Fast forward six months post-stroke to last January. His ankle muscles still hadn't returned but now he had the added issue of excessive tone. The tightness was causing his ankle to roll to the outside of his foot. He did six weeks of serial casting to try and increase range of motion for his ankle. Afterwards, he was fit for a new brace. It was a softer plastic around his foot and offered more support for the ankle (it's pictured on the right.)
Now here we are a year later. While his range of motion in the ankle continues to improve, he is still dealing with the excessive tone. He got botox back in October which helped quite a bit but wore off in about three months. While the ankle continues to roll to the outside, it's taking his knee with it. His PT has been very concerned about the pressure and stress this is putting on his knee and what that could mean down the road. If you've seen him walk, it's almost like his knee gives out a little as he takes a step and is pointed about 10-15 degrees to the left instead of straight ahead. She came up with the idea to put him in a full leg brace which is pictured on the left. It's pretty massive and goes high up on his thigh. It's got metal rods going down each side of the leg which force the knee to point straight ahead. The nice thing about this one is the top part can be removed and he is left with a brace very similar to what he had before below the knee. It offers a little more support for the outside ankle too.
He was excited about the idea of the brace since it was supposed to help him walk better. When we went to pick it up and he saw it, you could see the shock on his face. Neither of us quite realized how big the brace was going to be. He said to me in the car on the way home that he doesn't understand why his braces keep getting bigger, they should be getting smaller. In retrospect, I wonder the same thing, but there was no way to know at the time how long it would take his ankle to recover. He was also really worried it was going to show under his pants and what it's going to look like when he wears shorts this summer. He got a lot of questions at the beginning of school about his brace and now figures he'll get more. Luckily it doesn't really show under his jeans so that made him feel a little better. The good thing is the brace seems to be helping, we've really noticed an improvement in his walking. Having his knee properly aligned caused him some pain those first few days, but that has gone away. The idea is that his leg will stay in proper alignment after some time due to muscle memory. At this point, we're just taking it one day at a time and are grateful he's got it.
