First AFOs

Because the comment system will only allow one picture per comment, I had to start a new post.

pair (2)
Our little Pooka got her first AFOs on Friday.  They are cute.  They give her great ankle stability.  I am really excited about them, BUT. . . her shoes will NOT STAY ON!!!  She leaves them in her wake.  And she is not supposed to wear the AFOs without shoes.  Grrrr….

heelsWe think the problem stems from the shape of the heel on the right AFO.  The left shoe fits snug and never falls off.  This AFO has a very wide heel, a longer foot and a very distinct 90 degree angle.  The right AFO has a shorter foot, a more narrow heel and the angle is less severe.

After analyzing them and working with them, we’ve decided that the only shoe that has any hope of staying on would be a lace up hightop.  Have you shopped for an infant size 2 laceup hightop recently?  HA Ha ha, I don’t recommend it!!! They don’t really exist in any truly functional way.  Unless you want chiffon laces?

So the dilemma is, go back to our orthotist and show him the difference in heel shape or keep hunting for shoes that probably don’t exist.



  • I would def. take them back in to be adjusted. The orthotist can probably heat and tweak them without remaking the whole thing. Do they both stand up if you put them on a flat surface without shoes?

  • I love the pattern, by the way!

  • Neither of them stand on their own. Is that bad? :-0

  • Short answer: I don’t know. It seems a little concerning to me but I only have bits and pieces of info I’ve gathered. I *think* Dr. Jordan’s makes his braces so that they don’t stand up on flat surfaces but they are not made of rigid plastic and therefore, are meant to move more with the child. That being said, we once had a pair of braces that didn’t stand up and our PT was terribly concerned and sent us back to the orthotist immediately–his solution was to add a wedge (build up) to the bottom of the braces which did make them more bulky (long story but we returned the braces). On a separate occasion, when I asked an orthotist why the wedges were necessary (all of C’s braces have build ups because her feet are not completely unclubbed and can not get into the best position without one), she said that the whole foot needs to be bearing weight so that the proper muscles all the way up the leg are firing. OK, so I didn’t mean to over complicate the issue, but looking at the bottom of the brace, it makes sense why it would slip out of the shoe. And I would be worried that P would not being bearing weight on the whole foot and that they wouldn’t offer enough stability. I would just really question the orthotist about it and make sure that he made them that way intentionally.

  • Our next appointment is on the 5th. I’ll let you know what he says. She has been back in her boots (minus bar) until we get an answer on the AFOs.

    MrsK, did you get your DAFOs on the 22nd?

  • I didn’t. We postponed during to a trip out of town, rescheduling for this coming Monday but that was canceled as well. Braces aren’t in yet. They expect them tomorrow, just not in time for our appointment. Hopefully we will get a call tomorrow saying they are in and we can reschedule.

  • Well… we STILL don’t have them. Crazy. Going to call and check in today.

  • Did you get fitted for them through a PT or an orthotist?

    My orthotist told me that Cascade created the DAFO as a product that could be easily fitted by your PT, then sent off to Cascade and mailed back to your PT. No orthotist needed.

  • Btw, our orthotist said the question of whether braces should stand on their own is, “It depends!” and he went on to give me a bunch of examples that made sense to me.

    As to whether *our* AFOs should stand up or not, he said he was more concerned about strongly supporting her supination than he was about them standing on their own, which is why the inner side of the heels have a more severe angle.

    He watched her crawl around in them, then taught me how to put them on tighter. It helped, but one of them was still coming off sock, shoe, AFO and all. It finally dawned on me that if the sock is coming off too, maybe if I got tighter fitting socks it would help. And it did!!! Now it only falls off once or twice a day instead of every 30 minutes.

  • Orthotist. And they did send away for them. He said normal lead time is about 2 weeks but we had issues because of the holiday. Just hung up with them. They came in last week when the clinic was closed . We go in tomorrow morning.

  • Glad you got some answers. Are they maybe just too big? Have you tried putting her in them without socks just to look at how much extra space is there? B/c maybe he could add foam padding in the problematic side to help it fit tighter.

  • I hope you guys are beginning to get the hang of it!

    We went this morning and got our DAFOs. They are stiff, but still flexible. I can squeeze them in my hands if I use a bit of pressure. The orthotist said they refer to them as “softies” and don’t usually have issues with sores etc. Interesting to note, though I don’t plan to leave them on constantly. She didn’t take any steps, exactly, but it was easy to help her take them – a little tug at the knee and a little twist at the hip – much easier than without them. She thought it was mighty big stuff “walking” like that. She was very impressed with herself! She’s so into standing that I think this may well help her motivation, even if it doesn’t do that much for her from a technical/physical perspective.

    I went in with a pair of Mary Jane styled Tsukihoshi’s . We took the soles out, and our orthotist sewed some extra Velcro to the top strap to make it long enough. They were a size larger than normal and work very well. A bit long in the toe, but her feet are so tiny that even the ones that fit her are a bit long there. Width wise they were perfect and the open design on the top really makes it easy to feed the whole contraption in. So all in all, I’m well pleased on that front.

    I’m attaching a photo with and without the shoe plus the extra Velcro so you can see what we’ve done. I’ll attache another with me flexing them so you can see.

  • Yikes! Sorry that is so blurry. Let me know if you need me to correct it.

    Here is the “squeeze” picture.

  • I would have loved to have seen the look on her face while she was “walking”! How cute!

    So what’s your plan for wear time? Will you put them on just when you are working with her on standing and walking?

    • It was a huge AH-HA! moment. That’s for certain.

      Primarily I mean to have her in them when we are working on standing and walking, but I’ve put her in them some, sort of randomly, just to get us both used to them. I put them on her yesterday when we were getting in the van to go see Dad for lunch just because they were the closest shoes. But, as it turned out, she got a lot of time to stand while we were eating, so it was providential.

      That’s the long way of saying, I’m winging it! 😉

  • P.S. I love the pattern. They look so cute with the shoes too!

    Camilla – I think you are right that they are too big. He said he made them a little big on purpose and could put padding if needed. But for now I’m pretty content with them.

    Oh and I meant to say she pronates, not supinates. Duh!

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