Running in AFO's

[Bugsy74]

Hi. My son has recently started wearing AFO's and he can't run in them to play football. He has the 'traditional' hard plastic style that start behind the calf and go under his foot. Will he be able to run in them in time? He is only 10 and the easier I can make it for him to do everything he wants in the AFO's the better chance I have in keeping him wearing them.

Any other advice or tips about AFO's would also be appreciated as he has been told he will be wearing them until adulthood. I am getting lots of blank looks when I ask the orthotics or physio department whether there are diffent designs of the same product we could look into or whether eventually he could progress into a specially built shoe which keeps the foot in position. I have read about silicone AFO's on the internet but are they suitable for children and only available privately?

Any advice appreciated!

[John1945]

Hello to Bugsy72.......

I am so sorry to hear that your 10 year old son, has been prescribed for an Ankle-Foot-Orthotic, (A.F.O.'s) at such an early stage in his young life:

Have you, or his father already been diagnosed with Cmt Disease, if so what Type have you been diagnosed with, I personally have Type 1A:

Normally, most children do not present/display Cmt's main symtom's until they reach their teenage years, and their body's "natural-growth-spurt":

Yes, in their early years a parent may notice balance/clumsyness/walking/tripping/falls etc:

I personally have worn AFO's since 2004, inside my normal extra-wide shoes, and these AFO's were supplied to me, by an 1st class NHS Orthotist:

The orthotist will individually take a "plaster-cast(s)" of each lower leg, and moulds them to exactly match, and fit their patients individual foot/ankle/profile(s):

These "plaster-cast's", are then sent off to specialist manufacturer, for them to produce, and create a robust 'splint', which is usually made from >rigid-polyurethane-lightweight-AFO", which will have velcro straps to secure the AFO, around the patients lower leg(s):

Whilst they certainly, and currently provide me with support from my, toe's>to>ankle's>calf's>knee's, they also have a downside ?

Yes, whilst they do assist my walking stability, however, over a long period time, your calf's muscles will get "floppy", and may 'waste', due to the AFO, eliminating your calf muscle(s) normal 'day-to-day' usage, and exercise:

These type(s) of AFO's are designed, and formed to provide a "rigid", or "fixed" support around the patients'toes - ankle - calf' surfaces of your lower limbs, and would not be suitable for any sport that require's running !

They will certainly assist with 'stability', and 'foot-drop', plus any weak/wasted lower leg muscle's:

There are literally hundreds of different manufacturers of AFO's, online:

However, it is normally accepted that, ossur.co.uk, Ossur are the global leaders in this field: Also Buchanan Orthotics, based at Ibrox, Glasgow, may be able to assist you further:

Wikipedia have a very interesting "blog" on AFO's:

Please do NOT buy any orthotic device, online, or "off-the-shelf", without seeking a medical professionals advice, and opinion !

Best of luck to you, and your son.....

John.... (Glasgow)

[Bugsy74]

Hi John. Thanks for your reply and sorry if my post was not clear enough. My son already has the AFO's and has been wearing them for 7 weeks. He has CMT, as do I, through my family but I don't know which type as it is currently undiagnosed.

[John1945 in reply to Bugsy74]

Hello again to, Bugsy74.....

It is most important that your son continues to exercise, as much as he possibly can by, regular training, and playing football: It will will be most beneficial for his "muscle-tone", as he progress's into, and through his 'teenage' years:

Many times I have recommended parents, with Cmt children to purchase a trampoline + 'safety-net' for their children, (YES ? I am totally serious), as it will assist their lower limb's muscles, and will also stretch both of their "tight" achilles tendons, which is one of the major causes of Cmt foot deformities:

It will also assist them with any balance difficulties:

However, luckily both of my beloved Grandsons aged 17, and 14 managed football training twice weekly, plus a game on a Sunday:

Their Consultant Neurolologist, and the Consultant Orthopaedic Surgeon, both based at Glasgows Sick Childrens Yorkhill Hospital, were much surprised at their excellent muscle tone, and strength:

However, no matter what efforts you may apply, the onset of Cmts physical disabilities are certain to happen:

Recently my 14 year old Grandson was further diagnosed with "Spinal-Scoliosis", (a curveture of his spinal column), due to weak Cmt muscles not supporting his spinal columns, left hand side: We are all hoping that, as he grows in his teenage years, this further Cmt complication will not cause him problems:

Do Not "Give Up", together with his parents support, you will cope with this, very slow, but very slow but, progressively worsening Neurological disease:

In 1998, after (after 53 years) being finally diagnosed with Cmt Type 1A, my Neurologist explained to me what the future held for me ?

1) Look, you are NOT on a "slippy-slope", downwards, and into a wheelchair !

2) Look on your Cmt Neurological Disability, as if you were "descending a set of stairs":

3) You will step down ever so slowly, then accept, and adjust to, your further reduced mobility ability:

4) Accept, manage, and especially mentally, adjust to your "reduced-mobility" issues:

5) Finally, Tell Cmt ! Get Lost ! So sorry pal, but you "ain't gonna beat me" !

Best of luck....

John....(Glasgow):

[crookiemonster]

HI

Look at Dorset Orthopaedic website (uk based company). If your NHS trust has an orthopaedic choice department who can refer you to a orthotist they may be able to liase with Dorset Orthopaedic.

I have used their SAFO for 10 years and it has allowed me the flexibility to continue in the sports I love despite my drop foot.

Good luck.

[Susanne20]

Hi,

I hope your son is still enjoying playing football! I can relate to your situation although our son is only 5 and won't remember a time without AFOs and was never able to run anyway but he has managed to adapt his gait and can 'fast walk' with them and loves football. They have joints at the ankle so allow upwards movement but prevent downwards movement as required for running. We have tried to explain the benefits of the AFOs to him but have also allowed him once to leave them off when he wanted to wear shin pads properly (i.e. under socks). He decided himself afterwards that he was better off with the AFOs. Perhaps you can find a compromise That you can both agree on? Try to find support from your medical team perhaps to help fund the silicon type ones if they work better. And try to keep the long term target in your minds, it does help to maintain that muscle stretch. Best of luck!

[Bugsy74]

Thanks Susanne - unfortunately the silicone AFO's have too much flexibility and He needs a rigid AFO so no hinges allowed

[bansaleb]

It will be difficult for him to run in AFO's. He wont have the natural heel strike movement runners abide to since the hard plastic will only allow for his feet to midfoot strike comfortably. If he does do heel strike, he will have to learn how to run with midfoot strike. Even then, he will also have to learn how to push off midfoot as well instead of "tip toe" push. This will greatly reduce his speed as the AFO is greatly restricting his ability to have his feet flow natrually through the movement of heel>midfoot>toe of running. Is it impossible? No. Do I encourage him to continue playing football? Absolutely. Until his ankles/calves make it dangerous or nerve wracking. The exercise football consist of will greatly reduce his atrophy in later years ONLY if he keeps a routine workout regime and more importantly, stretches on a daily basis.