| Lisa Knox
Author: Kevin B. Rosenbloom, C.Ped, Sports Biomechanist
When a patient is adjusting to life with an AFO, there are many questions that arise. Among the questions, shoe recommendations are a common. This topic is not taken lightly and frequently discussed at the Kevin Orthopedic lab.
Our lab’s founder, certified pedorthist and biomechanical expert Kevin Rosenbloom prefers the series of New Balance shoes that end with “40”. Currently, his favorite is the New Balance 1540 V2. The 1540 V2 is an incredibly stable, neutral shoe with rollbar protection in the sole, assisting in the prevention of eversion or inversion of the subtalar joint. The shoe comes with a variety of widths from narrow to double extra wide, and goes all the way up until a Men’s size 16. Another option is the New Balance 840. It is a little less reinforced when compared to the 1540; however, with its lightweight materials, more cushioning, and softer outer and midsoles, it’s designed with comfort in mind and is an ideal alternative.
Fitting recommendations when selecting an AFO brace
Before ordering a brace, a practitioner must consider a few factors that can have an effect on a patient and the shoe that will be worn. First, choosing the right brace for the patient’s activity level, pathology and other concerns is essential. Because there are several braces to choose from, the designs of the brace itself will cause the circumference around the ankle, the heel and the midfoot to increase significantly. Instructing a patient to go up a size or two would be advisable. An example of this is best demonstrated with a gauntlet brace. A gauntlet brace, while providing increased support, will be thicker than a traditional or athletic style brace. Other braces could provide equitable treatment and support and should be considered.
Secondly, adding additional cushioning and extra lining, such as Plastazote and Myolite, will effectively increase the bulk of the device. Because Kevin Orthopedic offers a variety of customization options, it’s good to consider cushioning. If a gauntlet brace is required, the bulk and padding will make it more difficult for fitting. However, Kevin Orthopedic offers a “Heel Cut Out” option to help. This instruction involves removing the plastic from the posterior and plantar calcaneus, beginning at the plantar fascia insertion, terminating just superiorly at the achilles tendon insertion and encompassing the whole width of the posterior calcaneus. This option provides the patient the ability to sit further back in the brace and into the shoe.
Kevin B. Rosenbloom, C.Ped, Sports Biomechanist
Kevin B. Rosenbloom, founder and president of Kevin Orthopedic, is a renowned certified pedorthist and sports biomechanist practicing in Santa Monica, CA. With his continuing research on the historical development of foot and ankle pathologies, comparative evolution of lower extremities and the modern environmental impacts on ambulation, he provides advanced biomechanical solutions for his patients and clients.