<img class="alignright" src="https://opedge.com/Content/UserFiles/Articles/2021-08%2F3-2.JPG" alt="" width="400" /> Growing up on his family's farm in South Africa, Francois Van Der Watt, CPO, always assumed he would become a farmer. But a chance meeting in college took him down a much different path—toward international renown as a prosthetist for elite athletes and people with amputations from all walks of life. It was his college roommate, whose brother worked in prosthetics, who first introduced Van Der Watt to the profession. His interest was further piqued by an experience volunteering at a clinic, and after college he earned a diploma in medical orthotics and prosthetics at the Technikon Pretoria, South Africa. He began working with athletes in 1996 and traveled to Sydney in 2000 to support one of his patients who was competing on the South African team. Van Der Watt had begun to lament the lack of opportunities in South Africa to gain hands-on experience with the latest developments in prosthetics. Working with athletes such as Oscar Pistorius, the sprinter who later made history by being the first track and field athlete to compete in the Olympics and the Paralympics, further fueled Van Der Watt's desire to advance his knowledge by pursuing professional opportunities in the United States and earning his bachelor's degree in sports and health sciences. Starting in 2002, he worked as a prosthetist and clinical manager for clinics and businesses throughout Georgia, Texas, and Arkansas. In 2015 he opened Van Der Watt Prosthetics & Orthotics in Greenwood, Arkansas. Although he is perhaps best known for employing the Össur Flex-Foot Cheetah and creating the running legs Pistorius used during his high-profile running career, Van Der Watt has worked with various medalists in every Paralympic Game since Sydney 2000. While today more is known about adapting prostheses for high-performance activities, he recalls the task feeling like a dark area in his early days. "It drove me to be always learning and becoming more efficient and effective. At the time there was very little knowledge about the specifics of high-performance sport prosthetics. You just threw everything against the wall to see what worked," Van Der Watt says.<img class="alignright" src="https://opedge.com/Content/UserFiles/Articles/2021-08%2F3-1.JPG" alt="" /> Accompanying the 2008 US Paralympic Team to training camp in Japan was a unique experience on his path toward working with Paralympians and the US Paralympic Team. He was inspired by the reverence with which the team was treated throughout their journey. It was also here that he met and began working with Jerome Singleton, the first athlete in six years to beat Pistorius in the 100-meter sprint. After the pandemic-related postponement of the 2020 Summer Paralympics in Tokyo, Van Der Watt is looking forward to watching current clients such as Trenten Merrill compete this summer. A sprinter and long jumper, Merrill is a Paralympian, American long jump record holder for his classification, and World Championship silver medalist. He first met Van Der Watt at a running clinic and asked to work with him after crossing paths with him several times at meets over the years. "He blessed me for sure," Merrill says, recounting how Van Der Watt helped fit him for an updated sprint blade and socket, and later a long jump–specific blade, the first athlete in the US to use this jump foot. "Every time I worked with him in person, it was a good time. You get to bounce ideas around, very much like scientists in a lab. It's a cool relationship." Merrill's foot was amputated when he was 14 following a dirt bike accident. He says that when he first began to pursue track and field in college, the coach ignored his repeated requests to join the team. Merrill kept trying, training on his own, changed colleges, and made a point of surrounding himself with people who believed in him. He says that with the help of coaches and prosthetists like Van Der Wat, whose clinic's motto is "turning disabilities into possibilities," "there's not much I can't do." Merrill says he also enjoys the atmosphere of Van Der Watt's clinic because of the variety of people it attracts. Although sports memorabilia covering the clinic walls bears witness to Van Der Watt's work with top athletes, a wide range of patients come through his doors on any given day. <img class="alignright" src="https://opedge.com/Content/UserFiles/Articles/2021-08%2F3-4.JPG" alt="" /> "Everyone has a different story," says Merrill. "You always meet someone new." The variety of patient activity levels facilitates peer-to-peer sharing. For example, Merrill tells other clients to "describe exactly what you feel," noting that learning to better communicate with his prosthetists over time has been essential to his success. He also encourages others to work with professionals who support their goals and don't impose limits on them. Another client, Cooper Blair, is a high school junior and Paralympic track and field hopeful who has used two transtibial prostheses since age two. He was born with amniotic band syndrome that resulted in deformities in his feet and lower legs. After undergoing seven surgeries, physicians told Blair's parents that keeping his feet would likely mean he could never walk normally or play sports. They made the difficult choice to have their son's feet and lower legs amputated. When he was fitted for his first prostheses just a few months later, it became clear they had made the right choice. Blair began walking, and eventually running, with ease. By age nine, he had won first place in his division in a race at the Endeavor Games in Oklahoma City. Blair's mother Richelle remembers how the family felt when Van Der Watt began working with Blair. "We were living outside Pittsburgh, and there were not a lot of prosthetists around locally. We were dealing with an active child, and it was kind of frustrating at first. When we met Francois, we knew he was the one for our family. He looked at the whole child [Cooper] was and went the extra mile to see what was best for him." "He loves what he does, and you can tell," adds Blair. Blair and his family visit Van Der Watt every year or two when he needs replacement blades for running or basketball, another sport he loves. He notes that every one of Van Der Watt's clients—not just the athletes—receive his undivided attention. Blair appreciates that Van Der Watt allows him to go into his shop to see his prostheses being fabricated and sometimes even allows Blair to help in the process. He also knows that his prostheses will be high-quality, sturdy, and unlikely to break. For Van Der Watt, working for his clients means helping them find the best fit for their prostheses and work toward being able to do the activities they value most. "His approach is unreproachable," says Dennis Goodwin, an equipment operator who saw an advertisement for Van Der Watt's clinic when he moved to western Arkansas in 2016. Goodwin lost his foot in a boating accident in 1991, and in the years that followed used a series of prostheses that he says never fit quite right. He says he did not even become fully aware of the level of discomfort he had been feeling until he experienced the difference of working with Van Der Watt. When Goodwin arrived for his first appointment, his residual limb was covered in sores. "I wasn't doing really well," he says, describing his prior prosthetists' approach as "trying to put a stump into a round can." He had become resigned to the idea that discomfort and irritation would be an inevitable part of using a prosthesis. Goodwin says Van Der Watt's intervention "really turned things around." Working with Goodwin's physicians at the VA Medical Center, Van Der Watt helped him transition to an electronic prosthetic foot and fit that vastly improved his quality of life. Goodwin explains that the expertise Van Der Watt has gained from working with athletes helps all of his clients work toward their activity and lifestyle goals. The idea that a prosthetist can't effectively serve the general public and elite athletes is a huge misperception, Van Der Watt says.<img class="alignright" src="https://opedge.com/Content/UserFiles/Articles/2021-08%2F3-5.JPG" alt="" /> "It is sometimes as challenging to work with a K2 amputee as with a sprinter," he says. Although elite athletes may be participating in a higher level of activity, people ambulating at the K2 level have more of an adjustment to navigate in their daily lives. Van Der Watt says he finds great reward in helping both categories of clients overcome challenges through creative prosthetic solutions. Van Der Watt says that it is important to begin a relationship with any client with an honest conversation about his or her aspirations. Finding out what activities are most important for clients helps them find the products for their needs. Some clients, for example, do best with a model that uses hybrid components that can allow for different modes of activity. If a client wants to work toward running a 5K, for example, Van Der Watt will explain that while it may be possible with a regular prosthesis, a device with a wider range of functionality may be preferable. Working with athletes has allowed Van Der Watt to view biomechanics in high definition, an experience that benefits everyone who walks through his door. "It's made me more observant of how the body moves," he explains. Because athletes are in tune with their bodies to a much higher degree than the average person, they tend to also be skilled at articulating how a prosthesis feels and what adjustments they need in terms of fit and functionality. "They give invaluable feedback," he says, as well as inspiring his nonathlete clients to push their limits and consider what is possible. Van Der Watt urges all patients to advocate for their needs with their prosthetists and insurance companies, and to get a second opinion if they are unsure about the advice they have received. "It's still your choice where you want to receive care," he says. "Your physician can recommend [a prosthetist] but make that decision yourself." It's clear from his clients' effusive praise that they have found the right match. <strong> </strong> <em>Emily Dings is a freelance writer and editor living in Bethlehem, Pennsylvania.</em> <em>This article is brought to you by Amplitude as part of its coverage of the 2020 Tokyo Paralympics that begin this month. For more Paralympic news, athletes to watch, and highlights throughout the Games, visit livingwithamplitude.com/paralympics.</em>
