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Bracing Therapy

The Firefly Foot and Ankle Clinics are the first clinics in the UK and Ireland to offer podiatric bracing with the Richie Brace. With that comes a higher level of experience and knowledge in the non-operative treatment of foot and ankle pathologies.

The Richie Brace Ankle Foot Orthotic

The Richie Brace is an Ankle Foot Orthoses (AFO). An AFO is a brace, usually made of plastic, that is worn on the lower leg and foot to support the ankle and hold the foot and ankle in the correct position. It is used to treat a wide variety of foot and ankle pathologies such as Drop Foot, Posterior Tibialis Tendon Dysfunction, Chronic Ankle Instability, Ankle and Subtalar Degenerative Joint Disease and many other ankle injuries.

The lightweight construction and low-profile design features of the Richie Brace allows better shoe fit, more freedom of movement and reduced pain from injury. Many of our patients can eventually recover and discontinue wearing their brace.

It was originally developed for those patients who have end stage foot and ankle pathology and are not surgical candidates. The Richie Brace has been proven to give quality of life back to this patient group.

The brace is fabricated from an impression cast taken from the patient's foot and lower leg by the podiatrist. 

The Richie Brace is a revolutionary alternative to traditional ankle braces and ankle-foot orthoses (AFO's).  

Frequently Treated Pathologies

Adult Acquired Flat Foot-

This is a painful flatfoot condition which affects adults, primarily over the age of 50. Also known as Posterior Tibialis Tendon Dysfunction. Most people with Adult Acquired Foot have had flat feet all their lives. Then, for reasons not fully understood, one foot starts to become painful and more deformed.

Adult Acquired Flat Foot begins with a gradual stretching and loss of strength of the posterior tibial tendon which is the most important tendon supporting the arch of the human foot. Left untreated, this tendon will continue to lengthen and eventually rupture, leading to a progressive visible collapse of the arch of the foot. In the early stages, patients with Adult Acquired Flat Foot will notice a pain and swelling along the inner ankle and arch. Many times, they are diagnosed with “tendonitis” of the inner ankle. If the foot and ankle are not properly supported during this early phase, the posterior tibial tendon can rupture, and devastating consequences will occur to the foot and ankle structure. Eventually, significant arthritis can occur in the joints of the foot, the ankle and even the knee.

Foot Drop-

Foot Drop or “drop foot” is a condition where a person has difficulty lifting the front part of the foot. This is especially obvious during the swing phase of gait. If you have foot drop, you will tend to drag your toes across the ground during walking. You may compensate for this problem by lifting your knee or hip higher. In mild cases of foot drop, you will hear and feel your foot “slap” on the ground during walking

Foot drop is a sign of an underlying problem with nerves or muscles and can be the first indication of a serious medical problem. When foot drop is discovered, medical evaluation is recommended immediately to determine the underlying cause. Foot drop or drop foot can be very effectively treated with the Richie Brace®.

Degenerative Joint Disease of the Ankle and Subtalar-

Ankle arthritis is a debilitating condition that causes pain along with decreased function and quality of life. While there is no cure for this pathology, in which the cartilage is progressively lost in​ the ankle joint, many recent discoveries, including total ankle replacement, seem to be paving the way for a brighter future for patients. Arthritis of the subtalar joint refers to a degenerative condition of the articular cartilage in the joint that accounts for a large portion of the inversion and eversion range of motion of the hindfoot.

Chronic Ankle Instability-

Chronic ankle instability is a pathology that affects all age groups. This multifactorial condition can be debilitating for active individuals and athletes, but can also severely limit activities of more sedentary persons. The pathology typically involves the lateral ankle, and can occur to varying degrees of severity. Lateral ankle instability originates from a hypermobile and unstable ankle with a history of lateral ankle ligament disruption. This instability leaves the ankle susceptible to further injury.

Charcot Deformity-

Charcot Arthropathy is the progressive destruction of the foot. It is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking, the foot eventually changes shape. While diabetic neuropathy is the most frequent cause of Charcot deformity, other causes include syringomyelia, alcoholism, chemotherapy-induced neuropathy, syphilis, and multiple sclerosis. This results in an inflammatory response that can lead to bone resorption and potential deformity of the foot.

Frequently Asked Questions

Will this save me from surgery or just delay it?

For Posterior Tibial Tendon Dysfunction (Adult Acquired Flatfoot) studies have shown that at least 50% of patients can avoid surgery by wearing a custom AFO device such as the Richie Brace®. Wearing the Richie Brace after ankle sprains and other foot injuries will support the foot and ankle, allowing for faster healing times.

Should I use one on each foot to make my gait equal on both sides? As a preventative measure?

Most Richie Brace® prescriptions are for one foot only although some conditions require bilateral (both feet) braces. When only one foot is wearing the brace, the other foot should be supported with either a foot orthotic or a heel lift of similar height as the Richie Brace®.

If I get casted for this brace how long does it take to be manufactured?

It takes four to five weeks from the time of casting of the patient for the finished custom Richie Brace to be ready for your fitting appointment. We will book your fitting appointment following your casting.

As part of the treatment how often will I be reviewed?

It depends on the pathology but once fitted with a Richie Brace you will be followed up for your first review in the first 6-8 weeks. However, if there are any questions or concerns, contact our clinic and we will make your review appointment sooner.

“My ankles just feel a little unstable during sports. Should I use the Richie brace as a preventative measure? For added support? Protection?”

Studies have shown that bracing can be very effective in preventing ankle sprains, ankle strains and other foot and ankle injuries, especially in sports such as basketball, football and soccer.

Can the Richie Brace® be used for sports activity?

The Richie Brace® was originally designed for sports applications. Still today, there is no ankle brace that fits or functions properly with a custom foot orthotic footbed inside an athletic shoe except the Richie Brace. Moreover, most popular ankle braces do not fit in shoes well and do not support the foot. Thus, the Richie Brace® was born: a form fitted custom ankle brace that incorporates a foot orthotic. This brace is ideally suited to treat lateral ankle instability, tendon injuries around the ankle joint, and aid in recovery from Grade II and III ankle ligamentous injuries. The Richie Brace® has been used by many collegiate, professional and Olympic athletes with remarkable success.

I have tried other braces and had a lot of skin irritation. What can I expect from a Richie brace?

The Richie Brace® is probably the most comfortable custom ankle-foot orthosis on the market today. Occasionally, patients will develop a “hot spot” or skin irritation around the ankles which can be quickly remedied with a modification. Just ring for a review and we will be able to fix the area of irritation in our Lab in Sligo.

How long will I need to be in the Richie brace?

For some conditions such as Adult Acquired Flat Foot, the average length of brace use is approximately one year. For other conditions such as drop foot, the brace will be worn for a lifetime. Other conditions such as ankle/subtalar arthritis will vary in the length of time of brace use from a few months to several years. We will continue to review you throughout your pathology and advice on your continued wear of the Richie Brace. The Richie Brace is durable and easily reconditioned for long term use. 

Do I need to buy new shoes in a bigger size?

No, the unique advantage of the Richie Brace® compared to other custom AFO devices is the fact that this brace does not require an increase in shoe size. This holds true for any appropriate shoe style which has a removable liner. By removing the liner, there is plenty of room to insert the Richie Brace® without compromising fit. We will advise you on suitable footwear for the brace before taking a cast. We will also ensure during your fitting appointment that the Brace fits your shoes. 

Is the Richie Brace® difficult to put on and take off?

No, the unique strap closure system of the Richie Brace® products allows simple application compared to other AFO devices. Basically, a single back strap must be opened and closed when fitting the Richie Brace®. For people who have difficulty feeding the back strap thru the slot in the limb upright, a modification is available which provides a long strap which is wrapped around the lower leg. We will provide videos, written instruction, and a demonstration on fitting to ensure you can put the brace on and take it off.

My velcro straps are worn out can I order these from you? - My padding is worn out, how do I get new padding?

We will be able to replace any part of the Richie Brace that is worn out from wear. Just contact our clinic for a review appointment and bring in your brace.