Allie has grown a lot over the last few months and we're starting to notice some tightness in her right leg again. It's been over 6 months since she last had Botox in her right leg and we're starting to think about doing it again. I mentioned the idea to her physical therapist who suggested that we try an adjustable night-stretching brace for a little while first. I'm all for trying it because I would love to lessen the use of Botox, if possible.
The brace (shown below) gives a passive stretch overnight, which will hopefully improve her dorsiflexion. Allie's tone is mostly fine when she's not moving. She has a good range of motion and her heel is mostly on the ground when she's standing. However, when she walks she typically puts the ball of her right foot down first followed by the heel. This gets more pronounced as she runs with her heel rarely touching the ground.
To test the idea of a night splint out, Allie has been wearing her old ankle foot orthosis (AFO), which never really worked during the day. She was shockingly excited about it because her physical therapist told her if she did a good job with the trial she could pick the colors of the night brace.
Yesterday, after a successful week of the AFO at night trial, Allie was fitted for the brace and picked the rainbow pattern for the long trap, the flag pattern for the body of the brace, and red for the smaller straps. Allie has been campaigning for us to put a rainbow flag in the front yard and I think this was her way of fulfilling the urge.
I forgot to mention it before but a couple months ago Allie started wearing an insert in her right shoe to make up for a half centimeter leg length discrepancy between her right and left leg. It's called a hot dog (shown below) and just slips in her shoe just like a regular insole. The improvement in her gait was immediate. She's much more symmetric and has not tripped once since she started wearing it. It also promotes more weight bearing through her right leg, which may lessen the chance of her developing a larger leg length discrepancy in the future. It's nice when a quick and easy solution actually makes a difference.