Boston Othotics and Prosthetics

Helping Eli Defy Limits with Lower Limb and Scoliosis Care

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Eli Silver doesn't let severe hypotonia stop him from doing what he loves

Fifteen-year-old Eli is by most accounts a typical teenage boy. He is active on his high-school wrestling team, a Boy Scout, and also enjoys snow skiing and water skiing. However, Eli is far from typical.

Born with severe hypotonia, also known as “floppy infant syndrome,” Eli has low muscle tone, which makes it difficult for him to walk without the assistance of orthotics and a walker. He’s also hard of hearing and is nonverbal, so he uses American Sign Language to communicate. Yet, Eli seems unhindered by these physical challenges.

“He is a remarkably happy kid,” says his mom Laurie Silver.

Laurie and Eli

Correcting a Curvature of the Spine

Because of Eli’s condition, the Silvers always knew there was a risk he would develop scoliosis as he grew.

“His physical therapist at his school noticed there was a slight curvature in his spine,” says his mom, Laurie Silver. “Right away, we made an appointment with an orthopedic surgeon, and they verified he had the beginnings of scoliosis.”

Ordinarily, bracing is recommended for a curve equal to or greater than 25%, but Laurie thought, why wait?  In April of 2019, the Cleveland Clinic referred the Silvers to Boston O&P of Westlake in Westlake, Ohio, where Eli was seen by Todd Kirwan, CPO, a certified prosthetist and orthotist.

“For Eli, I recommended the Boston Brace Night Shift, which simultaneously applies a three-point pressure system to straighten the scoliotic curves while enabling the spine to shift into a more corrected position,” says Kirwan.”

Kirwan also suggested Schroth therapy, a non-invasive physical therapy treatment that focuses on halting curve progression by elongating the trunk, improving posture and lung function, and reducing pain. Schroth exercises include stretching, strengthening, and breathing techniques to facilitate curve correction.

Eli is improving and able to walk for short stretches without the use of his walker

A Path to Independence

Eli is on his second brace now and has completed seven months of Schroth therapy. Although, it's too early to tell if he’ll be able to avoid scoliosis surgery, Laurie says his condition is improving, “Todd has been great because he's very up on the literature, and he doesn't hesitate to give me ideas of what may or may not help Eli.”

One of those ideas was new ankle foot orthoses (AFOs). “I thought Eli would benefit from a different kind of AFOs that would gap less, provide greater ankle stability and mold to his feet,” says Kirwan.

Eli was fitted for the new AFOs this fall at the beginning of his ninth-grade year. He now can walk independently for short stretches. “We are convinced he's going to walk without any support, at some point,” says Laurie. “His progress is unbelievable.”


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