Polio and Post-Polio Syndrome Orthotics in London
Many people living with the effects of polio in the UK contracted it decades ago, managed well for a long stretch of adult life, and are now noticing that things are becoming harder again. That pattern is common enough to have a name, post-polio syndrome, and it is one of the most frequent reasons people return to an orthotist after many years away.
We assess adults with polio and post-polio syndrome at four London clinics, including people who have worn the same device for a very long time.
What Changes, and Why
The original infection damaged motor nerve cells, leaving some muscles weakened or paralysed. Surviving nerve cells compensated by taking on additional muscle fibres, which is why function often recovered substantially. Decades later, that compensation can begin to fail.
What people typically describe is:
- New weakness in muscles that had been stable for years, including some that seemed unaffected originally
- Fatigue that is disproportionate to activity and slow to resolve with rest
- Muscle and joint pain, often in the limbs doing the compensating rather than the obviously affected ones
- Reduced walking distance and increasing difficulty with stairs and slopes
- Falls, or a growing anxiety about fallingFalls, or a growing anxiety about falling
- Sensitivity to cold in affected limbs
Why Long-standing Devices Are Worth Reassessing
A caliper fitted in the 1960s or 1970s was built with the materials of its time, which generally meant steel and leather. Many were excellent devices and have been worn faithfully for decades. They are also heavy, and weight is precisely what someone with growing fatigue can least afford to carry.
Materials and componentry have moved on considerably. Carbon fibre and modern polymers offer comparable support at a much lower weight, and stance control knee joints allow the knee to bend during the swing phase of walking while remaining stable under load, which older locked designs did not permit.
There is also the simple matter of fit. Bodies change over forty or fifty years, and a device shaped to a limb as it was then may be loading it awkwardly now.
Overuse and Energy Conservation
One of the recurring themes in post-polio syndrome is the cost of compensation. A limb, a joint or a shoulder that has taken extra load for decades often becomes the source of new pain, and continuing to push through it tends to accelerate rather than delay decline.
Orthotic management here is partly about reducing that load. A device that lowers the energy cost of walking, or that transfers work away from a structure that is struggling, addresses more than the limb it is fitted to.
What Happens at Your Assessment
Assessment covers muscle strength across the affected and unaffected limbs, joint range and stability, any difference in leg length, skin condition, walking pattern and current device if you have one. We will ask about walking distance, fatigue through the day, pain, falls and what you have had to give up.
Where you already wear a device, bring it. Its wear pattern, its weight and how you manage it tell us a great deal.
Orthoses Used in Polio and Post-polio Syndrome
- Knee ankle foot orthoses, including modern lightweight carbon fibre or 3D printed hybrid designs and stance control knee joints, where the knee needs support through stance but freedom to bend during swing
- Ankle foot orthoses, where weakness is confined below the knee
- Carbon fibre designs, chosen specifically where reducing weight is a priority
- Custom and modular footwear, including sole raises where there is a leg length difference
- Custom insoles, to address pressure distribution and comfort
- Spinal bracing, where trunk support is required
Taking the Long View
Post-polio syndrome tends to progress slowly, and decisions made now have consequences a decade out. That argues for addressing overload early rather than waiting until a shoulder, a hip or a knee has given up, because the structures being protected do not recover once they have been worn down.
It also argues for periodic review even when nothing feels urgent. Small changes accumulate quietly over years, and a device that fitted well five years ago may now be working against you in ways that are hard to notice from the inside.
Common Questions
I have worn the same caliper for thirty years. Is it worth being reassessed?
It is usually worth a conversation at least. Both the available materials and your own body will have changed considerably in that time, and the assessment costs you nothing to have. These devices also require regular upkeep and maintenance to reduce any risks
Will a new device feel strange after so long?
Most people need an adjustment period, and a modern device often behaves differently through the walking cycle. That is something we plan for and support, rather than fit and send you away with.
I manage without a device. Should I still be assessed?
If you are experiencing new weakness, fatigue or pain, an assessment can identify where load is falling and whether anything can usefully reduce it. There is no requirement to have worn a device previously.
Can you help with a leg length difference?
Yes. Shoe raises and footwear adaptations are a routine part of this work.
Do I need a referral?
No. We accept self-referrals alongside referrals from consultants, physiotherapists and case managers.