Bracing Available for CMT Feet and Ankles
with an introduction by Linda Crabtree

One of the first symptoms of CMT is usually the weakening of the peroneal muscle down the front of the shin, in fact CMT was once called peroneal muscular atrophy. When this muscle becomes weak, we aren't able to dorsiflex or pick up our foot as easily and we trip, often going up curbs and steps and "stubbing our toe."

In time, this muscle weakening can lead to complete foot-drop and the foot has to be lifted from the thigh and slapped down on the ground, hopefully heel first. This slapping action gives many of us what is sometimes called by the medical profession an "equine gait." If you look at a walking horse you'll see it brings its foot up by using its upper leg. This slapping action also gives us the sound recognizable as a drop-foot walk.

Keep your eye open for people on TV who have a drop-foot walk. A popular British actor featured in many PBS murder mysteries walks with a drop foot. The condition isn't caused only by CMT, anyone with peripheral atrophy can experience it and peripheral atrophy can be caused by conditions other than CMT.
When you've had enough tripping and falling, you'll look around for the best way to correct the foot-drop that causes it. Surgery is one avenue to explore and for some it is definitely the way to go. However, to have your feet and ankles fused is time-consuming, painful and, in most cases, permanent. There is no going back.

On the other hand, ankle-foot orthoses (AFOs - simply meaning bracing for the ankle and foot) can be taken off if you wish and various styles are available for a variety of foot-drop types.

For those who can no longer mover their ankles, there are small, light polypropylene, short, one piece AFOs that slip on over your sock and fasten with Velcro around your upper ankles. Your foot and the brace go into your shoe and the AFO holds your ankle at a right angle so it no longer drops.

For those with some movement left in their ankles, there are several types of hinged AFOs.

For those who have a lot of movement in their ankles but much instability, there are alternate bracing devices such as the air-stirrup (Air-Cast) , the Caligamed ankle immobilizer, as well as the RocketSoc.

Some basic thoughts regarding bracing and CMT are:

· Bracing can add to your life in wonderful ways. Without all the falling you'll have more confidence in your walk and walk more.

· Bracing is a plus, not a minus. It helps muscles that can no longer work to keep going.

I'm often asked if it can also speed atrophy of muscles being used now. My answer to this is that the right AFOs, fitted by a good orthotist, will take advantage of what you have going for you and add more. Sometimes a brace will take over for an atrophying muscle but most of us cannot exercise a muscle served by CMT-affected nerves back into shape anyway. If you do not brace it, it is going to atrophy with use; if you brace it, it is going to atrophy as well, so it isn't a matter of stumbling along until you crawl; it's a matter of being able to tell when you need the help of a brace and going for it.

Search out the best orthotist you can find, and above all, don't buy off the shelf. Your AFOs should be custom made to your feet.

Good luck!