Henry’s New Orthotics

We visited our friend Eugene at Hodgsons Orthotics earlier this summer, as Henry had outgrown his last pair of orthotics and needed new ones.  Sometimes I can’t believe how fast his feet grow!  The design is very similar to his last pair, with three straps covering the area from his toes to just above his ankles.   Notice the cool fish pattern this time :).  Henry needs Supramaleolar Orthosis, or SMO’s to help support his feet and ankles.  These are the lowest type of orthotics… meaning they do not reach very high up his leg.

When wearing his orthotics, Henry typically takes a shoe size 1-2 sizes larger than what he would need otherwise.  And they have to be lace up… velcro or slip on just won’t go on over top.  He tends not to mind wearing them, and I think he knows that his feet need them.  In sock feet, his ankles sometimes turn and he falls more often.  Dr Reilly, our orthopedic surgeon, indicated that Henry will likely need some type of support for most of his childhood, especially during rapid growth spurts when his body is growing way too fast for his muscles to keep up.  On that note… we measured him this morning and he had grown over 2 inches in just under 4 months!

Here is a photo of what Henry’s feet look like when not wearing his orthotics:

It’s a little hard to see, but his ankles turn in and he has very flat feet.  His left side is significantly worse, and he will actually drag his foot behind him when not in shoes.

But with the orthotics on, he walks with his feet almost parallel, and with much more control.

We had some challenges this time around, with it taken significantly longer to get the orthotics.  The first set we received were of very poor quality, which didn’t make me happy.  But what I did very much appreciate was Eugene’s candid response that he was unwilling to give us an inferior product.  I didn’t even need to say anything – he beat me to it.  He remeasured Henry’s foot and ordered new ones that same day.

So… we waited longer, but in the end we got a new set of orthotics that will support Henry’s feet perfectly!

Cheers, Shelley

Henry’s orthotics

We visited our friend Eugene at Hodgekins Orthotics again about 1.5 months ago (I know… I’m a little late writing about this one!).   Henry is growing like a weed – like most toddlers – and his feet had gone through two shoe sizes.  Andrea, our previous physio therapist, always said to look for red marks.  If they didn’t look obviously too small, there were no red marks, and Henry’s wasn’t complaining of pain, then they were likely ok.  When we saw our new physio therapist for the first time, she checked his inserts and, since his toes extended past the front of the insert, she recommended going in.

As it turns out, he didn’t really need new ones yet – but since we were there Eugene extended the arch support a little bit, to buy us a bit more time.  For Henry’s type of inserts – SMO’s or Supramaleolar Orthosis – it doesn’t matter too much if the toes extend beyond the tip of the insert, as long it isn’t causing pain or redness.  What does matter is if the arch is extended too far beyond the insert’s arch support.

In Henry’s case, his toes were beyond the edge (thus his physio’s recommendation to go in), but his arch wasn’t too far beyond the insert’s support.  Since we were there, Eugene extended them, but if we hadn’t gone in… it would have been ok too.

Here are a few photos of the arch support.  Unfortunately it’s a bit hard to see, but the support is the “built up” white part (but as the whole sole is white… it’s hard to see the difference).

 

 

 

 

We’ve got another appointment to visit Eugene next month, to start the process of getting fit for new ones.  Since it takes about a month from start to finish, off we go again!

Cheers, Shelley

Henry’s Orthotics

 

 

Henry’s been wearing orthotics inside his shoes since about January.  We knew for a few months prior to that he would likely need them, however were waiting for his walking to improve to see how his feet would respond.  His low tone results in his ankles and feet muscles not being strong enough to support his movement.  He has very flat feet, with his arches being so low that his inner ankle bone almost touches the floor when he walks.  His left foot & leg are weaker than the right, and his foot turns outwards when he walks.  The better he gets at walking, the harder it is for his feet to keep up!

So… after “waiting & seeing” for a while, the decision was made to get him some additional support.  This first set is an “over the counter” pair, known as SMO’s or Supra-Malleolar Orthosis.  Here’s a link for a detailed description of SMO’s: http://www.scheckandsiress.com/orthotic_care/SMO.pdf.

Essentially, as I understand it, these orthotics support the leg just above the ankle, helping to maintain a vertical position and supporting the arches of the foot.

Here’s a few photos of Henry’s orthotics:

They simply fit inside Henry’s shoes.  We put on the plastic inserts first, the slide his shoe on over top.  It is a bit of a pain in the butt, as it’s harder to get his shoes on and trying to push his shoes over the hard plastic destroys the back of the shoes.  We tried a shoehorn, but that only made it harder.

We ripped out the insoles of these shoes to improve the fit.

The upper fabric piece is to cushion the plastic against his legs.  But he developed a red mark almost right away from the plastic rubbing on the outside of his leg, so now we fold his socks down over the orthotic tops to provide extra cushion.

Here’s a photo of the two pieces separated.  We don’t usually take them apart, unless they get wet and need to be dried out.  The white part is slightly more flexible, although it doesn’t have a lot of give.  The blue part is very firm and allows for almost no movement.  These inserts use Velcro tabs to keep them in place.

 

These have worked very well for the past 4 months, and his walking is much better when he’s wearing them.  However as he is getting faster and faster, we’ve noticed that his left leg is again turning outwards and dragging behind.  As a result, we will now be getting a new pair of custom orthotics which will provide even more support. They will look similar to these, but will be custom fit to his feet.  I’ll post more about them once he’s wearing them.

It is likely that Henry will wear orthotics on and off for his entire childhood, and perhaps into adulthood.  As he grows, likely his bones will grow faster than his muscles can keep up.  We always allow time for his to play without his orthotics every day, as his foot and ankle muscles can’t strengthen when provided with so much support.  So it’s a matter of timing… enough time bare foot to give his muscles a workout, but not so much that it does damage or he gets tired and hurts himself.  We’ve noticed already that he falls more when not wearing his orthotics, and I think his ankles seem to turn in on him at times.

He actually quite likely his orthotics, and like lots of other things… they are just a natural part of our day.

Cheers, Shelley