Shoes for AFOs

Many kiddos with special needs require Ankle Foot Ortosis (AFOs) or Supra Malleolar Orthosis (SMOS) to provide ankle stability and/or correct foot alignment when walking.  Over the orthotics, proper footwear is required for walking, but it is often difficult to find shoes that fit properly and compromises may need to be made.

What’s the Challenge?

The difficulty in picking a good shoe for AFOs has a few factors.

  • It is challenging for therapist to make recommendations about specific brands or styles, largely because styles change with each season and each year.
  • Shoes designed to be worn with AFOs/SMOs are sturdy but potentially quite heavy.
  • Shoes that don’t fit properly can negate or contradict goals set by having an AFO designed to provide good alignment.
  • Shoes that fit the extra width required to accommodate the AFO are often much too long – imagine walking in shoes 3 sizes too big! Now imagine learning to walk in shoes 3 sizes too big!

 

What are my options?

  1. There are some brands of shoes designed specifically for wear over AFOs.
  • Keeping Pace was a popular one, which is no longer in business, but you might luck out if
    your orthotist stocked these and has some left on the shelf.  Even since writing this I have heard that a different company has bought out KP but I don’t have details!
  • Hatchbacks are another brand which have some success but if the child only has an orthotic on one foot, the shoe is quite wide and deep which means the shoe is usually too big for the other foot.  Hatchbacks work great for some kids but are heavy and bulky for others.
  • Billy’s Footwear is a brand that is new to this therapist  but have good reviews – the entire laces section opens completely with a zipper.
  1. There are strategies/tips to finding a good commercially available shoe for over an AFO
  • Don’t wear the shoes outside until you get some input from your therapist – while needing to return shoes is obviously frustrating and time consuming the right shoe can really impact function and acquisition of motor skills.
  • Remove the insole to give a bit of extra depth to the shoe
  • Some companies you can purchase/special order a wider shoe – check out New Balance as an option!
  • Some shoes are designed to be a wider and deeper shoe and might be worth a try – look at DC or Vans which are originally a shoe for skateboarding

Finding proper shoes to wear with each new set of AFOs or SMOs can be frustrating – any suggestions on what footwear works for your child?  What about winter boots? Tell us your success stories!