Foot problems·Orthosis

Regaining mobility

Treating peroneal nerve palsy with a brace

From Bauerfeind Life Magazin

In short Christiane Fraatz has been living with peroneal nerve palsy for almost 35 years. During this time, she has used various ankle foot braces – without satisfactory results until she regained increasing freedom of movement with the Xtern summit from Turbomed Orthotics.

  • Previous braces all had similar weaknesses: too little lateral stability, the carbon plate prevented heel-to-toe movement, the rigid material damaged footwear, slipping socks resulted in pressure points and blisters on the feet.
  • Thanks to its spring effect, the brace by Turbomed intensifies dorsal extension, thus supporting lifting and putting down the foot as well as heel-to-toe movement.
  • With this brace, Christiane Fraatz can move much more easily – laterally in uneven terrain as well as backwards, she can squat and get back up, as well as shift her body’s center of gravity to the leg with the weak dorsiflexor muscles.

It’s never too late for a brace. Christiane Fraatz has been living with peroneal nerve palsy for almost 35 years. For 20 of those years, she was untreated. Since then, she has been using various ankle foot braces and has actively been following their development. The Xtern summit by Turbomed Orthotics has helped her gain increased freedom of movement – at work, during everyday activities, and when exercising – attached to all sorts of footwear.

Quality of life: easy to say, yet an abstract concept. Until Christiane Fraatz explains what it means to her. “Being able to squat down to and pick up my grandchild. Being able to walk backwards. Being able to enjoy the countryside when going for a walk instead of having to scan the ground for unevenness.” The things the 57-year-old mentions seem to be simple everyday activities, yet to patients suffering from weak dorsiflexor muscles, they are often insurmountable obstacles.

„I could have saved myself a lot of pain if I had received an early bracing.“

Christiane Fraatz
Fussheber Summit

Christiane Fraatz from Berlin is a nurse and works as a training coordinator in outpatient treatment. Since, at the age of 22, an idiopathic dorsiflexor muscle weakness occurred – “over night” – she has become a walking study on life with this chronic restriction and on the relevant treatment. She has been wearing the Xtern braces for several years, which has so far provided her with maximum stability while standing and during movement. Thanks to its spring effect, the brace by Turbomed intensifies dorsal extension, thus supporting lifting and putting down the foot as well as heel-to-toe movement. “I don’t fall anymore,” she says. That was not the case for a long time. For the first 20 years Christiane Fraatz remained completely untreated, she stayed at her job that involved a lot of standing, she gave birth, continued to exercise… and fell a lot: “But I was still young and didn’t want to be limited. I kept telling myself that I would have to put up with bruising.” 

But over time, she didn’t just suffer from bruising. Falls led to overstretching of the ankle ligaments and fractures.  More and more late-onset consequences developed from incorrect posture and unphysiological gait: damage to the lumbar spine with osteoarthritis of the facet joint, permanent misalignments of the hip and iliosacral joint, chronic severe pain radiating into the leg. By coincidence, she found something that might be able to help her: carbon spring braces. She mentioned them to her physician who prescribed dynamic ankle foot braces to her from then on. “I wore those braces for twelve years and happily accepted all the disadvantages. I could have saved myself a lot of pain if I had received an early bracing.”

Looking for more freedom of movement

“Over the years, I have worn different brands and models of braces, all of which had similar weaknesses. For me as a patient, they offered too little lateral stability and, due to the foot plate, it was hardly possible to roll off the foot. The rigid material in the shoe often caused damage to the inside of the shoe. In addition, the carbon brace contributed to pressure points and – in connection with constantly slipping socks – regular blisters on my feet in connection with constantly slipping socks.” However, not wearing braces was not an option. “Being in full-time employment today is only possible because I wear braces so I’m mobile again.”  Of course, there have been improvements because braces have continued to develop but they were always associated with certain restrictions that limited her freedom of movement. 

What is she able to do with the Xtern summit attached to her shoe? “I can move sideways better in uneven terrain and backwards in a stable manner, which I wasn’t able to do before at all. I can squat down and get back up again. I even dare to shift my center of gravity to the leg with the dorsiflexor muscle weakness and to walk physiologically correctly with the movement concept of spiral dynamics,” reports Christiane Fraatz. “And last but not least, I can finally wear woolly socks again because they don’t get damaged immediately, and I don’t have to buy shoes in two sizes; previous braces needed too much space.” These are achievements that she wants to share by educating others.

Limiting impact

Early outpatient treatment is particularly important to her. “Most elderly people want to stay in the home they’re accustomed to. If treated with a brace, many of them could go to the bathroom, to the fridge and to the front door by themselves, draw the curtains or open a window to let some fresh air in. A lot of everyday activities depend on moving confidently.” However, family members in charge of care or many treating general practitioners or specialists do not always know what medical aids are available. 

Christiane Fraatz is an example of restrictions not being insurmountable. She has been able to regain a lot of mobility – by trusting in herself when her confidence had returned. Her sporting portfolio is impressive: Hiking, badminton, cross-country skiing, line dancing. The Xtern summit, attached to sneakers, hiking or ski boots, renders good services and even had a special something in store for the summer months: “After 34 years, I was able to go barefoot in sandals. You can’t even imagine how thrilled I was!”

Xtern summit and Xtern frontier

The two dynamic ankle foot braces from Turbomed Orthotics provide functional support in cases of weak dorsiflexor muscles or paralysis of the dorsiflexor muscles. They promote physiological gait and minimize the risk of falling.

The lightweight plastic braces have a strong spring effect so they can offer a high degree of flexibility during movement. They are attached to the outside of the shoes using clips. Changing shoes is therefore particularly easy, and there is no direct contact with the skin.

The Xtern summit is attached to the calf dorsally. The Xtern frontier allows patients with limited motor skills of the hands to use the brace without external help. Thanks to its magnetic closure system, it can be put on easily from the front with one hand.

More information

“If the shoe fits, then the brace will also fit” – François Coté and Stéphane Savard, the founders of Turbomed Orthotics, talk about the development of their Xtern-braces in this interview.

Images: Andreas Wetzel, Bauerfeind

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