Walk of Life

Ankle-foot orthoses play critical role in correcting childhood condition.

Like a lot of young girls her age, seven-year-old Isabella Every is fascinated by unicorns, enjoys watching the TV show PAW Patrol and sometimes wishes she could live under the sea like Ariel in The Little Mermaid.

Photo by Jordan Pysz.

Playing outside on her swing set is one of Isabella’s favorite activities.

A first grader who describes school as “great,” her favorite subject is math, and when she’s not in school, she enjoys playing on her swing set, bouncing around on the family trampoline and playing outside with her friends.
Since she first began walking, some of those outdoor activities had been a bit of a challenge for Isabella, who has struggled to break out of a walking pattern that most children leave behind when they exit the toddler stage of development.
The pattern is called toe walking, and the moniker aptly describes the gait of someone who walks almost exclusively on the balls of their feet or toes while their heels seldom, if ever, make contact with the ground.
Most often a learned habit, toe walking can also develop as a result of Achilles tendon tightness or in association with cerebral palsy. In Isabella’s case, however, it developed as a result of a sensory processing disorder and proprioception.
Proprioception refers to the level of awareness a person has to their body position or certain parts of their body. Anyone who suffers from a loss of proprioception may find it difficult to realize their legs are crossed or their arm is raised above their head.
“Isabella has had a problem with proprioception since she was little, and because of the toe walking, her father and I were told that she could do musculoskeletal damage to herself if she kept on doing it,” explains Isabella’s mother, Pamela.
“She was around two years old when her physical therapist recommended we get her some special inserts for her shoes to help correct the toe walking, and that’s when we first started going to Sonlife.”

Full-Service Provider

Pamela’s reference is to Sonlife Prosthetics and Orthotics, a full-service prosthetics and orthotics laboratory in Spring Hill that has provided premium care to patients throughout Hernando, Pasco, Citrus and Sumter Counties since 1985.
Since her first visit to Sonlife, Isabella has been treated exclusively by Bill Woslum, CO, LO. Now in his 40th year in the medical field, Bill decided to get into this field after he was forced to wear custom ankle-foot orthoses, or AFOs, himself.
“I was a nurse in the Army and got busted up coming out of a helicopter the hard way,” Bill relates. “I had to wear custom knee-high AFOs for a couple of years after that and had to use polio crutches, so I learned what it’s like to be on the other side.
“That’s why I decided to go into bracing, and since I got started in this field, I’ve literally designed, built and fit thousands of braces. What I really like about this facility is that we’re allowed to utilize what’s best for the patient’s needs.

“Bill is so unbelievably good with her, and the work he’s done for her is just incredible.” – Pamela

“We’re very outcome oriented, and I like that, because some people will wear these for a short period of time, but others have physical needs that continue into adulthood. For those, we continue to tailor the devices to meet their lifestyle and level of activity.”
Isabella is among those whose needs have continually changed. Because she is still growing and is now becoming more active, she has had to be fit with several custom devices over the course of the past five years.
“Isabella is the sweetest little girl you can possibly imagine!” Bill exclaims. “When she comes here, she just lights up the room, and the first thing we did for her was fit her with some custom foot orthotics that were made from molds of her feet.
“We tried the smallest, most user-friendly device we could at first. We made one for each of her shoes, and what they were designed to do was redistribute the pressure and help her control her collapsing arches and help her walk more normally balanced.
“We made them very stiff because we were hoping that by changing the weight distribution when she walked, it would coax her to do less toe walking. Unfortunately, she eventually overpowered them and continued walking or running on her toes anyway.”
Isabella wore those first orthotics for about a year. It was then determined by her physician that she was not getting the desired benefit from them that was sought, so a second generation was developed for her, again by Bill at Sonlife.
“Some kids will simply grow out of their toe walking without any sort of treatment at all, but others will require more support in order to try to coax them into utilizing the limbs more functionally,” Bill educates. “That was the case with Isabella.
“After that first year, it was clear she wasn’t outgrowing the toe walking situation, so we had to go with taller and more supportive devices that wrapped around her ankles and gave her additional lower extremity stability.”
This second-generation device was an AFO that was worn inside the shoe over a sock and was designed to hold Isabella’s mid foot and ankle in a neutral position. That position, in turn, forced Isabella to walk with a more natural walking pattern.

Meeting Ever-Changing Needs

As hoped, the second-generation AFO helped reduce the amount of toe walking Isabella did, but as a result of her natural growth, she recently needed to be fit for a third-generation AFO that is largely a modified version of the second.
“As her needs evolve, we continue to meet those new needs, so when she sprouted up more, we needed a longer lever arm to get the control we wanted of the lower extremities,” Bill states. “To do that, we had to go higher up the ankle with the lever arm.
“The additional stability allows her to walk and run and do other activities much more safely than she would otherwise be able to do. Our goal, of course, is to allow her to do all activities and still maintain balance and functional control of the lower extremities.”

Photo by Jordan Pysz.

Isabella Every

The AFOs Bill has produced for Isabella have done that. Isabella is as active as most other children her age, and because of the corrective devices, she is not restricted from running, climbing or jumping, according to Bill.
“She’s doing things we never imagined she’d be doing,” Bill enthuses. “She’s as active and independent as any other kid her age and even more so because she’s got this unconquerable spirit. She’s like a little, mini dynamo. And her mom is so supportive and caring. It’s wonderful to see a family that puts their child’s needs first.”
That unconquerable spirit appears to be helping Isabella overcome her challenge with toe walking. She will still fall back into her old walking pattern on occasion when she’s not wearing the orthoses, but when she wears them, she usually walks naturally.
“She’s definitely improved,” Pamela says. “Her toe walking is nowhere near as prominent as it used to be. My hope, of course, is that she’ll get to a point where she doesn’t do it all anymore and no longer needs the AFOs, but I don’t know when or if we’ll get there.
“Right now, though, it’s not a big concern, really. She doesn’t like that kids at school are always asking her about them, but that’s how kids are. Other than that, she seems to be okay with them, and they’re clearly making a difference.”
Isabella confirms her mother’s assessment, saying the AFOs “feel fine” while adding, “I’m used to them now, so they don’t bother me.” And she wants everyone to know that she actually enjoys her visits to Sonlife and her visits with Mr. Bill.
“Bill is so unbelievably good with her, and the work he’s done for her is just incredible,” Pamela exudes. “We’re lucky to have found him and Sonlife. I wouldn’t want to go anywhere else. They’ve been great, and we absolutely trust them. They’re the best.”

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