Carol’s new socket saved her from surgery!

After many years of living with pain and limited mobility, Carol came to George for a second opinion.

George and Carol first met in May of 2021. She lives with Bilateral Symes Amputations and was experiencing significant knee pain. Doctors were recommending bilateral knee replacement surgery to possibly ease her pain and she was hesitant.

Prosthetic solutions for increased mobility.

George observed that Carol’s pain was exacerbated by the alignment of her bi-lateral Symes prostheses and the knee flexion contractures she had developed. The construction of new sockets with the correct alignment enabled Carol to have her foot flat on the ground. She now has added stability while ambulating and has less pain in her knees. Over approximately 10 appointments with George that included measurements, adaptations and adjustments, she was satisfied with the fit and function and was able to take her prostheses home.

It took her whole life to find the help she needed.

Congenital amputees are one of the most difficult population of patients to work with. A prosthetist needs the experience to recognize that the anatomy in regard to bone structure, nerve innervation, muscular presence and function is often abnormal. As lifelong amputees, congenital patients are very tuned in to how they feel their prosthesis should function, and it is our job to help them reach those goals with the proper device.

Learn more about Practitioner George and his congenital limb experience.

View on YouTube

Resources and Reading for Congenital Limb Patients and Families

Syme Amputation, what is it?

https://www.footcaremd.org/conditions-treatments/injections-and-other-treatments/syme-amputation

Why some people choose not to wear a prosthesis:

https://www.armdynamics.com/upper-limb-library/why-do-some-people-choose-not-to-wear-a-prosthesis

Congenital Differences resources – blogs – podcasts

National and state resources:

https://new-horizons.org/cmtamp.html

Parents of children with limb loss resources:

https://www.armdynamics.com/upper-limb-library/resources-for-parents-of-children-with-upper-limb-differences-or-limb-loss

Lucky Fin Project (kids):

Pediatric Upper Extremity Prosthesis, A Mother’s Testimonial

When treating pediatric prosthetic patients, working with the family ensures patient success.

Pediatric Upper Extremity Prosthesis

Colin’s Mom expressed her thanks: “It always seemed that George presented a wealth of information regarding the options for my son’s care — with the goal of helping my husband and I decide what would be best for our son as well as practical for our lifestyle.” Maria Haugseth, Sacramento, CA

Colin needed to be fit for his first prosthesis. His long-term treatment plan was developed with his team of caregivers and his mom. Colin was treated by George Villarruel, one of our pediatric and upper extremity prosthetic specialist practitioners. He customized the prosthesis and educated Colin and his mom over a period of about a year during treatment.

Colin’s Mom was with him every step of the way and she deserves a lot of credit for her positive outlook and supportive encouragement. Over the many visits and with a lot of hard work, Colin is now successfully doing more activities with his new arm prosthesis and is not letting anything hold him back.

Colin is ecstatic to be riding his bike!

With the support of his family, and a prosthetic device from Collier O and P, Colin is ready to tackle his next goal.

Our Pediatric Prosthetic Care Specialists

  • Extensive experience working with pediatric patients
  • Veterans are welcome to come for a consultation about problems or challenges with their current prosthesis
  • Our bilingual practitioners can converse with patients in their chosen language

Our lead prosthetist has many years of experience working with children and young adults with congenital deficiencies, trauma amputations and more. He is established as a specialist in upper and lower extremity prosthetic care for children and their developing needs. Educating the parents and the child  along the way and addressing their fears and concerns will allow the child to develop a healthy attitude and focus on their abilities.

Collier-Laurence Orthotics and Prosthetics has offices in Sacramento, Oakland and Pleasant Hill. Please call 916-979-9729 or send us an email below, and we can answer your questions and set an appointment at the location most convenient for you.

Kids and sports: Protect their sprains and strains!

Organized sports have so many benefits for kids, but exuberant over-use can cause repetitive stress injuries. Children who play basketball, volleyball, soccer, football and those who ski, are most likely to injure their Anterior Cruciate Ligaments when they slow down, pivot or land after a jump.1 When minor injuries are addressed promptly, a brace can help with recovery and often get them back in the game with less chance of re-injury.

1. “Recognizing and ACL injury in children”

Once you have a diagnosis, we can help!

Our trained and certified pediatric practitioners are here to answer your questions. You can learn more about specific sport injuries from foot pain to stress fractures with the resources below. Bookmark this page so you can come back to it later if needed.

You can be prepared with resources for many common pediatric sport injuries.

If your child gets hurt, there is no substitute for a doctor’s advice and diagnosis. Once you have a diagnosis and prescription, we can assist you to find the device that best suits your child’s needs.

The 3 most common injuries we see in youth athletes:

  • Knee Sprains: when a ligament stretches or tears; for example, an anterior cruciate ligament (ACL) or medial collateral ligament (MCL) tear
  • Tendonitis: when a tendon gets irritated or inflamed, usually from overuse or poor training (for example, in jumper’s knee)
  • Meniscal Tears: When the cartilage between the upper and lower leg bones (the menisci) tears

Pediatric Sport Injury Resources

OA knee patients share their stories

Michael Spoto, Sacramento, CA

Michael came to Collier Orthotics because he was having quite a bit of knee pain from arthritis and a torn meniscus, and wasn’t quite ready for knee surgery. Michael speaks about his care journey with Collier Orthotics and Prosthetics, and how they found him an unloader knee brace which allows him to get back to his daily activities with a lot less pain.

James Muelleners, Sacramento, CA

James shared his tWe are sincerely concerned with serving our patients in the very best way possible. James took the time to tell us about his experience.houghts with us below.

Q: What’s the most important to you about your experience?
A: The ability to work with my schedule and accommodate me in Sacramento instead of the bay area in a timely manner, with quality of care and they wanted to help me.

Q: How did you feel after the first evaluation was complete?
A: Very complete! Nick did an amazing job and was very thorough and willing to fight for the brace I needed.

Q: What was most important to you during your time in our care?
A: The quality of knowledge and the ability to relate.

Q: Why did you choose our company?
A: Quality, speed, knowledge and family

Thank you James, we are glad we could help you get back to your daily activities….pain free!

Double Upright AFO gets patient back on his feet

Mr. Harrell, a 50-year-old diabetic, presented with a very unstable gait and had been previously diagnosed with left foot drop secondary to a stroke and leaving him with left side paralysis. Mr. Harrell would use his arms for balance while ambulating, and had experienced a number of falls.

Gait Stability

To resolve his unstable gait, we fabricated a left double upright Ankle Foot Orthosis with extra depth shoes and custom accommodative inserts for Mr. Harrell. The AFO is used to control the instability in his lower limb by maintaining proper alignment and controlling motion and drop foot.

The Double Upright AFO will be attached to the diabetic shoe which allows for edema and protects the diabetic foot from any shear forces. His diabetic neuropathic condition requires extra depth shoes and custom diabetic inserts to accommodate his misshapen feet. The AFO will also protect his de-sensitized feet from repetitive stress and irritation – something his current shoes were not providing.

Mr. Harrell has been wearing the Double Upright AFO for a few weeks now and it has boosted his confidence. He has been very satisfied with the progress he has made toward resuming his normal walking routine.

Mr. Harrell had a few words to describe his patient experience at Collier:

“I had a stroke and lost a lot of my left side. I was treated with professionalism and the practitioner was very kind. I can now walk a lot better, love my new brace and shoes!” — AFO Patient Troy Harrell

Do you have a question about a current health issue?

How we help patients after their stroke.

The role of an O&P facility is to provide an orthosis that will aid the patient’s stability and ambulation during the stroke recovery process.

The Orthotist will visit the patient at their care facility and is brought up to speed by the physical therapist and physician with the patient’s diagnosis and outcome goals. We fabricate orthoses for patients with mobility issues who need help with ambulation and rehabilitation at home.

The O&P facility’s job is also to educate the patient and their caregivers on the goals and benefits of using the prescribed device. Follow up appointments with the clinician are very important due to the drastic and sudden changes stroke patients can go through during their rehabilitation process and to check for things such as skin irritation and unusual pain when wearing the device.

Post Stroke Patient Care Methodology

Our process when treating foot drop patients.

Fixed Ankle

During the motor skills assessment our team member walks the patient in parallel bars with no shoes or socks, the Orthotist holds the knee and foot to attain what kind of forces need to hold the patient in correct alignment and stabilize their muscle insufficiency. This is determined by the counter forces that we place on the knee and foot. Once we determine how much force is needed to control the patient’s ankle, foot and knee, a decision can be made on what brace will best help the patient walk. 

The team agreed that an ANC (articulated non-cut) AFO (Ankle Foot Orthosis) was the right solution. The function of this brace is to lock the patient’s ankle at the desired position (90 degrees). This helps with toe clearance and to prevent the foot from dragging while walking. It also helps mitigate hyperextension.

Free Ankle

The ANC AFO solution is fairly common for patients graduating from rehabilitation settings but who still need ambulation support to get back to their daily activities. The ANC orthosis we have developed is unique – it can be hinged at the ankle once the patient regains stability and strength. This gives the patient a more natural gait as they transition through their therapy. Essentially it is two braces in one, saving the patient a second co-pay, and saves waiting time during the healing process. For any stroke patient, it is critical to fabricate and fit a brace in a timely fashion to get the patient ambulatory as soon as possible for neuro muscular regeneration and gait training. We put a high importance on getting the patient what they need to continue to improve.

When it is determined what type of orthosis is needed, it is fabricated to specifications. It must help the patient meet therapy goals such as:

  • Toe pick up, ankle stabilization and improved gait
  • Sufficient clearance or relief for the head of the fibula
  • The patient can ambulate safely in the orthosis
  • The Varus/Valgus correction provides the desired support
  • Skin check was satisfactory
  • The range of motion settings meet prescription criteria

When we fit the patient after fabrication we double check:

  • The orthosis conforms to the contours of the body
  • The finished height of the orthosis is appropriate
  • The patient is stable while standing
  • The workmanship of the orthosis is satisfactory
  • The patient can sit and adequately flex knee with orthosis

Follow up from the clinician is a very important step we take due to the drastic and sudden changes these patients can go through during their rehab process. If you would like to speak with one of our practitioners about a specific issue, please send us an email.

Stroke Awareness: Three important milestones.

Why the first 3 hours, the first 3 days, and the first 3 months are significant during stroke recovery.

  • The first 3 hours are vitally important for patient to have critical medical care that will make a difference in their survival rate. Call 911, do not drive self or patient to hospital. Emergency responders can begin medical care as soon as they arrive and while patient is being transported
  • The first 3 days in the hospital gives doctors time for tests and assessments to determine the course of care. Rehab can begin as early as 24 to 48 hours after the stroke while the patient is still under hospital care.
  • The first 3 months are therapeutically important as this is when the brain is most capable of making reconnections through neuroplasticity. This can also be an exhausting time for a stroke survivor and they may need mental health and caregiving support.

Stroke Resources:

The American Heart Association has a plethora of resources about stroke research, recovery, and prevention. This article talks about Foot Drop and other effects due to stroke.


In Northern California at the Kaiser Foundation Rehabilitation Center in Vallejo, we work weekly with stroke patients who are completing their intense rehabilitation and preparing to transition home. Read more about their patient and family support.

NAMI: National Alliance on Mental Health

Stroke survivors have a high chance of developing depression and may have other mental health needs. This organization has terrific resources for family and caregivers.

Helping those with limb loss find a prosthetist

Amputees and those with congenital disorders who wear a prosthetic device typically have a long-term relationship with their prosthetist. If you have never worn a prosthesis, this is an outline of what you should expect during your journey.

Are you ready for a prosthesis?

Obtaining a prosthesis is usually a long term process. You need to prepare your muscles so they are in the right shape to utilize your new device. This usually means working with a physical therapist and other members of your care team to educate you about day-to-day living with a prosthesis. Having care team members that communicate is extremely important for a successful outcome with your prosthetic device.

If you decide having a prosthesis is the path you want to take, you will want to find a prosthetist to collaborate with on your care team. Your physician will provide the referral to be seen at our facility. The next step is for us to evaluate the best course of action for your daily living and future goals.

What is the best way to learn more about getting a prosthesis?

Before you can see a prosthetist, your doctor will need to:

  • Document your current condition
  • Diagnose your K-Level
  • Collaborate among the members of your care team

After the appropriate device has been decided upon, you will continue your PT while your prosthesis is manufactured. During the fitting process, over multiple visits, your prosthetist fine tune your device socket and provide the training you need to get the most out of your new prosthesis.

Step 1: Documenting your current condition

Your doctor will complete an evaluation checklist. This is when you should ask questions. This information will be the basis of the report being sent to your insurance company which ultimately determines the affordability of your prosthetic device.

  • Physical Exam
  • History of Amputation
  • Functional Deficits
  • Functional Level
  • Motivation to use prosthesis
  • Describe the condition of the residual limb
  • Patient’s past experience with prosthesis

If a replacement prosthesis is needed, describe the condition of current prosthesis or component and your recommendation based on your functional level evaluation.

Step 2: Diagnose your K-level

Your doctor will confirm your K-level which determines the type of device your insurance will approve. The K-level is based on your daily activities and current physical condition. it is possible over time that you can graduate to a higher K-Level if you continue to progress in your abilities.

Learn more about K-levels.

Step 3: Team Collaboration = Improved Prosthetic Care

On your first visit, options will be discussed to find the prosthetic configuration that allows you to get back to your daily activities and meet your future goals.

In addition to your doctor, your care team will consist of physical therapists and your prosthetist. Cohesive care during your rehabilitation will help you stay on track with your short and long-term goals to better improve your outcomes.

The team collaboration is a transparent process – the goal is patient education through communication with all members of the team. Collective input creates a clear plan which leads to higher patient satisfaction with improved functional results. After your final fitting, your prosthetic devices will need adjustments over time, so you will likely check in with your prosthetist once or twice a year.

“I believe that providing a prosthesis is just the beginning of my responsibility as a prosthetic provider, I am also involved in the education and follow up care of my patients”, says George. He is always eager to learn new methods and philosophies and share for the benefit of the team as well as the success of the patients’ prosthetic experience.

Read more about George Villarruel’s experience.

Patient Resources

Every patient is unique, physically and psychologically and we have the experience and compassion to guide them through this journey. We have put together a list of resources of organizations and articles to help you and your family members.

Check out our patient and family resources.

Certification Boards

The American Board for Certification in Orthotics, Prosthetics & Pedorthotics (ABC)

abcop.org
info@abcop.org
703-836-7114

The Board of Certification/Accreditation, International (BOC)

bocusa.org

Orthotics and Prosthetics Patient Care – Our offices are open.

Collier Orthotics and Prosthetics in association with Laurence Orthotics and Prosthetics logo

As an essential health care service provider, our offices remain open with a full staff of trained, licensed, bonded and insured practitioners who are ready to provide on-going care for those in need of mobility devices and for in-patient hospital calls 7 days a week, evening and holidays.

Providing Orthotics and Prosthetics care for seniors, pediatric patients, and those with special needs is the heart of what we do.

Our Practitioners and staff can assist those that are in need of orthotic and prosthetic devices to improve or maintain their mobility for all Activities of Daily Living (ADL’s) such as personal care, cooking, walking, exercise, essential transportation to the grocery store and pharmacy, safety, reassurance and especially with those tasks one may have difficulty in accomplishing during this period of Sheltering in Place.

We are here for you. If you need an appointment, please do not hesitate to call. Nothing is more important than the health and safety of our patients and staff. We have taken precautions based on state and federal mandates to provide a safe and comfortable environment for our patients and staff. We follow all social distancing guidelines and ask you to please remain 6 feet from any other patients and staff.

Orthotic and Prosthetic services remain an option to those at risk of mobility and we will do everything in our power to support our patients, staff members and community in every way possible to keep them safe and cared for by continuing services for improved mobility during these times.

Please rest assured that we are monitoring the COVID-19 situation very closely at all our locations.

We will continue to keep our Management, Practitioners, and Office Staff Employees well-informed on a daily basis about the virus and best practices to ensure the health and safety of all of our clients and employees. The following precautions are being taken to combat this changing situation:

  • Limiting the number of people in our facility at any given time. If you require assistance, we ask that you limit caregivers/companions to one support person only for your visit.
  • Reducing patient appointments to comply with social distancing in waiting rooms
  • All patients, caregivers/companions, and staff are required to wear a mask. The mask must remain over your nose and mouth throughout your entire visit to our office.
  • We ask that patient family members remain in vehicle at the time of patient appointment
  • Pediatric patient can be accompanied by an adult during their appointment
  • All patients entering the clinic will sanitize or wash their hands on the way in and out.
  • We will continue to disinfect all equipment and surfaces after each treatment.
  • We will be modifying treatment to accommodate your specific needs.
  • We ask you to help our efforts by staying home if you feel sick or are at risk.

Those defined as at risk are:

· The elderly
· Those with heart or lung disorders
– Diabetes
– Immunocompromised

We are doing our best to take the proper precautions and modifications to meet the needs of our patients under these unusual circumstances. Make sure you are doing your best to protect yourself, and if you have any questions or concerns, please visit www.cdc.gov/coronavirus.

Our compassionate and professional staff and practitioners have been serving the community since 1988 for Collier and 1946 for Laurence. We are committed to offering the same legendary service which we are known for, especially during this unprecedented COVID-19 crisis.

If you have any questions, or are in need of services, please contact us by email below or call 916-979-9729.

Ian McLaughlin: Rising to the Challenges of Post-Stroke Recovery

Ian’s latest achievement: The Rise Paralysis Recovery 5k Wheel & Walk

Ian, what’s most important to you about your experience with Collier?

As a person recovering from multiple serious strokes and complete hemiplegia, I needed to assemble a team of dedicated professionals I can rely on in my recovery effort for their support and expertise. The Collier team is like a family and is an invaluable part of my recovery team. The single most important thing to me is their dependability. I use an AFO to walk and as I recover motor functions over time my orthotic needs constantly are changing. I have been able to work with the Collier team on a regular basis to make the adjustments to my AFO as my needs have changed.

When you think back to your first evaluation with Collier, how did you feel when that was complete?

My initial evaluation with Collier occurred in November 2016 when I was in an acute inpatient rehab facility – only two months post-strokes. I was still cognitively very impaired and not walking very much and I had no idea what my orthotic needs were or what they would ultimately be. Collier orthotist, Dennis “DJ” Johnston, BOCO, CPA, fit me for my AFO (ankle foot orthosis) at that time. I have used the same AFO for three years now with numerous modifications as I become more ambulatory. In 2018, I wore that same AFO when I walked a 5K Turkey Trot in my local community.

If there were things that concern you about the future of your care, what would they be?

My concerns have nothing to do with Collier and their services. I am working very hard to control my post-stroke spasticity that causes me to need to wear an AFO and I hope to not need one someday. My concern is that I will never regain the ability to walk without an assistive device. I know that as I go through the process I will be able to work with the Collier team to fit me with progressively less cumbersome braces as my skills and abilities develop further.

Dennis Johnston, Collier Practitioner

A Board Certified Orthotist, Dennis fits custom orthoses for orthotic patients of all ages.
— Patient Care Specialist
— Specializing in Proprietary R-Wrap™ AFO’s since 2003
— Expert in Spasticity Management

 

Looking for a solution or second opinion? Contact one of our orthotic specialists at 916-979-9729 or contact us with the form below.

How to treat Scoliosis with the Chéneau-Gensingen Brace

This gold standard of scoliosis bracing treatment is the result of three generations of development.

As a treatment solution, this brace can be 90% effective for avoiding surgery with full patient compliance. In some cases, patients have been able to partial reimbursement through their insurance.

The 3D Chéneau-Gensingen brace utilizes the latest bracing technology for the best possible outcome:

  • CAD/CAM is used for the creation of each curve-pattern specific brace for a three-dimensional treatment addressing all three planes
  • Treats mild, moderate and severe scoliosis
  • A viable option even for patients with 40°+ curves
  • Custom fabricated with voids and pressure zones to work in conjunction with Schroth Method Best Practices
  • Front closing design and less material for more comfortable fit and ease of application

History of the Chéneau Brace Development

Dr. Chéneau was the first brace developer in 1979 in an effort to advance and improve scoliosis bracing an to work in conjunction with the Schroth corrective breathing method developed by Katharina Schroth, and the classification system being developed by Christa Lemert-Scroth. In the 90’s, Dr. Hans-Rudolf Weiss (Christa’s grandson) hosted courses at the clinic demonstrating Dr. Chéneau’s bracing concepts. At the time, braces were still being fabricated from a mold of the patient’s torso through casting. Dr. Weiss went on to develop the ‘Chéneau Light®’ brace. It had a record of improved patient outcomes and reducing the need for scoliosis surgery.

Learn more in this Research Study: A Prospective Cohort Study of AIS Patients with 40° and More Treated with a Gensingen Brace (GBW): Preliminary Results

CAD/CAM technology, comfortable design and solo donning.

The newest Chéneau-Gensingen brace design has evolved to a higher standard with the advent of CAD/CAM technology and many years of documenting and researching in-brace results. The unusual features of the brace work to reduce spinal rotation in all three planes. Openings positioned at the spinal concavities and corrective pressure points are plotted with CAD/CAM and fabricated to have a built-in correction effect according to a patient’s individual curve pattern. This exacting fit is much more tolerable for the patient which contributes to improved corrections and happier patient. In addition, most patients will not need assistance after they learn how to don the brace.

Our practitioners trained with Dr. Marc Moramarco, the most experienced Schroth Method practitioner in the United States. In the video, Dr. Marc Moramarco visited Dr. Weiss at his facility in Germany and they discuss the benefits of Cheneau bracing over other bracing methods.

The Schroth physcial therapy method is used in conjunction with brace therapy for best possible outcome.

Best practices for Schroth Therapy from our friends at Scoliosis3DC.

Learn about the history of the Gensingen brace development and how they set the standards for better scoliosis patient outcomes.

Seeking the Scoliosis Treatment Secret – A Personal Journey

Read about Dr. Moramarco’s healing journey with his daughter after she was diagnosed with scoliosis.

Contact us if you would like to learn more!

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