Custom Orthotics & Braces in Mumbai

Where control is needed at the hip as well as the knee and ankle, the next step up from a KAFO is an HKAFO — hip knee ankle foot orthosis — which extends to a pelvic section.

These are prescribed selectively. They control more, which also means more weight, more bulk and more effort to put on and take off, so they are used where the alternative would not hold. Reciprocating gait orthoses fall into this group. Fitting takes longer than for a KAFO and needs more review appointments.

Foot drop — being unable to lift the front of the foot during a step — is one of the most common reasons people are sent to us. The toes catch on the floor, which is both a trip risk and exhausting to compensate for.

It is a symptom rather than a diagnosis, and the cause matters: it may follow a stroke, a peroneal nerve injury, a disc problem, or a neurological condition. Bracing addresses the mechanical consequence while the cause is managed by your medical team.

The usual device is an ankle foot orthosis. Which type depends on whether the ankle is flexible or stiff, how much control is needed, and what footwear you need to wear it with:

• Flexible or posterior leaf spring AFO — lifts the foot during swing while allowing some ankle movement
• Rigid AFO — where more control is needed, or where the ankle also rolls inward or outward
• Articulated AFO — a hinge allowing controlled movement in one direction
• Carbon fibre AFO — lighter and more responsive where that suits the user. See orthotic innovations

Footwear matters more than most people expect: a brace needs a shoe with depth and a removable insole, and shoes should be bought with the brace on. See how to choose orthopedic shoes.

1. Understanding the problem. What the brace needs to achieve — support, control, protection, or preventing a deformity worsening — and what you have been told by the clinician who referred you.
2. Physical assessment. Joint range, muscle strength, skin condition, deformity and whether it is correctable, and how you walk or use the limb now.
3. Casting or measurement. Custom orthoses are made to a cast or scan. Off-the-shelf options are sized and fitted.
4. Fitting. The device is fitted and adjusted, and we check it against the footwear you will actually wear.
5. Wearing-in. You build up wearing time gradually rather than going straight to full days.
6. Review. Essential for children, who outgrow braces. See pediatric orthotics.

One thing worth knowing before you start: red marks that fade within about twenty minutes of taking a brace off are normal. Marks that persist, or any blister or broken skin, mean the fit needs attention — that is a fitting problem to bring back to us, not something to put up with.