Weak Ankles and Need for Braces

It looks like you've gotten some great advice already. In the meantime, you may want to consider some good Stride Rite hightop shoes. The physical therapist was thinking my daughter should be evaluated for braces and suggested the shoes as a "last ditch effort." It seems to have really made a difference!

Hi J..

It would be a good idea to get an orthopedic evaluation. Sometimes orthotics, placed in a shoe can help correct this, but it's sometimes neccessary to get AFO's. Your pediatricain can give you a referral to an orthopedist. Depending where you are, I would recommend a pediatric orthopedist. If you are in the Midland/Odessa area, there are free clinics offered at Midland Children's Rehabilitation Center ###-###-####. They bring in Dr. Weaver, a pediatric orthopedist, from Philidelphia. In either case, I highly recommend the orthopedist eval because your son is at a critical physical developmental age and he'd be better served by the appropriate care. I applaud you for getting early intervention. Sometimes it is hard to accept that our children may be struggling developmentally. I wish you and your child the best (sounds like he's already got the best mom!).
J.

Hi J. -

My oldest DD has had to do a lot of physical therapy, casting, splinting (braces) and even needs custom orthotics in her shoes, all because of toe-walking. It's weakened muscles and shortened her achilles and she needs a lot of "stuff" to correct it all. She's also got some bones in her feet that aren't in the right place, hence the orthotics.

I'm a single mom, so money is way tight for me, but my advice would still be to go the custom-fit, ortho doc route if your insurance will cover it, or cover a good portion of it. My DD is outgrowing both her splints and her orthotics, which means another $5-600 out of pocket, but t me it's worth it to make sure we're correcting the structural stuff that needs to be fixed.

Good luck!

Victoria, fab single mommy to two girlies, 4 years and 20 months

Having the feet 'cave in' to where the insides touch the floor is not uncommon. Both me & my sister have that. I use arch supports although I have nice arches, it helps. Also a good exercise for that is sitting on the floor & using one of those elasic stretch exercise bands (not the ones w/handles, the scarf looking ones) & place it under the ball of the foot, cover the toes & pull back taught on the band & move the foot back & forth while pulling back on the band then repeat w/the other foot. Although he is two, see if he can go up & down on the toes/balls of the feet. That can help too. My sister does nothing to correct hers, she just thinks that's normal I guess but I have weak ankles on the outside, always 'turning' my ankle or 'rolling' my foot under which has caused further weakness. It's great that you're trying to nip this early. Good luck!

J.,
I surely wouldn't spring for the 1000 ones when if they are not adjustable for several years and since they cast his foot, I assume they are not. Kids this age grow so fast, I would buy the cheapest braces if you decide to go that route. Have you considered doing an internet search? Perhaps you husband can watch the boys and you go to the University library and check it out.
K.

I think you need to see a pediatric orthopedist to confirm his need for these. They will be able to answer your questions and determine the best timing for braces, etc. As you said, money is tight so you want to make the best choice possible and only do it once. The pediatric orthopedic group in Austin is Central Texas Pediatric Orthopedics and they have an office at Dell Children's Medical Center. The doctors I know there are very good. The number is ###-###-####.

Hi J.
I am sure the treatment for this has really advanced in the past (50) years- but my daughter was born with one club foot- and she had to wear these horrible shoes from age 6 weeks. she had to have them specially made every 4-6 weeks as she grew- at that time braces were also used for nitetime.........she wore the shoes until she was about 8 when i finally let her have some low tops so she would not be embarrased......her ankles are still week- so if the shoes help, i would use the shoes no matter how much he fusses- the high tops will help strengthen his ankles and keep his knees in line as he grows- gradually you can get him out of them- your thearapist is giving you some really good advice.
good luck and blessings

I would check to see if your child qualifies for care from Shriner's Hospital or Scottish Rite. If you do qualify there is no charge for care.

J.,

I just read your post. Your son sounds a lot like mine: ECI, low tone, they way his ankles fall, etc. Although my son learned to walk a little before age 2 by getting braces. Here is what we have been through:

He went to a pediatric orthopedic doctor and got AFO braces. They went from just below his knee to past his toes. You are right they were expensive and insurance will pay some. Even though they cast their feet and make a mold they can still adjust the braces as your son grows (adjustments were free.) Once he was use to the braces he took off! It was a whole new world. He still had ECI help.

I have not heard anything about the Fast Fit. I would ask your ped. about that.

After he turned 3 he went into SMOs. These are still braces that have to be cast to the feet but they go just above the ankle. Wow, we were shocked that he could not walk in them...his muscles were so weak. It took a few weeks and again he was off and happy. He walked like a drunk for awhile.

He is now 5 and still wearing the SMOs. His right foot has improved. His left foot has not, the ankle still falls to the ground. He can walk, run, jump with and without braces but he gets tired and starts to limp when he is not wearing them.

So have braces helped him? Yes they have but not like we thought. We were told his ankle would correct itself by age 3. It hasn't.

There is Shiner's Hospital in Dallas that you can look into. You will need a referral: http://www.shrinershq.org/Hospitals/Main/ This is were my son will be sent depending on what the specialist says next month.

Feel free to email me if you have any questions,
Michelle

I had the same problem when I was a kid. I wore the braces when I slept and had orthopedic shoes until I was 12. Back in the 70's, they were so ugly! Now, a lot of doctors are saying that kids will grow out of pronation (ankles turning in) and being knock-kneed. My orthopedic surgeon that I have now, is pretty confident that I would have grown out of it if left untreated and I probably wouldn't have the knee problems I have today. I would get a second opinion. Maybe see a children's orthopedic specialist. Good luck!

Have you talked to your pediatrician about it? Perhaps he should see a specialist? I used ECI and while the therapist was wonderful she was far from a specialist. In fact, I knew much more about autism then she did.

I had an issue with my daughter (who hated shoes) and the way she walked. I started making her wear shoes and it largely corrected the problem. A friend of mine whose daughter has hypotonia (age 2) is just learning how to sit up on her own. I asked her if she'd tried one of those support seats and she said that the therapist said that she would then be relying on the support of the seat rather then her own muscles. So, she doesn't use the seat and is doing great!!

cheers to you, raising a special needs child can be very difficult and emotionally taxing!
S., mom to 4 girls with special needs

My son also walks like that but except his ankles don't pop,but he does walk with the insides of his feet and I'm scared that his foot might stay like that. I've been trying to get some ankle braces for him but I'm not having any luck. He was getting therapy but we recently moved to a small town in west texas and its impossible for therapist to come here since we live 60mi away from everything. But I have also wondered if anyone else had what my son has and its releiving to know that he's not the only one. The therapist told me that if he is not put on braces soon his ankle bone will stay like that and never heal.

Dear J.,
My name is L. and I work at Cascade Dafo. We make the JumpStart LeapFrog, one of the FastFit braces referred to above. If you or your ECI PT would like to know more about how these braces can help children with low tone pronation please give me a call and/or visit our website. We currently have a coupon available for PTs to try these at no cost. That will probaly show you better than anything I could say. Contrary to the belief that use of orthotics will weaken muscles, we believe that when foot position is well aligned and children are able to practice appropirate repetitive movement, they experience more success in everyday physical activities. This builds more activity and more strength rather than less. It's similar to the way you might choose good quality hiking boots if you were planning to cover miles of rocky terrain. Thanks for reading my comments, I hope this will lead to a answers for you and your son.

Kind regards,

L. S.
1-800-848-7332
www.cascadedafo.com