New Legs Will Help Young Athlete Continue to Excel at Football

[caption id="" align="alignright" width="300"] Calder is practicing to be his team's quarterback. Photographs courtesy of the Hodge family.[/caption] Calder Hodge was born ten years ago without a fibula in either leg. But don't think for a moment that has slowed the Texas youngster down. Since Calder’s three older brothers are all athletic and play baseball and football, it was only natural that he would want to follow in their footsteps. Calder's parents decided when he was an infant to have his legs amputated above the knees. "We didn't want Calder to remember this part," Kayla Hodge says of the surgeries her son had at Shiners Hospitals for Children - Houston. He was fitted with his first pair of prosthetic legs in October 2007 when he was two years old and started using a walker. By Thanksgiving, he had stopped using the walker, his mother remembers. And as Calder would show from the beginning of his rehabilitation, "he's always been ahead of the curve," Hodge says. Calder, who will be 11 in May, started out playing t-ball, then switched to flag football, and transitioned to tackle football as soon as his mother would let him. With that came the wear and tear one would expect with such a rough and tumble sport. At the Right Place, at the Right Time When Calder needed yet another urgent adjustment to one of his prostheses from playing football, Jeremy Bilow, CPO, who was with Hanger Clinic's Houston patient care facility, happened to be in the right place at the right time. "We had a connection during that first meeting," Bilow remembers. "So he and his family decided to stick with me." Bilow worked with Calder for four years before moving to a Hanger Clinic in Portland, Oregon, last fall. Bilow says he has always encouraged his patients to express themselves via a custom design on their sockets. With Calder, it was easy for him to make that expression known. "Calder doesn't need any encouragement to express himself," Bilow says. "Calder eats, breathes, and sleeps football." [caption id="" align="alignright" width="401"] Calder in full uniform on the field.[/caption] Bilow had made five sets of sockets for his young client and the majority of them have been football themed, he says. Since J.J. Watt of the Houston Texans is Calder's favorite football player, the defensive end was a natural choice for his current socket design. "To add a design to a socket, our technicians typically use a lightweight fabric with some stretch to it. In Calder's case, a pair of T-shirts," Bilow says. "Then they sew this fabric into a sleeve and stretch it over the other lamination materials on the positive model of the patient's leg. The socket is laminated as usual and the material becomes a structural and stylistic part of the custom socket." You won't hear any complaints from Calder-he's proud to wear Watt's number 99 on his right socket. Watt has become an inspiration to the boy, who one day hopes to play professional football. "He's so dedicated to his sport," Calder says of Watt, who he met in the spring of 2015 at a charity softball game. "He works hard, gives back, and never takes anything. He's so humble." Bilow says that Calder is "an extreme kid" who pushes his legs to the limit. "When I first started working with him, he was breaking components left and right," he says. "I received countless texts and photos from his mother asking for an urgent appointment because his foot broke-again-or his knee wouldn't bend anymore." [caption id="" align="alignright" width="287"] Strength training is key to successfully playing sports of all kinds; Calder lifts weights to help his performance.[/caption] Bilow says they tried almost every pediatric component on Calder. "It seemed to be his mission to prove that nothing could stand up to his punishment," Bilow says. "He seemed to be breaking everything. Mom was frustrated, and I knew it was time for a change." When Calder was about eight years old, Bilow decided it was time to try adult-size components for their durability. Calder was fitted with adult polycentric, hydraulic knees and a pair of Ability Dynamics RUSH feet, which are very flexible and energy storing, Bilow says. At that time, a pediatric version of the RUSH Foot was unavailable, so that further motivated the switch to adult components. In the beginning, Calder complained about the weight, but it didn't take him long to get used to the change, Bilow says. The change to an adult size seemingly did the trick-Calder was not breaking his components nearly as frequently, Bilow says. When it came to fitting Calder with running legs for sports, it was more difficult to convince Hodge. "I told her, 'He needs blades,'" Bilow says. Hodge, however, was hesitant. "I was in typical mom mode," she says. "I was scared." Bilow was eventually able to convince Calder's mother and they applied for a Challenged Athletes Foundation (CAF) grant. A few months later, when he was almost nine years old, Calder was awarded a pair of Össur Cheetah® Junior running feet. Bilow decided to fit Calder without knees when using his running feet, for maximum stability, "especially given the quick cuts and changes in direction he needed to perform on the football field," he says. "We also decided to use Calder's existing sockets, and to allow him to swap between his walking legs and running feet on his own." [caption id="" align="alignright" width="454"] The Hodge family, from left: daughter-in-law, Amanda; sons, Blake, Sheldon, Calder, and Tyler; and mother and father, Kayla and Mike.[/caption] Initially, it was Calder's parents who had to switch his prostheses from walking to running legs. Now a fifth grader, Calder can make the change on his own armed with a 4mm Allen wrench. He says he puts his running feet in his backpack to swap them out for gym class and to play sports while at school. Adaptation is Second Nature for Calder His competitiveness and determination aside, Calder has adapted so well to his prostheses because he is a child, like most, who seemingly knows no limits. Shane Wurdeman, PhD, MSPO, CP, FAAOP, Hanger Clinic, Houston Medical Center, who has been Calder's prosthetist since last fall, says there are multiple reasons he has done so well: A child's brain is undergoing constant neural development and the formation of new neural pathways is conducive to improved motor control incorporating the use of a new prosthesis within the child's natural movement patterns. Second, a child's connective tissues have more elastin, which makes the skin better able to take the forces associated with wearing a prosthetic socket, and a child's bones are less brittle and heal quicker. Thus, the child is better able and quicker to learn how to use a prosthesis, has better tolerance for wearing a prosthesis, and the potential consequences of any negative events such as a fall are less psychologically impactful, Wurdeman says. Many Duplications When it comes to everyday wear, Calder uses active knees that allow him to walk effectively, Wurdeman says. Hodge says the family is pleased with the RUSH Foot Calder has been using and will continue to use for the immediate future. "It's the only foot he hasn't broken," she says. [caption id="" align="alignright" width="274"] Calder on the sidelines displaying the Texans' logo on his left socket.[/caption] When it comes to his running legs, as active and tough as Calder can be, it is not surprising that he has gone through a number of iterations of soling materials, permanently attached football cleats, and removable football cleats, Bilow says. Of course, the young athlete has managed to break his running feet more than once, but as Bilow says, "I've never seen him happier than when he bolts on his running feet and takes off." At the time this was written, Wurdeman was working on a new set of sockets and running feet for Calder that are appropriate for his age and size, and Calder was still deciding what the new custom design for his sixth set of sockets will be. It will be football related, of course. Bilow says he's excited for Calder to get his new legs. "From what I have heard, Shane has something very creative in store for this project," he says. "The tricky thing is to create a setup where Calder can have some flexibility in the knees, but not one that will buckle underneath him when he is cutting or stopping quickly." To get the idea for the new design, Wurdeman has spent ample time on the football field watching his young client practice. "Currently, Calder's sport legs do not have knees, which has also provided increased safety for him when he runs so that he doesn't need to worry about the knees buckling," Wurdeman says. The new sport legs, thanks to another CAF grant, will include knee components for the first time. Of course having knees will present a new set of challenges for the young athlete who has never played football with knee joints, but as Bilow and Wurdeman agree, Calder isn't going to have a problem mastering the new set of running legs. "As Calder has shown repeatedly, I expect him to smash that challenge as well and excel," Wurdeman says. Betta Ferrendelli is a freelance writer based in Denver.

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