ToeOFF experience

[Guest guest]

Hello Bob,

I'm 60, so I guess I qualify as an adult!

Last year when my hinged AFOs were no longer sufficient for my needs,

my orthotist recommended the Toe Off brace. Unlike my plastic AFOs

that were custom made for my legs and feet, the Toe Off is an off-the-

shelf product that comes in small, medium, and large. They are made

of Kevlar and carbon graphite, with a full footplate that fits under

the innersole of your shoe and an upright strut that extends from the

outer side of your instep up the front of your leg to a plate that

rests on your shin just below the knee. It is secured with velcro

straps. (There is a picture at

http://www.camphealthcare.com/orthopedics_toeoff.html.)

They fitted me with a size medium and gave me an orthotic arch support to place

over the footplate to provide some correction for my severely pronated

feet. (No high arches here!)

It took a few days to get used to the new braces. Walking was a breeze, but I

had to find a new center of gravity afer years of leaning back into my AFOs for

stability. With Toe Offs I had to lean forward when standing still to keep my

balance. They were lighter and a lot less bulky. My gait was a lot smoother and

I felt like a gazelle! Insurance covered 80% of the $1600 cost.

Alas, the problems started. The edge of the strut was thin and sharp and acted

like a nail file, slicing the inside of my shoes. A little electrical tape

wrapped around the offending portion took care of it.

Less than two months later I noticed I was walking a lot less efficiently and

couldn't stand still without support. A quick look revealed that the upright was

separating from the footplate in a process called delaminating. Since the brace

was still under warranty, the company replaced it for free. We just figured it

was a defect in that one brace until the other one failed a month later. Hmm.

I'm not heavy or especially active, and take great pains not to

put undue stress on the braces.

Eventually, the manufacturer replaced three sets for me before they

suggested their new improved model, the Ypsilon. (There is a picture

at http://www.camphealthcare.com/ypsilon.html.) It is obviously thicker and more

sturdy than the Toe Off so I tried a pair of these nder the original warranty.

No shoe-slicing this time. Instead, the sharp edges of the top of the brace that

is encased in the straps acted like a razor blade and cut through them within a

few weeks. The orthotist replaced them with industrial strength leather and

velcro straps, and after a few more repairs and the addition of rivets we solved

that problem.

The Ypsilons were better, if less attractive, and more durable than the Toe

Offs. However, one failed after six months (same problem--delamination at the

strut and footplate) and was no longer under warranty. Since I needed them and

had no other immediate options, I ordered a new one, and while I was waiting for

it, the other one failed. Thank goodness my insurance covered the new set. After

all, even though I'd gone through braces like potato chips,they had only

paid for the first pair over a year ago.

Needless to say, I'm looking for the next big thing. I'll be checking

out the SAFOs on Monday and I've made some preliminary arrangements

to be fitted for a Helios brace in Las Vegas.

I hope this information is useful to you and that my story isn't too

discouraging. The Toe Off is a wonderful brace for the right person. My

orthotist has other patients who have used it with had more success than I had.

I hope you are one of them.

Best wishes,

Donna