Shoes That Fit Over AFOs and SMOs: A Buying Guide for Kids and Adults

Finding shoes that fit over an AFO or SMO leg brace is one of the most common footwear problems we hear about. A brace adds height, width and depth to the foot, so a shoe that fits a bare foot often will not close over a braced one. This guide covers what to look for, how to size, and which shoe features make the daily routine easier for kids and adults.

Looking for AFO friendly shoes now? Shop all Friendly Shoes: wide styles with a zip opening and removable insoles, for kids, women and men.

This guide is general shopping advice, not medical advice. Your orthotist or physical therapist knows your brace best, so check with them before changing footwear.

AFO and SMO: what the brace changes

An AFO (ankle foot orthosis) runs from the foot up the back of the calf. An SMO (supramalleolar orthosis) is shorter and stops just above the ankle bone. Both sit inside the shoe, so the shoe has to make room for the brace and the foot together. That usually means more width, more depth in the toe box, a higher and firmer heel counter, and an opening that lets the braced foot slide in without forcing it.

If you can, bring your shoes to your orthotic fitting appointment. It helps the orthotist shape the brace around the footwear you plan to wear.

Shoes for leg braces: AFO, SMO and KAFO

Most people who search for shoes for leg braces mean one of three braces. All of them end in a foot plate that sits inside the shoe, so the shoe advice in this guide applies to each:

SMO: a short brace that wraps the foot and stops just above the ankle bone.
AFO: a brace that runs from the foot up the back of the calf, often worn for foot drop.
KAFO (knee ankle foot orthosis): a longer brace that reaches above the knee. The part inside the shoe is like an AFO, so it needs the same width, depth and wide opening.

Knee braces and calf sleeves that stop above the ankle do not go inside the shoe, so a regular shoe with good support is usually fine with those. Whatever the brace, try the shoe on with the brace in place, ideally later in the day.

10 things to look for in a shoe for AFOs and SMOs

1) A wide opening. The hardest part is usually getting the braced foot in. Look for a shoe that opens far down the front or back, not just a loose tongue. Friendly Shoes use a patented rear zip opening called Easy Shoe Access, which opens the back of the shoe so the foot and brace go in from behind.

2) Extra width and toe box depth. A brace adds bulk around the forefoot and heel. Wide and extra deep shoes give it space without pinching the toes.

3) A removable insole. Taking the insole out frees up several millimetres of depth, which is often what makes a brace fit. Most Friendly Shoes have removable memory foam footbeds for this reason.

4) A firm, high enough heel collar. The back of the shoe should hold the brace in place. Very low backs, chosen because they are easy to get on, can let the heel lift out.

5) A low heel, but not completely flat. A totally flat sole or a high heel can both change how the brace works. Ask your orthotist what heel height suits your brace.

6) Adjustable closure. Hook and loop (velcro) straps or zips let you set the tension over the brace each day. Elastic laces only help if you can still adjust them.

7) Light weight. A brace already adds weight. A lighter shoe makes lifting the leg easier, especially over longer walks.

8) An anti-slip outsole. A grippy rubber sole helps reduce slips and trips.

9) Easy for the wearer to put on. The best shoe is one the person can actually get on, whether that is the wearer, a parent or a carer.

10) A fair return policy. Brace fit is personal and hard to judge online. Buy from a store that lets you try shoes indoors and return them. Friendly Shoes can be returned within 30 days if lightly worn indoors (see our returns policy).

Best shoes for SMOs

An SMO is lower than an AFO, so the shoe does not need as much height at the back, but it still needs room around the ankle and the midfoot, where the brace is widest. SMOs are most common in toddlers and young children, often for low muscle tone, flat feet or toe walking (see our guide to shoes for Down syndrome). When choosing shoes for SMOs, look for:

A wide, deep midfoot and toe box. The brace adds bulk on both sides of the foot.
A firm heel counter that sits at or above the top of the SMO, so the brace does not rub or lift out of the shoe.
A big opening. A rear zip or a front opening lets the braced foot go straight in without bending the brace or the child’s toes.
A removable insole to win back depth.
Adjustable closures such as hook and loop straps or set and forget laces, to fit snugly over the brace.

Good starting points for SMO friendly shoes for kids are our Excursion Moon Dust Wide Kids’ Shoe, the Excursion All Black Wide Kids’ Shoe and, for bulkier braces, the Excursion All Black Wider Fit Kids’ Shoe. All have a rear zip opening, a wide upper and a removable footbed.

How to size shoes over a brace

Measure with the brace on. Trace the braced foot on paper while standing, then measure length and the widest point. Compare that with the size chart, not the bare foot size. Our foot sizing tips walk through it.
Many people go up half to one full size. You want room for the brace, but not so much that the foot slides, which can affect balance.
Remember the ankle and instep. Note the width at the ankle and across the instep with and without the brace. These are often the tight spots, not the length.
One brace, two feet. If only one foot wears a brace, the two feet may need different sizes. Our single or split size shoe program lets you order a different size for each foot.

Shoes for kids with AFOs

Children grow out of shoes and braces quickly, so the shoe needs to be easy to get on at speed and roomy enough for the current brace. Parents tell us a rear opening saves the morning routine, because the foot and brace slide in from behind instead of being pushed through the front.

Kids’ shoes to start with:

Excursion All Black Wider Fit Kids’ Shoe: our widest kids’ fit, for bulkier braces
Excursion All Black Wide Kids’ Shoe: light, wide, school friendly
Scout Desert Spice Kids’ Boot: a boot for colder months (see how to choose AFO friendly boots)

See all adaptive shoes for kids.

Shoes for adults with AFOs

Adults wearing an AFO after a stroke, with MS, foot drop or another condition often need the same features: width, depth, a firm heel and an easy opening. Hook and loop closures are useful when one hand is weaker.

See all adaptive shoes for women and adaptive shoes for men.

Frequently asked questions

What is the difference between an AFO and an SMO?

An AFO runs up the back of the calf and controls the ankle and foot. An SMO stops just above the ankle bone and mainly supports the foot and the ankle’s side to side movement. Your orthotist decides which one is needed.

Do SMOs need a bigger shoe size?

Often a half size bigger, or the same size in a wider and deeper fit. Measure with the SMO on, standing, and check there is a thumb’s width in front of the longest toe.

Do I need to buy a bigger shoe for an AFO?

Often, yes. Many people go up half to one full size, and some need a wider fit instead of a longer one. Measure the foot with the brace on and compare it with the size chart.

What type of shoe is best for foot drop?

People with foot drop often wear an AFO, so the shoe needs to fit the brace: wide, deep, light, with a firm heel and an opening that is easy to use. A light shoe also makes lifting the foot easier. Your clinician can advise on the brace itself. See our guide to shoes for foot drop.

What is the difference between orthotic and orthopedic shoes?

Orthotics are inserts or braces, such as insoles, SMOs and AFOs. Orthopedic shoes are shoes built for foot support, often with extra depth and width. An orthotic friendly shoe is one with room and a removable insole so an orthotic can go inside. Our guide to extra depth shoes explains the difference between depth and width.

Can I put orthotics in any shoe?

Not always. A shoe needs enough depth and width, and ideally a removable insole, so the orthotic does not push the foot up and out of the heel. Shallow fashion shoes and many flat canvas sneakers rarely work. See our guide to orthotic friendly shoes.

Can you wear an AFO without shoes?

Most AFOs are designed to be worn inside a shoe, which holds the brace in place and protects it. Follow your orthotist’s advice for walking at home.

What shoes are best for leg braces?

Shoes that open wide, with extra width and depth, a firm heel and a removable insole, so the foot and brace go in together. Sneakers with a rear or front zip, or hook and loop straps, are the easiest to put on over an AFO, SMO or KAFO. See our shoes for leg braces.

Can you wear regular sneakers with an AFO?

Sometimes, if the sneaker is wide and deep enough and the insole comes out to make room for the brace. Many standard sneakers are narrow at the heel and shallow over the toes, so the brace pushes the heel out or squeezes the toes. A good AFO sneaker opens wide at the back or front, has a removable insole and a firm heel, and is tried on with the brace in place. Our zip-open sneakers for women, men and kids are made for this.

Are Friendly Shoes AFO friendly?

Most of our wide styles fit most AFOs and SMOs, thanks to the rear Easy Shoe Access opening, extra width and removable insoles. Braces vary a lot, so check the size guide on each product, and use our 30-day returns if the fit is not right.