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The Align Clinic Blog
​ Your Home For Orthotic and Prosthetic Knowledge

Below the Knee Prosthetics

12/22/2021

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If you’re an amputee, you’ve probably considered prosthetics as a possible treatment option. However, the world of prosthetics is rather complicated, which is why you should do as much research as possible and consult with your doctor before you finalize any decisions.
We’ve devised this guide in hopes of helping amputees decide whether BKA prosthetics are a good fit for them. We’ll discuss how to know if you’re a good candidate, what the fitting process is like, and all other important information about prosthetics.
Are Below Knee Prosthetics for Me?
Prosthetic legs have the power to change your life. However, not everyone is a suitable candidate. So, how do you know whether BKA prosthetics are a good fit for your needs?
First and foremost, always consult with your prosthetist. They are familiar with your particular case and will know best whether you’re a good candidate for them or not.
If you’re impatient and would like to learn as much as possible before your doctor’s visit, here’s what you must know about below the knee prosthetics.
To be able to wear a below the knee prosthetics, you must have some soft tissue left. This helps with cushioning the bone to avoid further complications. Some other important indicators are the health of the surrounding skin, health of your other leg, and the amount of pain you experience on a daily basis.
If you’re a suitable candidate, the next step is getting fitted for prosthetics and choosing the correct components.
The Process of Getting Ankle Prosthetics
The fitting process is the most important part of your prosthetics journey. It has to be done properly and without rush to avoid any further complications. Here’s how it usually goes:
  1. Make sure that your leg is fully healed. Trying to put a prosthesis over a fresh injury will only result in a poor fit and even more damage.
  2. You’ll then have several fitting appointments to ensure that all measurements are correct.
  3. Once all measurements are taken, the company of choice will either outsource production or produce it in-house. 
  4. Lastly, you’ll probably have to undergo physical therapy. This is an important component because it helps you adjust to your new leg, but also because it shows whether there are any issues with the prosthesis, which should be corrected immediately.
Prosthetic Leg Components
There are three main components of each below the knee prosthesis:
  • The prosthesis - made from lightweight materials and some contain ankle joints
  • The socket - molding that fits over your stump and is used to attach the prosthesis to your leg
  • Suspension - suspension is what keeps your prosthesis attached to your leg, usually bu vacuum, suction, or distal locking
What Are K-Levels and Why Are They Important?
K-levels are basically a scale that’s used to describe how well you’ll be able to use your new prosthetic limb. The scale goes from 0 to 4, and your doctor is the one who determines which level you’re at.
It’s important to note that K-levels aren’t set in stone. They can improve or worsen over time, depending on treatment and physical therapy. Here’s what each K-level represents:
  • K0 level - the patient is not suitable for prosthetics and it can’t improve their life
  • K1 level - the patient is able to use prosthetics but only on flat surfaces
  • K2 level - the patient is able to use prosthetics to overcome moderate challenges like stairs
  • K3 level - the patient is able to use prosthetics in all environments and conditions
  • K4 level - the patient is able to use prosthetics so well that it even exceeds the conventional mobility level
How to Put on a Prosthetic Leg
Putting on a prosthetic leg is tricky. It has to be fitted properly to avoid any further damage or pain. Here’s how the process usually goes:
  1. Remove the shrinker and check the stump for skin irritation.
  2. Place the sock over the stump. The seam should be in the back.
  3. Put on a liner and pull it up firmly.
  4. Make sure that there’s no gap between your stump and the liner.
  5. Hold your liner at the knee and place your stump in a prosthesis. The prosthesis should be standing upright while you do it.
  6. Push it down firmly and don’t take the pressure off until you stand up.
  7. Fold the sock over the liner and the socket.
  8. Roll the silicon sleeve up your leg.
  9. Make sure that the silicone sleeve is snugged properly and smooth out any wrinkles.
How to Care for Your Below the Knee Prosthetics
Prosthetics require regular maintenance. You should clean your prosthesis every day, without exception. Doctors recommend avoiding harsh chemicals because they can damage the prosthesis and your skin. Your prosthesis should be fully dry before putting it on.
Will Your Below the Knee Prosthetics Be Covered By Insurance?That depends on the severity of your situation, as well as your insurance plan. We recommend consulting with your insurance agent to check what is included in the deal and what’s not included.
Final Thoughts
Getting a prosthesis is a strenuous process filled with ups and downs. However, it is going to transform your life for the better. Make sure to choose a suitable prosthetic practitioner who understands and cares about your problems. They will also be a part of your journey, so compatibility is the key.
If you want more information, you can always reach us at the Align clinic. Either book a free consultation call with one of our prosthetic practitioners or stop by our offices - we have locations all over the United States.


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Everything You Need to Know About Scoliosis

12/15/2021

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Scoliosis is a very common issue in both children, adults, and the elderly. It is estimated that scoliosis affects around 2-3% of the population in the United States. Some argue that the number might be even higher since many individuals go through their lives without ever receiving a proper diagnosis.
If you’re suffering from this issue or know someone who is, this guide might be helpful. We’ll discuss different scoliosis types, as well as popular treatment options. Let’s get right in.
What Is Scoliosis?
Scoliosis is a medical condition where one’s spine has a sideway curvature. Some get it as a side symptom of other conditions such as muscular dystrophy or cerebral palsy, while others get it in early childhood.
The vast majority of scoliosis cases are mild. However, scoliosis curvatures can worsen over time, especially if not treated properly. Mild scoliosis can result in some back pain. On the down side, severe scoliosis can be seriously debilitating. Larger spine curvatures can even lead to difficulties in breathing.
Depending on the severity of the curvature, scoliosis treatment can either involve simple exercises to relieve back pain or include additional treatment like braces or surgery. Common scoliosis symptoms are:
  • Uneven shoulders
  • One shoulder blade protrudes more
  • Uneven waist or hips
  • Uneven ribs
Scoliosis Types and Levels
Scoliosis can also appear as a consequence of dealing with some other medical issues like cerebral palsy, muscular dystrophy, spina bifida, or the marfan syndrome. When we look at it as a standalone condition, we can divide it into a couple of scoliosis types:
  • Congenital scoliosis - congenital scoliosis is something that people are born with. Usually it stems from a bone malformation which results in spinal deformities.
  • Neuromuscular scoliosis - this type of scoliosis occurs when individuals suffer from medical issues that damage the body’s power to control the muscles that support the spine.
  • Idiopathic adolescent scoliosis - this scoliosis type is more common in females and, unlike congenital, it develops in adolescence.
  • Adult de novo scoliosis - this type of scoliosis happens with individuals who have never been previously diagnosed or suffered from scoliosis in the past. Hence the name ‘’newly adult scoliosis’’
  • Degenerative scoliosis - occurs in older individuals whose spine is becoming weaker due to age-related damage.
  • Traumatic scoliosis - happens as a consequence of a physical damage to the body like a car accident, or any other accident for that matter.
  • Pathological scoliosis - occurs when there are tumors near the spine, which put pressure on a spine and result in a curvature.
The severity of your scoliosis is measured by observing the angle at which your spine curves. Here’s a quick scoliosis degree chart:
  • 0-10° - no scoliosis present, no treatment required
  • 10-25° - mild scoliosis, should be observed over time, no immediate treatment required
  • 25-40° - moderate scoliosis, usually requires the patient to wear braces
  • 40-60+° - severe scoliosis, either requires a boston brace or spinal fusion surgery
Can Braces Help with Treating Scoliosis?
If you suffer from scoliosis and are interested in braces as a possible treatment option, there are some key things you should be aware of. The first and the most important is the difference between treatments that hold and correct the spine.
Holding treatments include wearing traditional scoliosis bracing or undergoing a spinal fusion surgery. These traditional methods were specifically designed to hold the spine. While these procedures are a quick and relatively easy way to fix the issue, they do come at a price. 
First and foremost, spinal surgeries are always risky and have a relatively long downtime. Secondly, having your spine held so straight can decrease its flexibility and strength. 
On the other hand, we have correction methods that include chiropractic manipulation, exercises, and therapy. These methods are great for scoliosis rehabilitation. Their downside is that they require regular treatment and exercise, which is time-consuming and potentially costly.
We also have modern corrective scoliosis braces, which are probably your most efficient and cost-effective option. Let’s learn more about them.
Scoliosis Braces for Adults
In adults, scoliosis braces are usually used for pain support and management. Depending on the level of scoliosis, different braces may be prescribed. The two most common scoliosis braces for adults are:
  • Rigid - these require a full time wear, somewhere between 16 and 23 hours every day. Can potentially lead to muscle atrophy or spine degeneration.
  • Flexible - flexible scoliosis braces are commonly used by patients who need support during sports and other physical activities.
Scoliosis Body Braces for Kids
Scoliosis braces work better for younger patients because their body hasn’t fully developed yet, and there’s time for their condition to improve or stabilize. It’s important to start early, to counteract the consequences as soon as possible. 
A cool thing about braces today is that they can be visually customized by adding stickers, jewels, and other stuff. Your kids can have some fun too by customizing it themselves.
As a general rule, we usually recommend the option for custom scoliosis braces instead of shelf-ready. Custom scoliosis brace cost might be slightly higher, but it can prevent many issues in the long run.
Customized bracing will also work with your measurements precisely, which is why the solution will be more targeted and effective. Regular braces are fitted on a model, after which it is produced and sold. Once it gets to the user, the orthotist adds pads and other elements according to your diagnosis. This may lead to potential issues and discomfort.
Either way, combined with exercise, braces are probably the most effective way to treat or stabilize scoliosis. Make sure to consult your orthodontist before making any purchasing decisions.
Final Thoughts
While scoliosis is difficult to deal with at times, it’s certainly treatable. If you wear braces to correct your posture and support your back, and combine that with exercise, you can achieve great success and pain relief.
Align clinic has some of the best orthotists in the industry and we also do scoliosis braces. If you think this might be a good treatment option, book a free consultation call with one of our experts. 
Stop by one of our many clinics across the US and find - drop us a visit to discuss possible therapy options. 
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Pediatric AFOs vs SMOs - Which One Is Better for Your Child?

12/8/2021

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Does your child have some mobility issues and you’re considering investing in a brace, but don’t really know where to start or which one to choose? We’re here to help.
As a general rule, always consult with your orthotist before making decisions based on articles and blog posts. 
However, if you’re impatient and would like to explore your options before the orthotist appointment, we’ll give you a brief rundown of the two very popular brace types - AFO and SMO ankle and foot braces.
What Is an AFO Brace?
AFO stands for ankle foot orthoses and it is a type of brace that is quite tall and usually sits just below your knee. There are many different types and use cases for an ankle foot orthosis brace. For example, they are particularly useful for children who suffer from hypertonia.
AFO braces resemble regular snow boots, except that they’re made from plastic. Depending on your particular needs, you can choose between dozens of different types, such as:
  • Hinged AFO - suitable for cases where the leg requires slightly more movement and freedom. It consists of two parts and a hinge which helps with mobilizing and stabilizing the foot.
  • Static AFO - very hard and rigid AFO brace type that’s suitable for cases where the foot or ankle have to remain completely still and movement-free.
  • Dynamic AFO - similar to static AFO, with the exception that it allows minimal movement of the foot. Also very strong and rigid.
  • Low AFO - AFOs with a lower reach, only covering the leg up to the ankle.
How to Know If My Kid Needs an AFO Brace?
There are a couple of key indicators that show whether your child is a suitable candidate for this type of ankle orthosis. Those include:
  • Hypertonia
  • Hypotonia
  • Foot, knee, and ankle instability
  • Contractures
  • Foot drop
General Tips for Using and Fitting an AFO Ankle Brace
If you’ve decided that an AFO foot ankle brace is a good fit for your child, then there are some things you should be aware of before you purchase a pair. Let’s go in-depth about important aspects of buying and wearing an AFO brace.
First, decide whether you’d like to buy an AFO brace directly from the store shelf, or if you’d like a customized pair. When you go in to buy AFO braces, the first thing to expect is customized fitting. The expert will make a cast of your kid’s ankle and foot to ensure that the fit is correct and comfortable. This part of the process lasts about 15 minutes per leg.
Most companies nowadays offer some sort of additional customization to make the brace more fun and interesting for your child. Who likes boring white braces anyways? You can add custom colors, elements, and patterns before the production process, or you can add stickers and stick-on jewels once the brace is ready.
Once it’s time for your kid to start wearing the brace, we recommend avoiding ribbed and short socks. They can cause irritation and damage the skin. Socks with seams can also cause friction issues and irritate the skin. Your best bet are plain seamless socks that reach up at least to their knees.
What Are SMO Foot Braces?
SMO ankle brace stands for supramalleolar orthoses and it is a type of brace that’s much shorter than traditional AFO braces. They are suitable for situations where your child may need a brace that allows more movement and freedom.
SMO design is very compact, but in a way that still stabilizes the foot and helps with its alignment. These braces are especially suitable for kids with pronation that is usually a consequence of lower muscle tones.
Good SMO braces shouldn’t only tackle ankle issues by propping it up. Instead, it should address other aspects like forefoot, heel, and the arch.
Because of their size, SMO braces are particularly suitable for cases where a child only has issues with their ankles and feet. If your child’s issues are more complex, you might want to consider other options or pairing the SMO brace with another device like AFO or derotation steps.
How to Know If My Kid Needs an SMO Brace?
There are a couple of key indicators that show whether your child is a suitable candidate for this type of leg support. Among others, some of them include:
  • Foot instability
  • Ankle instability
  • Hypotonia
  • Pronation 
  • Hypermobility
Can I Use Both Pediatric AFO Braces and SMO Braces?
As a general rule, you shouldn’t combine multiple braces unless it’s absolutely necessary. Less bracing is usually better, as long as your child’s condition allows it. However, in more severe cases, a combination of braces might be your best bet for success.
So yes, you can also combine AFO and SMO braces. A large number of companies even offer a combined solution where you can use both of these braces simultaneously or individually, and adjust it to your child’s daily needs.
Where Can I Get Pediatric SMO and AFO Orthotics?
The world of orthotics does seem daunting at first. With so many different options and use cases, it’s understandable to be confused and unsure as to what is your best option. Because of that, we highly recommend working with a team of orthotists to ensure that your child is taken care of properly.
Our team at Align clinic is here to help with anything you might need. Book a free consultation call with one of our experts to see whether AFO or SMO is a better option for your child. We have offices all over the United States - drop us a visit.
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San Mateo, California
700 S Claremont St
Suite #105
San Mateo, CA 94402 
Hours: 8:30-5:30 M-F
​Phone: (650) 375-2231
Fax: (650) 627-4632

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Hours: 8:30-5:30 M-F
Phone: (920) 940-5277
Fax: (844) 308-8462


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The Woodlands, TX  77380
Hours: 8:30-5:30 M-F
​Phone: (346) 770-2970
Fax: (281) 419-1615
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  • Home
  • The WCR Brace
    • Case Presentations >
      • Infantile Idiopathic Scoliosis
      • Juvenile Idiopathic Scoliosis
      • Adolescent Idiopathic Scoliosis
      • Switching to a WCR Brace
      • Adult Scoliosis Bracing
      • Neuromuscular Scoliosis
      • Treating Upper Thoracic Curves
    • Brace Articles
    • Patient Testimonials >
      • Grant's Testimonials
      • Paul's Testimonials
    • WCR Partner Testimonials
    • Grant's MS Thesis
    • Our Patients
    • Patients and Sports
    • Patients and Hobbies
    • Brace colors
    • Scoliosis Fashion
  • Locations
    • AC San Mateo, CA >
      • Inside AC SM
      • Advanced Technology
      • Stanford Children's Health Partnership
      • Local Hotels
      • Contact Us
      • Team Members
      • Our Practitioners >
        • Grant Wood
        • Paul Burnette
        • Steve Baum
        • Miguel Bustamante
    • AC Green Bay, WI >
      • Inside Wisconsin
      • Patient Testimonials
      • Contact Us
      • Emery Maloney
    • AC The Woodlands, TX
    • AC Fort Lauderdale, FL
  • Patient Resources
    • WCR Brace Clinics >
      • USA Clinics
      • China Clinics
      • Canada Clinics
      • Australia Clinics
      • WCR Brace Clinic Finder
    • WCR Certified Practitioners
    • Professional Contacts & References
    • Forms & Insurance
    • Clinical Photos and X-rays
    • Scoliosis Rehab PT, CA
    • Blog
  • Events
    • Brace Clinic Calendar
    • Sosort 2022 - San Sebastian, Spain
    • Past Events >
      • Advancements in Conservative Treatment of Scoliosis 2018 >
        • Award for Advancements in the Conservative Treatment of Scoliosis
      • Past USA WCR Clinics and Conferences
      • Advancements in Conservative Treatment Of Scoliosis 2017
      • Shanghai Clinic
      • AAOP Meetings
      • BSPTS Schroth PT Training
    • Past SOSORT Conferences >
      • sosort2019 San Francisco - CA
      • SOSORT2018 Dubrovnik/Croatia
      • SOSORT2017 Lyon/France
      • SOSORT2016 Canada
    • Northeast Region Re-Align Clinic
  • Services
    • Scoliosis & Spine Online Learning
    • Prosthetics
    • Orthotics >
      • Pediatric Orthotics
      • WalkAide
      • Cranial Remolding Band
  • Hope's Embrace® Undershirts
  • Wall Grids
  • WCR Brace Fitting Evaluation
  • For PTs/Orthotists
  • WCR Measurement Order Form
  • Masterclass Conferences
  • Careers
    • Cert Orthotist - San Mateo CA
    • Cert Orthotist - Florida
    • Orthotic Lab Technician