Photo by Nora Edinger CHRIS SURFACE of Hanger Clinic in Bethlehem works a prosthetic leg through a range of motion. After job shadowing at the clinic during high school, Surface was inspired to launch a career focused on helping people keep moving.

BETHLEHEM — About a decade ago, when Chris Surface was facing the same life-path decisions as 2022’s crop of high school graduates, a family member had a job-shadowing suggestion that was on point.

“I shadowed at this exact clinic back in high school,” said Surface. He also went on to do a bachelor’s degree in human biology at West Liberty University and a vocation-specific master’s at Northwestern University near Chicago before returning home to engineer prosthetics and orthotics (braces) for the local branch of Hanger Clinic.

“I’ve always liked to build things, and I’ve always liked to help people,” he added. “It was a pretty perfect fit.”

The office where Surface works is, indeed, a physical manifestation of that dual interest. “The front half is like a doctor’s office,” the now 20-something noted. “The back half is like a machine shop.”

An unusual machine shop.

There are trays of raw materials for the kind of robotic, superhero-ish legs that have largely displaced prosthetics that mimic human limbs. There are plaster molds of actual human legs lined up in a dust-contained area — ready to stand in for the real thing as precision-fitted, resin braces are created in a system that includes everything from an oven to a sander.

“I do a lot with interacting with patients,” Surface said of the kinesiology side of his business. He watches them move to see what the body is doing.

For a patient who has lost part of a leg, for example, he has to see exactly where the body’s center of balance is and adjust the position of the prosthetic accordingly. If the prosthetic is too far forward, the knee will buckle, he said. If it’s too far back, the leg won’t bend properly.

“I do the designing and, sometimes, I do the building,” Surface said of what amounts to a blending of engineering and art. He noted the local clinic also has a talented technician who does so much on the building side that little needs to be sent away for outside expertise.

Other patients may have all their limbs, but can need a wide variety of braces, he added.

An older patient, for example, might have a condition called “drop foot, a localized type of paralysis. A brace can hold the foot in a flexed position and reduce the danger of toe-stub falls while walking.

At the other end of the age spectrum, Surface sees a fair amount of infants who have so taken to sleeping in one position that they’ve caused a flat spot on one side of their skull. A globe-shaped, helmet-like brace can fix this.

In the middle, Surface said there are lower-limb braces that help children stop walking on their toes and custom-fitted, upper-body braces for teens with scoliosis. There are also a variety of orthotics that might be needed on a temporary basis for patients injured in car accidents or adjusted over a lifetime for someone with a condition such as cerebral palsy.

BUILT TO MOVE

Surface — who has done mission work and once saw a man have surgery in conditions that included an open garbage can to collect the blood — sees the point of such work as keeping the Ohio Valley literally moving forward.

“Over the last three years, I’ve had a couple of people who were told by doctors they wouldn’t be able to walk again,” Surface said. With a fresh team that included him, a new doctor and a physical therapist, he saw the opposite outcome.

“It takes months,” Surface said of such cases, which often involve extensive work in the clinic’s gait room, where railings offer support to patients learning to walk with new braces or prosthetics.

“To be able to see someone get up and walk is a big deal … I love to see people overcome those obstacles.”

Technology helps, he noted of the advancement of mobility aids, especially prosthetics. Newer limb replacements nearly have the superpowers their metal rods and dramatic joints suggest, he explained.

Prosthetic arms can be sensor connected to remaining limb muscles so that tiny motions can lead to controlled grasps or even something as precise as finger motion, he said.

Lower-body prostheses now range from dramatically curved running legs to more stick-like limbs that can sense speed (and respond with faster or slower limb swing), the slope of the walking surface and direction of movement, he said. Some can automatically stiffen at joints to help restore balance if a fall is in progress.

At the cutting edge, Surface noted that some prosthetic legs can even help propel a walker up the stairs.

“I always ask my patients, ‘What do you want to do? What are your goals?” Surface said of engineering solutions to life’s vagaries whenever he can. “Some people, their goal is more safety than being able to run.”