Spasticity and Splints (Part 1)

A couple of years ago, I saw an image of a girl wearing a pair of AFO splints with the caption “If you give a girl the right pair of shoes, she can conquer the world”. I didn’t think much of it until my recent issues with my splints.

I can walk without splints but not long distances because I get tired easily when I have no support to control my movements, so I wear splints on my legs called Ankle-Foot Orthoses, also known as splints, but there are many types of splints. You can get splints that support your knee, ankle and foot (called KAFOs), splints that support your hip, splints to support your hand and arm… The list goes on.

I used to go to a clinic in a local medical centre in Gosport, but now I have to go all the way to Portsmouth. This wouldn’t be so bad if they got it right the first time, but these last few months, I have been back and forth, having two new pairs of splints, and neither of them have fitted. (They should last a good few years if you have stopped growing, which I have.)

For as long as I can remember, I have had AFOs to keep my foot in a better position, especially when I walk. AFOs are made from plaster casts of the user’s feet. If you have ever broken a bone in your leg, it is a similar process to get new AFOs… You get plastered, but not by alcohol. I’ve always hated the feeling of being plastered for splints because of the sensation of the plaster getting warmer as it sets. I can’t actually describe the feeling, but I remember crying every time I had it done when I was young. I still detest having it done, but I can just about handle it now. The worst parts are having to sit still while the cast warms and sets and then taking the mould off my leg.

Since I’ve got older, they have put cling film on my leg and foot to stop the plaster from sticking to my leg. I’m not keen on this feeling either, but I suppose it’s better than having plaster stuck to your leg...

Let me walk you through the process… First of all, the cling film goes on and the Orthotist smooths it out to make sure that there are no big bumps because this could affect the mould of my leg.

Then they put a stocking on my leg, and they put a long piece of rubber inside the stocking, at the front of my leg. This prevents them from cutting my skin when they cut the plaster off my leg. They wet the bandage and wrap it around my foot and leg all the way up to just below my knee. They smooth it out and hold my leg in a good position until the plaster hardens off – this takes between two to three minutes, but it seems like a lot longer. They draw small markings on the cast to highlight where all the “bony bits” are so they can include them in the splints to have a replica of your foot. Or that’s the idea anyway...

Finally, they cut the plaster cast off my leg with a special pair of scissors. These scissors can’t cut into my skin because of their shape. They double-check the mould to see if it looks ok, and to check for weak points. Sometimes they touch up the pencil marks.

I’m not quite sure what the process is between casting and getting the splints, but I believe that they cover the moulds in plastic and put them in a kiln to melt the plastic onto the moulds. That seems logical, doesn’t it? It usually takes about eight weeks for the splints to be made, and then I have to go back to the hospital to get them fitted.