Ankle-Foot Bracing for Young Athletes
By Loretta Sheldon, ROA The Practitioner as a Team Player
The key for bracing young athletes is to identify
the appropriate amount of support without over-bracing the patient
and restricting movement.
 As a clinician, it is a great pleasure to have the
opportunity to help those with mobility challenges accomplish what
they otherwise couldn't. Helping a young athlete who dreams of
being the next Michael Jordan or Mia Hamm step out and play
alongside his or her peers is truly a rewarding experience.
Like all patients, the key for bracing young athletes is to
identify the appropriate amount of support without over-bracing the
patient and restricting movement.
The emotional impact associated with wearing a brace is an
important consideration. Teens (and some younger children) can be
reluctant to wear a brace that will make them stand out from their
peers. Parents may harbor a fear that if their child wears a brace,
it will result in the child being teased by others. Those are
understandable concerns. While it's important to discuss the vital
role the brace plays in helping patients overcome their mobility
challenges, it is not unusual to compromise in favor of something
the child is willing to wear.
Comfort Influences Compliance
 Fortunately, most brace manufacturers today go to
great lengths to address the concerns of young people and their
parents. Today, many braces come in fully customizable colors and
patterns. Sending your young patient off to the game in a brace
that matches the team's colors may go a long way toward helping the
patient feel more comfortable in his or her brace. And that is no
minor detail. A person who feels comfortable in his or her brace is
more likely to actually use it.
Other features, such as a hinged brace versus a non-hinged
brace, can have significant implications for the patient. Young
people who wish their brace to be as unobtrusive as possible will
not appreciate a hinged brace that clicks every time they move
toward plantarflexion (PF). Designs that better accommodate
movement via cutouts or flexible struts in the posterior of the
brace are a good alternative to hinges.
Steer away from braces made out of very rigid materials.
Instead, look for softer plastics that flex with your patient's
movements. Braces that are too rigid often lead to overcompensation
by the athlete, and negative side effects such as hyperextension of
the knee can occur. In addition, patients will need to fit their
braces easily and comfortably into athletic shoes. For fit and
comfort, it's best if the brace is made of a thin, flexible
material.
Sport Influences Brace Design
 Considering the sport your patient plans to
participate in is important because the patient's athletic stance
will figure largely in determining the appropriate brace design.
For example, a catcher in baseball needs to make quick movements
from extreme dorsiflexion to standing and PF to throw the baseball.
A brace that doesn't allow this movement simply will not work.
However, other sports like basketball and soccer tend not to
require such extreme foot positions, and therefore lend themselves
to a greater variety of brace styles. By evaluating your patient's
specific needs, you can then match him or her with a brace that
accommodates the motions required by the chosen sport.
Most importantly, consider the level of support your patient
needs based on his or her physical challenges. You might ask
yourself, "How much voluntary control of postures and movement does
my patient have?" In other words, where are the problem areas, and
what areas do not need intervention?
Balancing Support and Ability
When considering the specific bracing needs of a young athlete,
you need to find a balance between the amount of correction
required to bring the patient's foot alignment into balance and the
degree of plane movement you plan to allow or restrict with the
device. The key to correcting your patient's specific mobility
challenges comes when you've found the appropriate balance between
the level of support applied by the brace and the patient's ability
to support him or herself. When the brace intervenes only enough to
increase stability and confidence without getting in the way of the
play, you've met your mark.
Selecting the most appropriate brace for your athletically
inclined patient means taking the time to truly understand his or
her needs. Running alongside friends and imagining oneself as a
sports superstar is a rite of passage. The effort made to
communicate well, matched with an appropriate solution, can mean
the difference between sitting on the sidelines and getting in on
the fun.
Photographs courtesy of Cascade
Dafo.
Loretta Sheldon is an ABC-registered orthotic assistant and
certified fitter of orthotics. She is the clinical assistant to Don
Buethorn and manages the Education Resource team at Cascade Dafo.
In her ten years of service at Cascade, Sheldon has worked in many
areas of the company, from the technical support of practitioner
customers to product development and clinical problem
solving. 
Table Of Contents - April 2008
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