Orthotics

Providing orthotic care involves assessing, designing, and fitting custom orthoses to support and improve the function of patients’ limbs or spine. It requires a thorough understanding of biomechanics, patient needs, and ongoing adjustments to ensure optimal comfort and effectiveness.

 

Below are a few examples of the orthoses Beacon Ortho can provide. 

Whether they be a simple arch support, an activity specific foot orthotic, or a diabetic insert, foot orthotics can be custom made for a multitude of applications. We would hope a custom orthotic would last a typical user at least 9 months to 1 year. It’s often adjustments can be made to help extend the life, but this should be at the discretion of your orthotist. 

Depending on your needs an AFO can help with most ankle instability and aide in regaining a more natural gait pattern. There are some AFOs that are an off the shelf item and can be sized to you. Often an AFO will need to be customized to your specific needs

 

KAFOs (Knee Ankle Foot Orthoses)

  • Are most often custom made for individuals with significant knee and ankle instability. Patients with pathologies like some Clubfoot, Polio, and Spina Bifida are often assisted with a KAFO.

 Knee Braces (KOs)

    • Braces that only support the knee joint. 
    • Osteoarthritis and knee injuries like ACL/ PCL / MCL insult can be very easily supported with a Knee Orthosis

 

Hip orthoses are sometimes needed as a post operative support. 

an RGO (Reciprocating Gait Orthosis) is an HKAFO that patients without the ability to walk or stand independently use to walk short distances. It’s a low tech exoskeleton for these patients who might normally used them for daily exercise. 

Fracture Bracing

Spondylolysis and Spondylolithesis

Lumbar Support

Scoliosis

Cervical Bracing and Halo

Cranial Remolding Orthoses/ CROs/Cranial Helmets are intended for babies between the ages of 4 months and 12-18 months. They are used for the treatment of Plagiocephaly (an asymmetric flattening on one side of the head) and Brachycephaly (a symmetric flattening on the back of the head), or a combination of the two. Head shape asymmetry is usually caused from unvaried head positioning. It’s important to implement a helmet as young as possible in order to achieve the greatest amount of correction. If you have concerns about your infant’s head shape, we are here to help! Even if your child is younger than 4 months, we are happy to discuss what you can do at home to try to correct the flattening by repositioning. In some cases head shape asymmetry is caused by the bony sutures in a baby’s head closing early, or Craniosynostosis. This is often diagnosed by xray or CTscan ordered by your physician. Craniosynostosis presents in a different pattern than plagiocephaly that we are trained to recognize and we will refer you back to your doctor should it be suspected as a helmet would not be appropriate. A helmet only works if the infants head is growing quickly, so the only window of opportunity is before 1 year of age.

Repositioning

  • Laying your baby specifically so that the flat surface of their head is not in contact with a hard surface. This is most effective before 4 months of age. Once the infant is rolling over on their own, repositioning is very difficult to implement. If you are needing some tips and tricks we’re happy to help!
  • Torticollis:  If you notice no matter what you do, your baby always turns their head back to the flat area or they only look towards one direction, it may be worthwhile to check with your doctor about possible torticollis. Torticollis is a shortening of the neck muscles on one side that makes it difficult for the baby to turn their head in both directions. It can often be worked out with therapy and stretching regimen. Torticollis and plagiocephaly are often seen together.

Caring For Your Orthosis

  • Never try to fix your brace on your own unless instructed to do so.
  • Wash your brace at least once each week
    • Hand wash with mild soap and warm water.
    • Dry the brace by using a towel or air dry.
    • Be sure the brace is dry before using it again
    • Straps can be cleaned by hand with a laundry detergent and warm water. Rinse well and squeeze with a towel or air dry.
  • Here is a list of Nevers:
    • Never use a hairdryer to dry the brace or “warm it up”.
    • Never put your brace in a washing machine or dishwasher.
    • Never use cleaners that you would not normally use on your skin (no clorox or lysol wipes).

General Orthotic Wear Plan

Often with braces that support the foot will change the shape of the foundation you are standing on. That can have some significant changes on your joints moving up your body and the muscles that control these. You can feel achy and sore at first. When first getting a brace we want to start slow and break in the brace.

 

Specific Diagnosis Information

Scoliosis can occur at any age in childhood but is most often found and treated in Adolescents. Adolescent Idiopathic Scoliosis is a three dimensional curve of an otherwise healthy spine. The term ‘idiopathic’ means that there is no obvious cause of scoliosis, but research is pointing to a genetic component. Early identification of scoliosis is very important and is often done either at school screenings around grade 5 or 6 or by your physician. Scoliosis is any curve that measures over 10°. It is often monitored by xray regularly to be sure it is not progressing. Curves that measure between 20-25° or more have an increased risk of progression and is generally when a brace is started. The goal of a scoliosis brace is to prevent the curve from getting larger – we cannot make a curve go away. A brace is used until a person is finished with their spine growth. For girls that is usually around the age of 14 and for boys, it’s harder to predict when they will finish growing, but is usually between the age of 16 – 18 years. There are several tools we use to determine spine growth and skeletal maturity. Curves that continue to get worse and measure more than 45° usually require surgery to correct the curve with a spine fusion.

What is a Scoliosis Brace?

  • A brace is the only tool in our tool box for keeping scoliosis from progressing or getting worse. There are a variety of scoliosis braces. They all have the same goal in mind – prevent progression of the scoliosis. There are ‘full-time’ braces which are worn both day and night for a total of no less than 16-18 hours each day. There are also ‘night-time’ braces that are worn only at night for about 8-10 hours. The different types of braces are made in such a way to consider the position a patient will be in and so it’s important that you wear the brace for the minimum amount of hours prescribed. Your physician will prescribe the type of brace they think is most appropriate for your case. We have over 10 years of experience bracing scoliosis in all ages and can help you through your scoliosis journey.
  • You will always wear a shirt under the brace. This will provide material to wick any sweat away and provide a layer of protection between your skin and the brace.
  • Your Orthotist will show you exactly how to put the brace on and off yourself or with a family member. We will draw lines on the straps so you can see how tight the brace should be worn.
  • There is a learning curve to getting used to the brace and we map out the first 1-2 weeks of wear. The brace should never hurt or rub your body. Adjustments can be made to prevent these if they do occur.
  • A brace will usually fit for about 6 months – 1 year, depending on how much and where a patient grows. Your orthotist will want to follow up with you about 3 weeks after getting the brace and 6 month intervals after that to be sure the brace is fitting properly. A brace that is not fitting properly could potentially cause problems by pushing in areas that could make the curve worse.
  • It’s important to follow up with your orthopedist for routine xrays and monitoring of your scoliosis. Xrays are also how we determine your skeletal maturity and when you can be done wearing your brace.

Is there anything you can do to help your back?

  • YES! Being Physically Fit and Active is the best thing for your spine. Having good core strength and using proper mechanics when moving or lifting. Maintaining good flexibility – touch those toes everyday! Scoliosis should not define what you can and cannot do, especially if we can keep the curve measurements low.
  • Wear your brace as directed. We’ll say it all day, the brace is the only tool we have to prevent the scoliosis from progressing to the point of surgery. 

Resources for Scoliosis Patients and Families

https://www.bracingforscoliosus.org/

 

 

Clubfoot Bracing

  • Clubfoot, or Talipes Equinovarus, is a congenital foot deformity meaning babies are born with their foot  or both feet in a ‘clubbed’ position. The foot is pointed down and turned in. This is an orthopedic concern and should be followed closely and immediately. Standard treatment initially consists of a series of casts applied by your orthopedic specialist to stretch the foot out of the deformed position. This can take several weeks and weekly cast changes. Sometimes the tendon that flexes and points our foot is too tight and needs a small surgery to lengthen it so the foot can achieve the proper, normal position.  Once the casting is complete, the next step is bracing.  Ponseti Bracing is the gold standard when it comes to clubfoot bracing. The brace is made up of two shoes connected with a bar. The shoes and bar combination hold the now corrected foot in a position so that the deformity does not return. The Shoes and Bar are used 23hours/day for 3 months and then only at nighttime until the child is about 3 years old. The brace is the only tool we have in our tool box to prevent the deformity from reoccurring.