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Paralyzed ankle forces me to ski with a rigid ankle-foot orthotic inside my ski boot

post #1 of 10
Thread Starter 

My left leg, below the knee, is completely paralyzed.  The calf / foot muscles are completely atrophied.  This injury requires me to wear a rigid AFO (ankle-foot orthotic) to walk.  I also wear the AFO inside my ski boot for support (and to fill the ski boot because of the atrophied muscles).  Obviously wearing a rigid brace inside my ski boot makes it impossible to flex or to roll my ankle. 


I love to race when skiing.  Using NASTAR's scoring system, my handicap is generally around a 45 (45% slower then the 0% pace-setter).  I'm in the "back-seat" a lot when I ski and my curve technique is almost nil - mostly skidding and scraping. 


Here's my questions: Do you think switching to a hinged AFO would help me?  By a hinged AFO,  I mean an orthotic that allows the ankle to bend forward and backward. 

Or should I continue skiing with a rigid brace (I already know this works), but change the angle my ankle is immobilized from approximately 82 degrees (what I'm currently using) to something like 75 degrees?   I think this would help get me lower to the ground and center me better on the ball of my foot allowing me to use the shovel of the ski instead of "floating" it.


This is probably a really weird question for this forum because I'm not sure how common it is for someone with a paralyzed leg who likes to race.  My goal is to get my handicap down to the mid 25s.  Thanks for any advice!



post #2 of 10

A few ways to look at this


Will your insurance cover another afo? call your insurance and ask if the cover code L1970.


The hinged will take up more room in ski boot, which u say is not a problem. I am not sure having ROM will give that leg more control.


I like the other option of centering yourself in the boot via wedging and alignment. Also having a bootfitter soften that boot to accomodate for the weakness.

post #3 of 10

It also might be possible to use one of the new "Anterior" AFOs (front of the leg/shin) made of carbon fiber, which could be heated and bent to match the forward lean of the boot. Used in combo with a intuition liner to let the strut embed into the side of the liner.  This would be supportive and allow you to load the front of the boot plus it has a lot of spring.  As mentioned you might be able to get insurance to cover this.



post #4 of 10
Thread Starter 

Johnnyatomic - thanks for the reply and advice.  Insurance does cover this so that is not a problem.  I am thinking the rigid brace is still the best way to go.  I want to set that brace so my ankle is flexed approximately 75 degress, and then work with a boot fitter to tweek the fit.  I'm also thinking about making the brace almost all the way to my toes so that I can get the extra leverage inside the ski boot.

Thanks for your input sir!


post #5 of 10
Thread Starter 


Thanks for the great idea - I need to do more research into anterior AFO and intuition liner though and I thank you again for the path for my research.  Your idea made me think of making a "front" side to the AFO that would help me fill up the ski boot and allow my shin to engage the front of the ski boot better which would also protect my shin.

Thanks for the input Mike!


post #6 of 10

So here is another idea.  You ski with a rigid AFO now and aren't happy with the results.  You can ski as you say but not carve and since your ankle is locked I'll assume without any dynamic movement.
  Your ankle is not fused so I'll assume could tolerate flexion/extension.


Why not let your boot serve as your AFO?  Even stiff enough to add support you will probably still have some movement in your ankle and possibly be able to more correctly load the ski.



post #7 of 10
Thread Starter 

hi Louis - and good morning sir!  I have had your suggestion suggested to me before, but I shot that idea down a couple years ago and never re-considered.  But now - with 3 years of racing experience, I am re-considering because you're absolutely correct - the boot itself is really an AFO...  The number 1 reason why I never tried skiing without my leg's AFO brace inside the ski boot was: fear.  I was (am!) afraid of either breaking my leg and / or having absolutely no control of that ski that I am totally unable to ski without the AFO.  It sometimes feels like it goes where the ski wants to go - and skiing is actually very difficult for me in powder!  But racing is not deep powder skiing, unless you get out of the "track"and  in the "washout".


My ankle is not fused, and I have movement in all directions with it - just no muscle control.


So - I grabbed my ski boots and wanted to see how this would feel.  This was actually the 1st time I put a ski boot on without my AFO inside since I recieved the injury that caused me to have to wear the brace.  My foot is so "floppy", it was an kinda weird pushing it into the boot - BUT, I can roll forward, left and right inside the ski boot which I cannot do wearing the AFO brace also inside the ski boot.


I am going to try and ski without my AFO - just my foot and leg inside the ski boot - this weekend - see how it feels.  I'll let you know how this experience feels as well.  If it works out, wouldn't that be something? 


Thank you for the suggestion - I feel excited about trying this.  Again, I'll let you know about the results - maybe you can use this experience as well in your Skiing Performance Centre (I notice the Canadian/English spelling)...  Thank you sir!



post #8 of 10


don't forget that the ski boot which can contain your foot AND AFO may be too large to properly contain your foot bare.  Good luck!  Anxious to hear how it goes.



post #9 of 10
Thread Starter 

I skied with a free left ankle for the 1st time since 1989!  My atrophied leg is just skin and bone - no muscle - so the ski boot was very loose, even buckled as tight as it could.  What I did to remedy the looseness was by taking an older, cracked - orthotic brace, and cut the foot / ankle portion of the orthotic off so that all that was left was the portion of the orthotic that fit around my leg: from the bottom of my knee to the top of the ankle.  This still left my ankle free to bend forward and roll left/right and also gave me comfort in knowing that I had this extra support to protect my leg from breaking!  I was nervous my 1st run, but it felt great and I enjoyed the freedon of being able to move around instead of being completely rigid inside that boot.


It will take some time / practice to get used to being able to push my knee forward into the ski boot, but the ski doesn't float like it did and I liked the way I felt skiing.  On Saturday, I skied the Joe Rauscher Memorial Race at Wild Mountain, MN - a cancer benefit race.  On the Black Diamond early morning race course (South Wild), I scored decent, but not my best.  I raced again that day in the late morning race on the Blue Square course (Expressway) and got the best score of my racing career - a 32.xx! 


I want to thank everyone who helped me answer this question.  I needed a path to investigate and found the courage to ski with a free ankle.  Instead of building another rigid brace, I am planning on building this ankle free brace and visiting a boot fitter to get the best fit.


Lastly, I'd like to thank you Louis for his advice.  I actually lived in Airdrie, Alberta for about 10 weeks for some engineering training back in 1998.  If I'm ever in Calgary again, I'd like to stop by your shop and pay you a visit. 



post #10 of 10

DBK, thanks for the nice note.  Good luck with your boot design work next year,   If you need any more recommendations we'll still be here.  See you in Alberta or join us in Big Sky March 26th for a week.





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