It took me 2 days wearing it to get it adjusted just right. I couldn't find a thing about FIT ADJUSTMENT on the product website or even on Youtube, only instructions on how to put it on. Also, there was no clue as to how to determine what size to order. Sizes are the number of inches the brace extends up your calf. Just going by the pictures, I aimed for the top of my crew sock, which turned out to be a size Small, even though I have a wide shoe size and a large calf. As to adjustment, I found the trick is getting the bottom width adjustment wide enough that you don't actually feel the cast when you walk. At first there was a slight pressure on the inside of my heel that became very uncomfortable after awhile. A few test adjustments and voila'- comfort and a very effective product.
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