Brace Adjustment/Prescribing by a Podiatrist
Question: I have a new problem. I went to my foot doctor to have my nails cut. My second toe (on my leg with my AFO), was burning to the point it was hard to walk due to pain. He was dumbfounded when I had a blood blister on one of my hammer toes. Like "how did that happen?" He said it was friction then he evaluated and prescribed changes to my brace because I walk on the tip where the blister is. It’s come back again. The whole toe feels like fire. I think I use my toes for walking and balance a lot more than before.
Dr. Bruno’s Response: I don't like podiatrists prescribing polio survivors' braces. If you have a PPS rehabilitation doc, let them evaluate the brace. It sounds like it's too short. Typically, polio survivors have great circulation, actually it’s too good since they radiate body heat from their wide-open arteries and veins. But this sounds like a friction issue, not a blood flow problem.
Second Question that applies to the first: My toe is a hammer toe (so is my third toe). They both raise up and curl under, so I have a callus build up and a blood blister on one toe. My brace has a cut-out area in the plastic & only have cushion under the hammer toes. I think its friction too, but what do I do to prevent it? I'm hoping it isn't going to my scooter full time. I feel like a wee-bo wobble and fall down toy. I'll make an appt with my PPS rehab physician who prescribed my brace and podiatrist today.
Dr. Bruno’s Response: It looks like they have to rethink and maybe widen the cutout and cushioning under the brace/toe. You may have too much cushion or it's in the wrong place and pushing your toes together or against the shoe. There are open toe box shoes (shoes with a bigger space up front) that might reduce friction for you. Also you might benefit from a simple cushion to separate the toes.
I hope this helps.