Charcot-Marie-Tooth disease (CMT) is named after the three doctors who first described the disease in 1886: Jean-Martin Charcot (shar-coh), Pierre Marie, and Howard Henry Tooth. Today, CMT refers to any peripheral neuropathy with a genetic cause, whether or not the specific genetic mutation is known.
CMT is a rare multisystem, multiorgan disease that causes lifelong, progressive symptoms, including muscle weakness and atrophy in the arms and legs, sensory loss, and other complications. These changes can lead to challenges like high arches, hammertoes, and foot drop, increasing the risk of pain, pressure sores, and balance issues. When needed, proper ankle-foot orthoses (AFOs) are essential for managing these challenges, preserving mobility, and preventing complications.
Bracing and AFOs for Individuals with CMT
CMT can impact mobility, balance, and confidence in movement. One of the most effective ways to address these challenges is with AFOs. Understanding when and why braces may be needed and selecting the right type can help improve overall quality of life.
Do You Need Braces?
AFOs can help if you experience any of the following:
- Foot Slap – An audible slapping sound when walking due to weakness in the dorsiflexor muscles (the muscles that lift the front of the foot).
- Foot Drop – Weakness in the muscles that lift the front of the foot, causing difficulty clearing the ground and leading to toe dragging or tripping.
- Lateral Ankle Instability – Weakness in the evertor muscles (the muscles used to turn the foot outward), leading to chronic ankle sprains or difficulty walking on uneven terrain.
- Poor Balance – Frequent reliance on objects for stability while walking or difficulty maintaining confidence when not looking downward.
- Fatigue – Struggling to push off the ground while walking due to weakness in the plantar flexors (the muscles that help propel you forward), leading to slower steps and increased effort.
What to Expect from AFOs
A well-fitted AFO should:
- Support foot and ankle alignment for better weight distribution.
- Correct foot drop and ankle instability.
- Restore a natural heel-to-toe gait pattern.
- Improve balance and reduce reliance on downward gaze.
- Enhance propulsion and walking speed while reducing fatigue.
- Be comfortable, lightweight, and easy to put on and take off daily.
- Increase confidence in movement and daily activities.
- Align with your personal mobility goals—clear expectations help ensure you and your provider choose the most effective AFO for your needs.
Choosing the Right AFO
Selecting the right AFO depends on your specific mobility needs:
- Foot Slap – Needs dorsiflexion support.
- Foot Drop – Needs support to lift the foot and prevent toe dragging.
- Lateral Ankle Instability – Needs stabilization features.
- Difficulty Walking on Heels – Needs forward propulsion support.
- Mild to Moderate Balance Issues – Needs support to improve foot position awareness (proprioception) and stability.
- Severe Balance Problems – Needs maximum stability and full-contact support.
Because AFOs must meet mechanical needs and be practical for daily use, working closely with your provider to establish clear goals can make all the difference.
AFOs Based on Ankle Stability
- For Flexible Ankle Instability:
- Dynamic Carbon or Ground Reaction AFOs provide support while allowing controlled movement.
- For Rigid Ankle Instability:
- Custom Thermoplastic Solid Ankle AFOs with a total-contact flexible inner boot offer maximum stability and comfort.
Regaining Confidence in Movement
AFOs provide stability, support, and control, helping to create predictable and consistent foot placement. By reducing the need for constant visual monitoring, AFOs allow for more natural movement and greater independence. With time and the right fit, walking with AFOs becomes second nature, helping individuals move with greater confidence and ease in daily life.
Explore More: CMTA Bracing Webinars and Conferences
Watch expert-led discussions and presentations on AFOs, bracing solutions, and real-world strategies for empowering mobility:
- Bracing Education and Solutions for CMT: Watch Here
- Boston Summit Bracing Session: Watch Here
By choosing the right AFOs, individuals with CMT can enhance mobility, reduce fatigue, and regain confidence in their daily lives. The right AFO should feel like an extension of yourself and not a hindrance.
Take the Next Step Toward Empowering Mobility and Confidence
The right AFO can make a meaningful difference in maintaining mobility, reducing fatigue, and improving confidence in daily life. Working with a knowledgeable provider to establish clear goals ensures your bracing solution is tailored to your needs.
CMTA Centers of Excellence provide expert care from specialists who understand the complexities of CMT. Visit the CMTA Center of Excellence directory to find a provider near you and take the next step in optimizing your mobility.
