Best Orthotics for Children with Low Muscle Tone – Let’s Stabilize Your Child’s Feet!

Has your child been diagnosed with low muscle tone (hypotonia) and your medical professional recommended a pair of orthotics to be fitted inside the shoes? Have you noticed that your child’s feet are not in alignment, and this is affecting your child’s foot posture and walking gait? Let me show you the best orthotics for children with low muscle tone.

I am not a doctor, but I have seen and helped several children with low muscle tone (hypotonia) as they are referred by physical and occupational therapists to a specialized children’s shoe store where I work. These children are referred to the store to be fitted for supportive shoes, and depending on the degree of their foot condition, orthotics as well.

Pro Tip: If you’re pressed for time here is a list of the most effective orthotics for children with low muscle tone.

Does Your Child Have Flat Feet?

Most low-tone children fall into pronation. I have noticed that children with low muscle tone tend to have flat feet, and children with flat feet tend to have poor balance and coordination. 

Don’t worry too much if your child is not walking yet. Children with low tone tend to walk late because their feet are in poor alignment and their toes curl under for stability, making their feet tire faster.

Properly supporting your children’s feet is essential for their legs and body to function properly.

Sometimes all children need is to be fitted in a pair of supportive shoes, but in my experience, most children with low muscle tone can strongly benefit from wearing an orthotic as well.

I have seen hundreds of children with foot issues and foot conditions, and you have no idea how many of them stand up and walk a lot better after being fitted in the correct pair of shoes and orthotics.

What Are Good Orthotics for Children with Low Muscle Tone?

There are several orthotics out there so it can be challenging for parents to decide which ones are best for their children.

I have tested different orthotics and I know which ones are more effective than others from observing the child stand and walk with them. There is one specific orthotic that provides similar benefits as custom orthotics but at a more affordable price. I will show you this orthotic shortly but let’s first find out at what age should children start wearing orthotics and the benefits that this orthotic provides.

How Soon Should Children Wear Orthotics?

This is quite a complex subject in which some medical professionals recommend early intervention while some others recommend waiting until the child is 5 years old or older. In my experience it should not be a matter of age, it should be a matter of whether we can help improve the child’s stance and overall posture.

I speak to families of children with low muscle tone on a weekly basis, and most of them regret not having acted sooner. These families are frustrated and infuriated as their medical professionals tell them “Don’t worry, your child will outgrow it soon”.

I strongly suggest families not play the “waiting game” when it comes to treating their children’s foot conditions. Waiting for your child’s foot condition to “magically disappear” might only lead to the condition getting worse. 

The Complications of Leaving Your Child’s Low Muscle Tone Untreated

When your child’s feet are not in alignment, your child’s knees and hips also become misaligned.  This means the muscles that move those joints no longer work efficiently, and it will take more energy for your child to do the same work as other children who don’t have this condition. Muscle fatigue and stiff leg muscles are common complaints of children who have persistent foot pronation. 

Children between the ages of 1 and 5 are undergoing rapid neuromuscular development and foot pronation during these years can often be easily managed with proper foot orthotics and correct footwear. Unresolved foot conditions after age 5 or older, although still manageable, can become a bit more difficult to control.  

What a Difference the Correct Pair of Orthotics Can Make!

Most parents make the common mistake of assuming that the orthotics only support the arch of the foot. Orthotics should not only support the arch, but they should also mechanically support all of the pieces of the foot that causes the feet to collapse such as the heels.

Certain orthotics can make a world of difference for a child with low muscle tone as they help capture the child’s heels into a more appropriate alignment for taking body weight while leaving the forefoot active and operative.

Before Image

After Image

Notice how the deep heel cup is stabilizing the heel in a midline position. This will help improve the child’s stability.

What Makes these Orthotics Effective for Treating Low Muscle Tone?

The orthotics I recommend for children with low muscle tone are the least restrictive ones as they allow for the normal movement of the foot. One of the main reasons why this orthotic works so efficiently for children with low muscle tone is that it provides a deep heel cup (30mm to be more precise) that provides stability and improves the child’s walking gait. 

1️⃣ 30mm heel cup helps control the alignment of the heel and lower leg, and supports the arch:

2️⃣ Medial and lateral flanges help keep the foot aligned over the orthotic. I have noticed how most children’s prefabricated orthotics lack this feature and the child’s foot pushes through the orthotic and does whatever it wants.

The Best Orthotics for Low Muscle Tone

The orthotic below is the best prefabricated on the market for helping treat and control low muscle tone. One of the main goals of this orthotic is to prevent your child’s balance be affected by their low muscle tone.

Find Out What Orthotic Size You Should Order

Take a look at the chart below to figure out what size to order based on your child’s shoe size:


This orthotic can be shipped anywhere. Within the USA, shipping can take about 10-15 days depending on the location and the shipping method. Overseas shipping is available but will be more expensive. 

Are the Orthotics I Recommend Better than AFOs and SMOs?

I believe they are better. I have fitted several children with SMOs and AFOs at the shoe store I work for, and I always found those orthoses devices too rigid, and I felt like they immobilize the foot. With that said, it’s a fact that SMOs and AFOs can be extremely effective in helping treat a child’s foot condition.

I am not saying that if your medical professional wants your child fitted in a pair of AFOs or SMOs you shouldn’t comply, I just prefer to always start with a less invasive orthotic and take it from there. 

A lot of children have a hard time getting used to wearing AFOs and SMOs. In addition, parents always have a hard time finding a good pair of shoes to fit the braces.

What Are the Best Shoes for Children with Low Muscle Tone?

The shoes I recommend for a child with low muscle tone who wears orthotics must provide the following features:

1️⃣ Substantial Outsole: This feature helps align your kids’ feet properly, providing a stable base for your child’s feet:


2️⃣ Firm Heel Counter: This is the back part of the shoes that provides ankle and heel support. The firmer the heel counter is, the better. Always press on the heel counter of the shoes before buying shoes for your child:


3️⃣ Straight Last: Shoes with straight lasts will help keep your child’s feet in the correct position. Always try to avoid shoes with excessively curved lasts:


4️⃣ Extra Depth: This feature is going to allow the orthotics to fit deeply inside the shoes and prevent giving your child the impression that his/her feet are coming out of the shoes:

Where Can You Find Shoes that Provide Those 4 Important Features?

If you want to see a selection of sneakers that are supportive and capable of accommodating orthotics you should read this resource.

Final Thoughts on Children with Low Muscle Tone

It’s quite clear that the correct type of orthotics can help optimize your child’s foot-joint alignment and weight-load distribution. 

Keep in mind that supportive shoes or orthotics won’t make your child’s muscles weaker. All you are doing is providing your child with structural support.

Your child’s walking gait determines how much energy your child used with each step. If your child’s feet are not in alignment, your child will tire easily and likely become sedentary.

Please take early action and prevent your child from gaining excessive weight, as it might become harder to get them active again.

“Low Muscle Tone And Your Child – What You Need To Know.” ​Surestep​, 1 Dec. 2016,

“Muscle Weakness (Hypotonia): Boston Children’s Hospital.” ​Boston Children’s Hospital,​