Adaptations – AFO’s

I often hear parents having issues with their child’s AFO’s.  We have NO problems with Nathan’s AFO’s, so I wanted to share what they look like.  We had a hard time finding shoes to fit that weren’t too big, we finally found a pair at Stride Rites which was only 1 size bigger.  We took the soles out and VOILA!

Nathan doesn’t mind his AFO’s  AT ALL and can wear them for hours and hours without any issues.  Since Nathan isn’t permanently spastic, we only use the AFO’s sporadically and when his feet feel tight.

The reason these are so great is because they have that inner boot.  The inner boot holds on to his foot real tight so he can’t pull out of it.  Then you fit the inner boot into the AFO shell and voila!



  1. Those are beautiful and thank you for showing them so clearly – so other parents can see. I know other mothers who complain bitterly about their child’s AFOs and it is clear the AFOs are poorly made. For other readers – try to compare yours with Nathan’s and show your orthotist this post if you want better results.

    The only comment I would make is that I believe wearing orthotics is critical during standing and not only based on level of spasticity.

  2. Cody’s have the inner boot too. We’re on our second set and haven’t had any problems with the AFO’s. I really like how Nathans have the cushion inside the boot. Looks so much more comfortable. How’s he doing with the hinged AFO? Cody pushes and bears weight much better without his AFO’s and won’t step in his gait trainer with them on so we pretty much only use them in his stander. Good to know about the stride rite too….hate those huge oversized shoes!

  3. Hi Barbara, I totally agree about using them while weight bearing.  I wrote the post really quickly and wasn’t very thorough.  I try not to use them EVERY TIME he is weight bearing because I want him to learn how to stand on his own as well.  The other problem I’ve heard of is that if they’re always weight bearing with AFO’s their calves can get weak.  So I sometimes have him wear the AFO’s while weight bearing, sometimes not.  I would love to know your thoughts on this.

  4. Hi Laura yeah the cushion makes a big difference, after I take them off I see no redness at all and he is just comfortable as can be.  Nathan also does not know how to move with them.  The PT that we say yesterday at the suit therapy clinic mentioned that it will be very difficult for him given all of his issues.  Her belief was to just let him walk without the AFO’s in the pony so he enjoys moving and being upright, and having him wear the AFO’s while at rest or standing.  When you go to stride rite, bring the AFO’s and tell them to show you the widest shoes.  We pretty much tried them all and found 2 pairs that fit really well and are just slightly bigger than his foot. 

  5. One of the reasons I am so adamant about wearing orthotics in standing is to help good foot formation. With the 2 part brace, the inner part can be used in the shoe without weakening the calf. Actually, it is more complicated than that, but that is enough for a comment on a blog.

    Standing on poorly-aligned feet will not help standing independently. Orthotics are critical for placing the feet in good alignment until the muscles become more active.

  6. Love the afo’s! & with the inner boot I can see how they would really work. Little Man can wear his for hours on end too, but his were given to us & are about 3 sizes too big. 2 pairs or socks & they are great though! I only got them because his ankles were colasping after standing for 15 min. But even with the too big afo’s he stands for about an hour w/o complaints! I’m this out to show his orthotist. Thanks for sharing!

  7. Thanks so much for sharing this info Barbara, I appreciate it, I will keep this in mind with Nathan’s standing program! 

  8. Hi I was wondering what lab provided your AFOs with inner boots? we would really like to try this with our son but our lab did not offer them…(if you could email me that info, it would be great!) Thanks 🙂

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