AFOs - A Down To Earth Guide on Ankle Foot Orthoses and Orthopedic Braces - Part 8

How To Apply A Plastic AFO

1.) First apply a sock or long stockinette to the leg. This will absorb perspiration so it does not accumulate inside the brace. It will also help to proactively protect the patient's skin. Skin irritations are not common, but being aware of the possibility is a good idea.

2.) Loosen the closure straps on the side of the AFO to allow for your leg and foot to enter the orthosis.

3.) Slide the ankle foot orthosis into position. It is important to ensure that the heel is well seated in your AFO. You can check this by looking along the sides of the brace, or at the back of the heel aspect.

4.) If putting an AFO on a child, first make sure that any plastic that is located at the top of the foot aspect is spread open for easy access of the foot. Then with this aspect drawn open, you can "scoop" the foot inside the brace. You may also want to bend your child's knee and push the foot backwards and down by gently exerting pressure on the instep or top of knee.

5.) Apply all available tension straps and pull them to make sure the brace is worn in a snug fashion. A mark can be made at the end of the strap to keep the tension levels consistent between each and every application.

6.) Then, once the brace is on, it is slid into a shoe (unless the patient has a metal and leather AFO). A shoe horn can be used on occasion if you find it easy to handle. The shoelaces may need to be loosened so the shoe can be drawn open wide. This will help allow for easy entry of the brace into the shoe. - Sometimes people put the brace into the shoe first and then slide the foot in place afterwards. This may work just fine, just proceed with caution. It may be a little more challenging to apply the brace and the shoe at the same time, but some people like it and think it is the easiest option available.

7.) You do not necessarily need a new shoe or a special shoe when it comes to using your AFO. If necessary, you may need a larger shoe but do not assume this is always the case. However, if you plan to go shoe shopping it is best to bring the brace with you so you can "test drive" the shoes with the brace while you are in the store. Shoes that have wide toe boxes and Velcro closures can be helpful for patients.

Take Home Points For Medical Professionals

It is imperative that you remind the patient of the importance of a shoe when their foot is on the ground, while using a brace. There is not tread underneath an AFO in most cases and the shoe will be extremely important while using the AFO.

*Note: This is health information. Although this is good information, it is best to talk with your providing licensed orthotist regarding medical advice when it comes to braces.

AFOs - A Down To Earth Guide on Ankle Foot Orthoses and Orthopedic Braces - Part 13

The Difference Between Traditional AFOs & CAM Walkers

CAM Walkers are effective orthopedic braces that should not be confused with AFOs. Yes, it is considered to be an orthosis for the ankle and foot, but there are large differences between a CAM walker and a traditional AFO.

What Does "CAM" Stand For?

CAM is an acronym that stands for "controlled ankle motion". These kinds of orthopedic braces are like removable casts for patients, except better. Many times patient's will wean into one after a cast is removed. The benefits here are that a CAM Walker can be removed so the patient can monitor their skin and clean themselves. From here, eventually, a patient can then wean into an AFO when the physician
sees fit.

Why Would A Patient Use A Cast Instead of A Cam Walker?

Interestingly enough, patient's might not go directly into a CAM walker after an ankle or foot fracture. For example, if the physician is concerned that the patient might now wear the orthosis provided, or it will worn incorrectly, then a cast might be applied and left on for these reasons. Not everyone is able to notice whether they have a brace on correctly (due to confusion or not being alert) and this is a major reason why a cast might stay on instead.

What Do These Braces Look Like?

CAM walkers usually have an open toe, are gray or black in color, and will also have tread and a rocker bottom on the plantar surface. (The plantar surface is considered to be the bottom of the foot.) These braces are typically prefabricated. These orthopedic devices also typically come up your leg as high as a traditional AFO (ankle foot orthosis). This means that a CAM walker will come up to the widest part of the calf for most people. As a result of having tread and a rocker bottom, as opposed to a traditional AFO, the patient does not have to put them inside a shoe, in the vast majority of cases. Why? Because of the presence of the rocker bottom and tread, these brace are already like their own shoe in effect.

Closing The Toe On A Cam Walker

If you are a professional in any field, or a student perhaps, then your association with work or school may insist that you have closed toe footwear. Yes, it is probably to protect your toes. You can also probably assume that closed toe footwear is required for insurance reasons as well. CAM "boots" as they are sometimes called (incorrectly) do not usually have a closed toe, so if you need one added to your orthosis, then do not worry. You can go to your local, licensed orthotist and they can help provide this for you.

* This is health information. Brace scenarios can vary slightly, so it is best to get medical advice from your local, licensed orthotist regarding your particular situation.

AFOs - A Down To Earth Guide on Ankle Foot Orthoses and Orthopedic Braces - Part 16

A Note To Medical Professionals Ordering a C.R.O.W.

Sometimes in the medical industry, medical professionals will refer to these orthoses as "CROW Boots", "Diabetic Walkers", "Charcot Boots" etc. These are incorrect terms for this device and in an effort to be more precise, this needs to be understood. You may have a clear picture in mind when you use these terms, but as an ordering individuals you might not be expressing yourself as clearly as you think. If you are an ordering APN (advanced practioner nurse), P.A. (physician's assistant) or physician, you might see why it is redundant to refer to one of these devices as a "C.R.O.W. Boot". This is redundant because what you are really saying is "Charcot Restraint Orthotic Walker Boot". - You can simply refer to them as a C.R.O.W. and you will be correct. You will also be communicating more efficiently with your local, licensed orthotist who will be providing your patient with orthotic treatment. Isn't that what you would want to be doing anyways?

Instructions That Apply To All Orthopedic Braces - Note To Patients

Whenever a patient uses an orthosis (brace) they need to make sure it is on snug. Your local orthotist will show you what this means for you as a patient. Moreover, it is very important to monitor your skin when it comes to braces as well. - No, you will probably not develop a rash or a sore, but it is a good idea to monitor your skin with whatever you place on your body. For example, the first time a young woman wears earrings, she will probably monitor her skin to make sure nothing is going wrong; although they doubt anything bad could really happen. If you, as a patient, have skin sensitivity issues, then it is extremely important to monitor your skin. Why? Because your skin will tell you how you are feeling and any redness needs to be noted and treated accordingly. Contact your providing orthotist with any concerns about skin irritation with respect to bracing. This last section is more of a word to the wise, instead of being something that you need to very worried about.

Note: This is health information. Bracing scenarios can vary slightly and that is why we would like you to talk with your local, licensed orthotist for medical advice on orthoses (braces). This is good information, but it is best to talk with these brace specialists regarding your connection or need for orthopedic bracing.

AFOs - A Down To Earth Guide on Ankle Foot Orthoses and Orthopedic Braces - Part 12

Detailed Information About PRAFOs

Floating The Heel With A PRAFO

PRAFOs are very important for people because they are very soft on the inside. Now you can start to see where the "pressure relief" part of the acronym comes into play. The cushion can help prevent bedsores from happening for patients. Moreover, if a person has a heel sore, a PRAFO can be a good idea as well because there is usually an open spot where the heel is not touching anything. It is basically "floating", if you will. This "floating of the heel" helps to make sure contact pressures are avoided at this area of heel and this can help to facilitate healing as a result.

How PRAFOs Help To Avoid Contractures

Another positive thing about the use of a PRAFO is that they can help to eliminate a contracted foot and ankle. Sometimes, if you have noticed, when you lay down, your toes start to point in a downward direction. Once this happens, you will also notice that your heel is up in comparison. A foot that stays in this position can develop a contracture and this is not ideal for patients. - The PRAFO will help to keep the foot and ankle in a neutral alignment.

What's The Bar For On The Back of Many PRAFOs?

Lastly, a PRAFO will have a bar that rests on the back of the device. This bar can swing either left or right and can serve as a lever that will stop the feet from being "windswept". When you do not want your foot to always be pointing in when you lay down, then this bar can be something that prevents this foot and ankle posture from happening.

As a recap, the three positive things that PRAFOs do for patient are:

1.) Help to Prevent Bed Sores
2.) Help patients to maintain a neutral alignment at the foot and ankle (avoiding plantar flexion contractures.
3.)Help patients to avoid swinging their feet (excessive toe in or toe out, or supination and pronation avoidance).

A Note To Medical Professionals Regarding PRAFOs

Try and check the heel of the patient before assuming that the PRAFO is donned correctly, if and when you apply one. Based off of the information we just talked about, one of the main purposes of a PRAFO is to help avoid ankle contractures. - Just because a PRAFO is on a patient does not mean that it is on correctly. Do the patient a favor and make sure their heel is down and back inside of the brace as much as possible. A plantarflexed foot is easily disguised inside of a PRAFO, if you we as health care professionals do not pay close enough attention. It may be an honest mistake, but it can be a mistake that the patient has to pay for longterm if the heel is not well seated.

Moreover, remember, if you call a PRAFO an AFO, you might turn around and find out your patient has a traditional style AFO (made from plastic, or metal and leather). When you order an AFO from an orthotics company realize that when you say, "AFO", you should clarify to the brace specialist if the patient is walking or not. Just remember that PRAFOs are typically for bed bound patients and AFOs are typically used for patients to help them walk better again. This will help your patients get what they need more efficiently.

* Note: This is health information. When you need to get medical advice regarding bracing then it is best to speak with your local, licensed orthotist. This is good information, but since each brace scenarios can vary, we suggest you talk with a brace specialist for medical advice.

AFOs - A Down To Earth Guide on Ankle Foot Orthoses and Orthopedic Braces - Part 7

How Long Do I Wear The AFO For?

Usually AFOs are to be worn when a person is sitting or standing and/or walking. Typically, people do not wear a traditional AFO while they are in bed, because these brace are typically used for walking. In terms of how long wear the brace, for long term usage, it might be best to talk with your physician about this. Many patient's need to use an ankle foot orthosis indefinitely depending on the state of their diagnosis while others can discard them after a short time.

Take Home Points For Medical Professionals Ordering a Brace

Many times, an orthotist will get a script from a physician that will say "Leg Brace", "Walking boot" or "AFO Brace". Although, this gets the orthotist's mind started in the right direction it is actually still quite a vague request. As the ordering individual, you might know exactly what you want for the patient, but it is best to use the right terms when ordering an orthosis. If you use unrecognized terminology, you are just asking for the orthotist to call you for clarification. Moreover, using the term "AFO brace" is a misnomer as well. The medical term "orthosis" means brace, therefore, when a doctor or APN requests an "AFO Brace" this is actually a redundant statement. As a result, this phrase alone (AFO Brace) may trigger a phone call from your local orthotist. Why? Because you are in effect requesting an "ankle foot brace brace". We mean all of this in a positive sense and hope that it helps you in your future when ordering these braces for your patients.

Other Braces For The Foot & Ankle - Very Important!

The Difference Between Traditional AFOs & PRAFOs - Medical Professionals, Please Read This Carefully

What Are PRAFOs?

There are other braces for the ankle and foot that exist, which are referred to as PRAFOs. Yes, the PRAFO acronym ends in AFO, but traditional AFOs and PRAFOs are very different. The acronym PRAFO stands for "Pressure Relief Ankle Foot Orthosis". PRAFOs are typically used for people that are not walking currently. A traditional AFO is meant for someone that is ambulating. Very big difference! - The patients who use a PRAFO are typically in bed or in a wheel chair. Although many PRAFOs might have tread on the bottom of them, this is meant for a quick transfer from a bed to a wheel chair, or some movement of this nature. PRAFOs are typically not thought of as a brace that patient's walk in.

Note: This information is health based. Remember that each bracing scenario is different, so if you need medical advice regarding braces then speak with your local, licensed orthotist.

AFOs - A Down To Earth Guide on Ankle Foot Orthoses and Orthopedic Braces - Part 14

Why CAM Walkers Work

CAM walkers usually limit motion at the site of a patient's foot and ankle. (This is why there are considered in this series to be an ankle foot orthosis, although not the traditional type.) This limitation of movement happens with a rigid plantar surface (the surface underneath a patient's foot) and with ankle uprights that help to inhibit movement. When unwanted ankle and foot movements are avoided, a patient has a higher degree of likelihood that they will heal properly. Why? - When a fracture at the foot or ankle is not moving and being aggravated then the body has a better chance of healing itself.

How can a fracture or injury such as a sprain or fracture be aggravated?

The answer is simple, with movement. The wrong movement. For example, in a normal gain cycle, you will notice that your ankle and foot need to move dynamically in order to adapt to the floor and allow for a patient's body to move forward in space. Now consider walking the distance of 100 meters. The repetition of movement at the injury site can be a severe problem. You might think to yourself that if a person could just be careful enough they would not need a brace like this CAM walker stated here. The reality is that the patient only needs to forget one time and then the injury can be worse as a result. Do you know anybody that likes going back to "square one" when they are trying to heal? - We think you know the answer to this question.

CAM Walkers & The Use of a Rocker Bottom

You will also see that there is something called a "rocker bottom" located on the bottom of a CAM walker. You may wonder what a rocker bottom can do for a patient when it is part of a brace. Rocker bottoms are used to help induce a more fluid gait pattern, when you take away normal ankle and foot motion. In the case of CAM walkers, you are taking away ankle and foot motion for a good reason. As a result, people will benefit many times from a rocker bottom. on the device so it will smooth out movement.

Note: This is health information. Orthopedic bracing scenarios can vary slightly, so it is best to get medical advice on bracing and orthotics from your local, licensed orthotist (brace specialist). This is good information, but we can not cover ever patient care situation.

Knee Braces - Orthopedic Medical Supplies Near You

Are you looking for a knee brace company near you?

Do you want to pay little to nothing for your knee support?

If so, then this article can help you.

1.) Introduction

Knee braces can help to provide support to the knee, but is is not always easy to figure out where to get the best one for your needs. This free article on knee supports will guide you to quality brace providers in your area. When you visit a medically credentialed provider, this means that you can possibly get a brace for little to no cost to you. This is not a joke and no, this is not an infomercial. This is solid information that can save you a lot of money and get you great support for your knee at the same time.

2.) Knee Support Types

There are 4 main different kinds of knee braces. There is an unloader, functional, post op and rehabilitative type of knee support. Usually, you will hear about people that need a knee brace due to a ligament tear. These are sometimes referred to as ligament knee braces, or ACL knee braces by medical professionals as well. If you have a ligament tear of some kind, then obtaining a high quality orthopedic support, should be something a person considers, to help avoid a worse knee injury. In the end it is your choice, but many quality knee braces exist which can help keep you out of harms way.

3.) Where To Get A Quality Knee Support Near You

When it is time to get a quality knee support, it is important to visit a local, licensed orthotist. Why? These individuals are trained in orthotics and specialize in braces. These individuals can also help you get a knee brace free of charge. No, this is not a joke, it actually happens everyday. If your insurance covers durable medical equipment, then you might be paying little to nothing for your new knee support. - Many times, if your insurance does not cover a brace, it will cover a large portion of the support. This is something that an orthotist can help you with.

Note: This is health information. Not medical advice. When it comes to medical advice on bracing, it is best to work with a local, licensed orthotist near you. The orthotist will work together with your physician to get you the best knee support for your needs, based on your diagnosis.