Getting the right brace can make a major impact on your life
—but it’s not a one step process

Generally a custom-made brace will undergo various alterations and adjustments. You can count on us for ongoing support on all stages of your journey, from the first fitting to figuring out all the paper work, to the final fine-tuning and follow up.

1. A visit with your health care professional

You can’t just walk in off the street and get a custom-made brace. Because an orthotic device is a medically-necessary treatment for a foot or lower leg condition, you will need a prescription from a doctor or nurse practitioner. Once we have that, we will do a thorough assessment to determine what kind of brace is right for you. We call this a Biomechanical evaluation.

An evaluation generally entails:

• Asking detailed questions pertaining to your injury or condition

• Reviewing your diagnosis, medical history, lifestyle and typical footwear

• Determining what goals you have for your orthotic treatment

• Performing a full biomechanical assessment, which includes assessing joint range of motion, muscle strength and gait analysis (a study of the way you walk). Often at Boundless, these occur in a mult-disciplinary setting either at Erinoakkids Centre for Treatment and Development or Sunnybrooke Hospital among others.

• Following the evaluation, we will take a 3-D cast of your limb. This is an essential part of the process because it gives us the exact shape for making the brace.

Here are some tips for your initial evaluation:

• Bring along your written prescription or a signed Assistive Devices Program (ADP) form, OHIP card and any test results you might have. (X-ray, MRI, etc.)

• Make sure you know your insurance information—e.g., what specific coverage does your policy have for assistive devices such as braces and splints, etc.?

• Wear shorts or loose fitting pants

• Wear the shoes you most commonly wear on a day-to-day basis. We want to see you walking in them to evaluate your gait. Keep in mind that you will likely need to go up a shoe size when it comes time to fit your brace.

• If you have edema (lower leg swelling) try to see us in the afternoon when the swelling is the worst

• Bring current and previous devices if you have any. This will help us evaluate what worked and what could be improved.

 3. Your input goes into every design

Based on our evaluation with you, your funding and affordability,  we’ll discuss the best orthotic options for you. We consider your input and feedback throughout the process. 

This includes:
Showing your creative side with a coloured transfer. Selecting a decal to represent your favourite sports team. Adding air holes to increase ventilation. Discussing the direction or pull of your straps. Adding ring loops to your straps to make them easier to pull. Adding cushioned foot liners. Adding soiling for braces that are only to be worn indoors. Asking for a strap extension on velcro shoes (usually done on children’s shoes so they can be done up around the brace.)

From there, we’ll create your orthotic in our on-site fabrication lab. Each device is unique, and is made to fit you and only you. 

In some cases, we may recommend a ready-made brace. Once again it will be fine-tuned to your specific biomechanical and lifestyle needs.

 4. Fitting—making it your own

Most devices are ready 2 to 4 weeks after your evaluation. When it’s ready, we’ll schedule a fitting to make sure it’s comfortable, functions properly and fits you and your footwear. Again, this will likely involve a gait analysis, watching how you walk in your new orthosis. If it needs an adjustment, we do that while you wait.  

5. Breaking in your brace

Using your brace in the real world can take some getting used to. Most people will need a break-in period. That is why we recommend wearing it occasionally during the first week and increasing that to more frequent and longer periods in the upcoming weeks. 

Don’t be concerned if light red marks appear on your skin after you are fitted for a new orthotic device. They should disappear 30 minutes after you take if off. If, however, they linger longer than 30 minutes then you may be at risk for skin breakdown, including blisters and callouses. In this case your brace/orthosis should be adjusted by your Orthotist.

6. Follow-up is key to your long-term success with your orthotic device

Along with re-evaluating it for proper fit and function, it allows us to re-assess your treatment goals.
Were you able to meet the challenges you set out for yourself? Are you ready to take on new ones? Generally we pre-schedule follow-up appointments, or you can call in to make an appointment with your Orthotic Technician as desired.