Wednesday, December 28, 2011

The story of how I got back up!

After 800 miles of training over 16 weeks—which translates into thousands of foot strikes consuming two pairs of running shoes—I was finally ready for the Boston Marathon. This race takes everything a good runner possesses, no matter how well trained. Even Lance Armstrong says it’s tough. And Armstrong never ran Boston wearing an AFO. But I have, twice.

That’s me in the picture, crossing the finish line in 2008 despite a hamstring injury that happened during a fall at mile 16, wearing a big grin and my ToeOFF!

To complete the picture, you should know what else I was wearing. Most runners run with mettle. I run with metal. This is the story of how I returned to Boston, despite major spinal surgery and permanent foot paralysis.

I’ve been involved in many sports, including running, gymnastics, tennis, and soccer, since I was a child. In 2001, I turned my focus to distance running and ran my first marathon in Chicago that year. My finishing time of 3:44:34 qualified me for the Boston Marathon, which I ran in 2002 and 2003. Throughout my life, I had always suffered back pain, yet was somewhat habituated to this pain, thinking it was "normal." One spring evening in 2004, however, the pain intensified to an unbearable peak, and I collapsed on my kitchen floor. Later, the neurosurgeon who operated on me described "a perfect storm" of spinal defects, including spina bifida occulta, spondylolisthesis, conjoined nerve roots, and ruptured L3-L4/L4-L5 discs. In addition to performing the discectomies, the neurosurgeon implanted cages, rods, and screws in my back.

I experienced some leg weakness prior to surgery, but after the surgery, I could not lift my forefoot. The surgeon said it might resolve over the next year, but it didn’t, so in addition to the back brace I had to wear, I was also fitted with a custom-fabricated AFO. What a lovely, sporty look.

During the six months following surgery, I focused on learning to walk again, first with a walker, then two canes, then one cane, and finally just with the AFO. When I was cleared by my neurosurgeon for more intense exercise, I set my sights on returning to the activity I loved—running.

Slowly, I resumed walking the trails and began tentative, painful, jogging. The AFO was clumsy and bulky and often left me raw and bloodied after running. My orthotists worked tirelessly to trim, file, and pad my AFO, but nothing seemed to help. I spent a lot of my own money on a custom-fabricated articulating brace hoping this would ease the pain, but this was an expensive failure.

I couldn’t help but think that there must be something better for an athlete with foot drop. For 18 months, I searched the Internet while painfully continuing my training in my original AFO. My orthotist continued to assist me; he was as determined as I was and kept making modifications and seeking solutions.

Trying every search option on the Internet, I searched "foot drop and running," "drop foot," and "running with an AFO." Finally, the prize! I discovered an article on OANDP-L, the O&P listserv, that had nothing to do with running but did offer me an international forum of professionals. I posted this plea on April 19, 2006, inquiring whether anyone could help me return to the Boston marathon:

"Under my neurosurgeon’s supervision, I have been slowly increasing my mileage and feel terrific—except for pain, blisters, and hotspots on my foot caused by running with my AFO. I alternate my rigid AFO with an articulating AFO, but both are extremely clunky and do not lend themselves to comfortable running. I have to wear a larger running shoe on my left foot to accommodate the brace, but even with that the ‘fit’ is poor. I recently completed a half-marathon and am actually quite close to the finishing times I posted before my injuries—the only thing stopping me from stepping up the training and entering a qualifying full marathon is the foot pain. Is there a less ‘primitive’ orthotic that works well for runners? Maybe a shoe and brace all-in-one? No combination of orthotic, padding, moleskin, callus cushions, socks, or shoes has worked for me yet; I continue to get new blisters in places that didn’t blister weeks ago, and the sharp pain in the ball of my foot is present with almost every stride.
Thank you,
Beth Deloria, AFO wearer and 2002, 2003 Boston Marathoner"

I immediately received more than 70 replies from the O&P community. Many of them were from suppliers of various AFOs. This message caught my eye:

"Hi Beth,
I work for a company named ALLARD USA. We are a subsidiary of a company based in Sweden that manufactures a product called ToeOFF. ToeOFF is a carbon composite dynamic response floor reaction AFO. If you are game, we are game to have you give our product a try. This product does require fitting by an orthotist. We are willing to provide the product in exchange for advertising support if the product works for you.

Carol Hiemstra-Paez
Allard USA, Inc. ... Your O&P Partner!"

Carol confessed she was unaware of marathon runners wearing ToeOFF, but she was confident I should try it. I received free samples from Allard as well as several other suppliers, and my orthotist fitted each of them. I quickly chose the one that helped me function without pain, and it was Allard’s ToeOFF. The orthotist fabricated a custom foot orthotic to go on top of the footplate—it was working!

My first ToeOFF broke when I tested it running greater distances. After consulting with Carol and Allard’s on-staff orthotist, Bob Meier, CO, my orthotist adjusted the custom insole, and it held. I recognized I had to modify my running pattern to reduce stress on the strut. My next ToeOFF endured more than 800 training miles!

Two and a half years after surgery, I was back in Chicago attempting my first marathon with foot drop. On October 22, 2006, I turned to the starting line and broke down crying—it was a long road back. I finished the race that day with a personal-best time of 3:39:26—qualifying for the Boston Marathon!
Now I have marathoned time and again thanks to Allard USA and the wisdom and perseverance of clinicians like Michael Bissell, CPO, of Advanced P & O, Greensboro/Winston Salem, North Carolina. ToeOFF is the only thing on the market that keeps me running, despite having permanent foot drop, and I’m grateful to all the people who’ve made this possible.

My request to O&P professionals is this: Prosthetics and orthotics are a trial-and-error process, straining the patience of all involved. Yet, orthotics improve with the feedback of the professionals and the patients who test them in their daily lives. I had wonderful professionals advising me, yet sheer persistence and chance led me to Allard USA. Allard’s ToeOff enabled me to resume competition and a fuller life. Even the slightest possibility that a new device might restore a patient’s life’s passion is worth exploring. Please share information about all products and possibilities—your patients may wish to join me on the road in 2012 at one of the Rock 'n' Roll marathons!  First stop, Phoenix.

For more information on ToeOFF, visit