Hello from a SpryStep Ankle Foot Orthosis
Hello! My name is Oscar and I am a SpryStep Ankle Foot Orthosis (AFO) by Thuasne USA. Specifically, I am a custom AFO made especially for Cheryl Hile. She has a symptom of Multiple Sclerosis called foot drop. The electrical signal from her brain to dorsiflex her foot is impeded by lesions in her spinal column. She constantly feels like she is going to trip while running. I am a medical device to lift Cheryl’s right foot so she can run safely without fear of falling.
Cheryl met the inventor of the SpryStep AFO, Tim Cooney, CPO Clinical Specialist, at a prosthetics and orthotics trade show in January, 2018. She was drawn to the Thuasne USA booth of sleek blue SpryStep AFOs. Cheryl spoke with Tim and Damien Rivoire, Bracing Support Manager (now Orthoses Program Manager). Tim offered to work with Cheryl to fabricate a special custom AFO with the integrity to run a marathon and the springiness to lift her weak right leg.
The process of my manufacture started with Cheryl’s awesome orthotist, Ara Mirzian, in Encinitas, California. Ara has been Cheryl’s orthotist since her Arst AFO in 2008. Thus, it was fitting (pun intended) for my fabrication journey to begin with Ara. First, he evaluated Cheryl’s range of motion at the ankle and knee, and then analyzed her muscle strengths and weaknesses. All of this information was important for Tim to ensure the biomechanical objectives of the custom SpryStep AFO were met.
Next, Ara wrapped Cheryl’s leg in casting tape, ensuring her hip, leg, foot, and joints were in perfect sagittal and coronal alignment. Cheryl has a weak thigh and Ara did not want her leg to wobble and compromise the cast. Thus, Ara held her leg in place for about 5 minutes while the cast dried. Once the cast was set, Ara identified all the landmarks, like the fibula head, medial and lateral malleoli, and whatever funky bony protrusions he saw that would be important for Tim to know about. A perfect cast was crucial for Tim to work his AFO magic.
The cast was shipped to Tim in London where he began the task of designing a structurally efficient and dynamic orthopedic brace for Cheryl’s running. Some issues Tim had to consider were durability to run 26.2 miles, but still maintain springiness. Not only does Cheryl have foot drop, but MS disease progression has made her right thigh weak and she needs the energy return to help her bound forward. A brace with just enough strength to not break under repeated pressure, yet flexible to move with her leg and not cause pain. Also, an AFO that can control movement, but not be so restrictive that it causes muscle atrophy, which is another problem Cheryl developed during her 13 years of wearing AFOs.
The cast was Alled with liquid plaster. The resulting model was built-up to account for expansion and compression of the leg while moving, or in Cheryl’s case, running a speedy 5K or a super slow marathon. Other parts of the model were filed away to prevent bony prominences from hitting or scraping against me.
I am constructed of five components: carbon fiber; a special composite that is light and flexible like ropes used on ships, but 10 times stronger; glass fiber; a special aramid material similar to Kevlar; and a proprietary ingredient that is highly safeguarded like the Coca-Cola recipe!
Tim engineered my cuff with a light and flexible material. It is squeezable, and molds to Cheryl’s calf. This is useful because her leg can be wider or skinnier on any given day, so I can cradle her calf muscle better than a rigid cuff. My strut is made of multiple layers of carbon graphite sheets and is positioned behind the leg for optimal energy return. And my footplate is more dynamic than any other AFO Cheryl has owned and I add a lively spring to her step!
Of note, there are several designs within the SpryStep family. The custom SpryStep and SpryStep Flex are the AFOs people wear for sports. The strut of the Flex is spiral-shaped to allow it to bend more and provide greater flexibility. Cheryl wears a custom because she has several deficits and weaknesses that require extra tailoring.
Once all of my rough edges were smoothed out and padding was added, I was shipped back to California where Cheryl took me out on a test run along the ocean. The cool air and exhilaration of carefree running felt liberating for us both. I did a fabulous job and highly impressed Cheryl! I was perfect and Cheryl grew to love me more and more on each run. She named me Oscar for my attractiveness just like an iconic Oscar de la Renta evening gown.
I have completed 10 marathons, 5 half marathons, dozens of 5Ks, and hundreds of exhausting training miles over the course of two years. I even ran two trail races which is highly unusual for Cheryl because her previous AFO models tended to bruise her leg badly on runs over undulating surfaces. The SpryStep has been laboratory tested to 2 million steps, which is the equivalent of two years of usage. But that is just walking. It’s impressive that I was so dependable and could withstand running all those miles! I still feel good and look great, but I have since retired from running, though I still enjoy an occasional hike in the great outdoors. My more colorful siblings Stardust, Vincent and Lord Stanley are now among Cheryl’s regular running rotation, but I still remain her absolute favorite!
I have cousins around the country who are also part of the Run A Myelin My Shoes team. We have accumulated a massively impressive resume.
Koreen Burrow, from Florida, has a custom SpryStep AFO which is yet to be named. Koreen claims she is boring by not naming her AFO but together they are anything but boring. In 2019, they hiked the entire 2,200 mile Appalachian Trail. The hike is strenuous and grueling over mountainous terrain. Koreen may as well name my cousin “Badass!” And in the middle of the hiking adventure, they went to Richmond, Virginia to run their first marathon together! Koreen says her SpryStep AFO is lighter, more durable and more comfortable than any of her previous braces. She can hike and run longer with less fatigue. Furthermore, she has more confidence because of the reduced possibility of falling and inuring herself. Koreen “sets a bar and strives for higher.”
Heather Goodrich, from Alabama, has been wearing bilateral AFOs since 2012. Heather’s disease has progressed quite significantly and she says she was in a horrible place prior to her SpryStep AFOs. Nothing was working and she was always worried of stumbling while exercising. She did not feel safe. She received her first SpryStep AFOs in 2018, custom ordered in rose pink. They are elegant, strong AFOs and Heather named them My Pink Ladies. Her SpryStep AFOs are comfortable and she can wear them all day, every day.
Although Heather and her My Pink Ladies go together “like rama lama lama ka dinga da dinga dong” the Ladies have retried. Heather now dances with Fred and Ginger, custom orange AFOs. They are always prepared to party, run, hike, go boating, or go fishing. Most impressive of all, they are ultra-marathoners! Fred and Ginger are over-the-top-active!
Speaking of another over-achiever, Ellie Tillotson from Virginia is a marathon runner, triathlete and cyclist. Foot drop was the MS symptom that eventually led to Ellie’s diagnosis. She tried two AFO brands, but the first one broke after only 8 months and the second one was so stiff that she developed a numbingly painful neuroma. She started using the off-the- shelf SpryStep Flex AFO in 2019, which she appropriately named Bionic Leg. She said it’s simply amazing.
Better still, Ellie recently received a custom SpryStep AFO and that has helped align her gait. Ellie loves her new AFO. It sits closer to her leg, is more comfortable, and has better reaction to keep up with Ellie’s pace. There is no worry of tripping. Ellie still has to name my newest cousin. It can take a while for the AFO and user to become familiar with each other’s nuances. Once there is trust, a suitable name will come to mind. Ellie does confirm her pearlized orange AFO, outfitted with blue reflective tape, is a girl!
Note: In our experience, custom AFOs are better than off-the-self for running and other dynamic activities. They are just more comfortable and make the experience more enjoyable. The orthotist may still need to do tweaking like beveling an edge or trimming the foot plate to fit inside the shoe, but it shouldn’t be anything major.
I hope I have given you some insight on how the SpryStep AFO is made. My cousins and I hope to continue to empower these women (and the other seven SpryStep-users on the team). Our sincere wish is to help them pursue their running goals safely and without fear of falling. And I sincerely hope I have motivated you to start moving!
Enjoy your day!
Oscar the SpryStep AFO
Disclaimer: It is a lot of hard work to adapt and learn how to run with an AFO. The people in this article make it seem easy, but there is a lot of trial and error to make things work. The have a lot of experience with different AFO brands. The learning curve was not as high when they transitioned to the SpryStep as it can be for a newbie. It also helps to have an experienced and understanding orthotist who is willing to make adjustments on the AFO to make it comfortable for running. The SpryStep AFO is one of many medical bracing devices on the market. Just because this particular product works well for the people mentioned in this blog post, it does not mean it is the perfect AFO for everyone. Please work with your neurologist, orthotist and/or physical therapist to determine the best AFO for your personal goals. If one particular brace does not work for you, please do not give-up! Keep on trying! Good luck and feel free to contact us at runamyelinmyshoes@gmail.com.