mine only goes up to my midcalf, yet it clears the foot when walking.

They are really wonderful whenever you need to use them near water. Basically, you can use them without a shoe. It solves the problem of entering places where you are asked to take your shoes off. I love my SAFO, it took me a while to get it, but it was worth it.

[springville girl]

Dang, i just ordered a pair of new shoes (200) that accomodate AFO's. I searched for the booklet before writing this but can't find it, (so i could get the company name for you). They said the shoes are normally for diabetics?? Still, i had to order a men's 11 when i normally wear a women's 10. But.... now that i have this information about the SAFO's, i am going to ask about them when i pick my shoes up from the orthotist.
I actually went in there SPECIFICALLY ASKING if there was a AFO didn't take up so much room. Wonder why he didn't mention the SAFO?? Other than that, i am extremely happy with my current ones, No sores, they are sturdy enough to put a foot into a saddle stirrup and stay rigid enough to hold my ankles in place when i get onto a horse. Looks like i'm going to have to do some homework!!! Thank you for the info. springville girl

[jessie.gray]

The AFO's I have are solid plastic and have a velcro strap just below my knee. These are the only style of leg brace I have used, so I have no experience with the metal ones. They also have padding inside of them, so I don't get sores or irritation from them rubbing on my legs and ankle's.
The only trouble I have with the AFO's is trying to find shoes wide enough for them to fit into. I usually have to resort to buying mens athletic shoes to get my AFO's to fit properly in the shoe. Right now, men's Nike shoes fit perfectly.

Jessie
(spastic paraparesis and L-4 SCI)

[springville girl]

since these are from the UK, i am having trouble find US distributors.
i'm not even sure i will like them over what i have, stability wise, but the thought of not having to have such a large shoe is a nice thought.
The company i just found for shoes that accomodate AFO's is " Dr Comfort".
I ordered them through my orthopedics company, but i went and found the booklet to see if they had a web site. (in case any of you are interested) although mine are still en-route, so can't say what i think of them yet, but at least you could look at them.
www.drcomfortshoes.com

[Baetis]

Since my surgery I've worn custom but heavy, rigid, plastic AFO's that have a white strap right below the knee.

I've been wearing the carbon-fiber Allard "Toe-Off" for over a week now. I love it. So far, I only have one issue with it. I'm sure I'll have more after a couple of months though.

In any event, this new AFO fits right inside a regular pair of shoes. I simply take out the insole of the shoe (if I can't remove it, I'll use a cheap drugstore insert) and put it on the brace's footplate. I put the footplate in the shoe and then slide my foot right into the shoe. Since 1999 I've been splitting pairs or just buying custom ordered dress shoes from Alden or Allen-Edmonds. I required a EEE on my left. I'll be able to wear this with a regularly sized pair of shoes now. I can't tell you how happy that makes me. The only problem is that it is wearing a thin line/hole inside my new dress shoe - it seems as though that could wear through even the outer. I wonder if it would help if I wrapped the shaft of the leg brace in a thin piece of leather chamois. Has anyone else experienced this "wearing through" of shoe leather?

Does anyone have experience with these carbon fiber braces snapping? That damn popping noise always comes at the worst time. I want to go hiking but this brace is so thin and lightweight I'm afraid it will break under the pressure.

I'm happy to post photos if anyone thinks it would be helpful.

[live2ride]

I went through two toe-offs (delaminating at the post and breaking) before I went up to a blue-rocker. The large blue-rocker with the footplate cut down to size is great - no problems at all and I've had it almost two years now. I think if you are very active then you might need to upsize to get the required strength. It does cut into the shoes but I have just used strapping tape in the shoe and replaced that every couple of weeks and seems to prevent it cutting right through.