Width of bar

[Guest guest]

Hi All,

From time to time here, it has come up that a common error of some

orthotists is to put babies in braces whose bars are too short. It's

a problem, because babies whose feet are too close together not only

are uncomfortable but are more likely to slip out of the shoes, and

have problems, such as interrupted sleep, etc. For the same reason,

as the babies grow, the bar needs to be widened, to keep the feet at

shoulder width apart, to keep them comfortable.

I have heard it said, in fact, that it's better to have the bar too

wide than too short. Based on something we went through recently,

however, I'm not so sure that that is the case. I think, actually,

that the width needs to be 'just right.' (A recent conversation with

Joanne prompted me to refocus on this, so I thought I might share it

here, while the measurements and thoughts are fresh!)

Claire is almost 4 years old, and wears a size 9 1/2 in regular

shoes. A few months ago, she got new size 8 Markell shoes. I put them

on the brace, and widened the bar a tiny bit, thinking that I needed

to. With a few days, however, she started complaining, and saying

that her non-clubfoot hip and upper part of her leg was hurting. I

was puzzled, but finally, I figured it might be related to my

widening her bar. I moved it back to the way it was before, and

within a day or so, she was fine again. I was amazed what a big

difference a tiny adjustment made.

Soon thereafter, we went to Iowa for a checkup, and Dr. Morcuende

noted that her bar was STILL too wide, and had it shortened a bit

more.

So now, the measurement between the inside edges of the heels of her

brace shoes is about 9 inches. Her shoulders measure about 10 inches

edge to edge, maybe a little more. Her bar width, from the edge of

the big screw to edge of the other big screw is 14 inches. She has

the two-piece adjustable red bar, and there's still 3 inches of

overlap.

If I hold the brace up to her shoulders, the heels of her shoes sit

on top of the edges of her shoulders. The shoulders can't fit within

them.

Maybe the proper setting depends on the kid, on the case, I don't

know, but I just wanted to relate that, in our case at least, a too

wide bar wasn't a good thing either.

(I have a theory about why a too wide bar was bothering only her non-

clubfoot leg, but won't bother you all with the details unless

someone wants to hear it!)

I do wish that all parents had more support from their doctors and

orthotists about the brace. I'm not sure many doctors check out the

brace during follow-up checkups, when obviously it's so important,

and such a big issue of continuing concern for parents.

Just passing this along, in hopes it might help someone.

and Claire