AFO Challenge/ROM Issue/Change Angle PT Request

The patient was seen today for adjustments to her bilateral solid-ankle AFOs with anterior panels. She continues to have problems on the left AFO. The right solid-ankle AFO is not causing any skin problems, but on the left over the medial malleolus it is still causing problems. The front panel was padded with Aliplast and flared at the problem area. She was given more room medially. She is still unable to get her heel all the way back. Therefore, 2 calcaneal pads were added on each brace to try to hold the heel down. After the adjustments were made, I applied the braces. She wore them for 20 minutes. I checked for redness. The right brace is fine. She continued to have redness on the left and I added a third strap on the left to even the pressure. She wore the brace for an additional 10 minutes. I rechecked the brace and everything looked much better. I told mom to allow the patient to wear the brace for 1 more hour today. She has had this brace on for 2 hours currently. Tomorrow she may wear the left brace for 3 hours, the following day 4 hours, the following day 5 hours working back up to 8 hours. On the right, she is not having any problems and her mother will allow her to wear it for 8 hours. I told her to return if there are any further problems. We may have to remake the left brace depending if she continues to get pressure in that area. We will change the angle slightly. She is set at 90 degrees, and this was per the therapist's request. The patient continues to be a challenge on that side due to the lack of range of motion, in my opinion. I believe this is from where the difficulty is caused. This patient will be seen as needed.