Find Out the Right Shoe Size for Kids Who Wear a SMO on One Foot and an AFO on the Other Foot

July 15, 2025 AFOs Juan Valenzuela 0 - Comments

Does your child need to wear an SMO (supramalleolar orthosis) on one foot and an AFO (ankle-foot orthosis) on the other? Are you feeling overwhelmed trying to figure out which shoe size to buy to fit both braces comfortably? It can be tricky to know whether your child needs two different shoe sizes (one for the SMO and a larger one for the AFO) or if the same size will work for both feet. Many parents also find themselves confused about the differences between AFOs and SMOs. So, let’s start by clearing that up and looking at what makes these two braces different.

How Does an SMO Look Like?

SMOs are much shorter than AFOs and take up less room inside the shoe, making them easier to fit. Here’s a look at an SMO without a footplate extending over the toes—notice how compact and streamlined it is!
Keep in mind that some SMOs come with a footplate that extends over the toes, adding extra length and making shoe fitting a bit trickier. Here’s an example so you can see what that looks like!

How Does an AFO Look Like?

An AFO is a taller brace that typically reaches just below your child’s knees, offering strong support for the leg and foot. Notice how it includes a footplate that extends past the toes, as shown in the image below—it’s this feature that often makes finding the right shoes more challenging!

As you can see, there’s a big difference in how much room AFOs and SMOs take up inside shoes. I always tell parents that finding shoes for kids who wear SMOs is usually much easier than for those who need AFOs. The extra height and bulk of AFOs can make shoe shopping feel like a real puzzle!

Find Out the Right Shoe Size for Kids Who Wear One SMO and One AFO

AFOs and SMOs both offer unique advantages and for some children, the ideal solution isn’t one or the other, but both. These braces can do amazing things when it comes to improving your child’s mobility and control.

Step Number One: Measure Your Child’s AFO Footplate

Only follow this step if your child’s SMOs have a footplate extending over the toes. For these types of braces, measure from the back of the heel cup to the tip of the longest part at the front. Take note of the measurement—or feel free to email me a photo of it—to ensure we get the perfect shoe fit without any confusion.

Step Number Two: Measure Your Child’s SMO Footplate

Find out what shoe size you should order for your child's SMOs.
You only need to do this step if your child has an SMO with a footplate that extends over the toes. If your child does have an SMO with a footplate that extends over the toes measure it the same way as shown in step number one.

Step Number Three: Measure Your Child’s Foot Length

Measure both feet to the tip of the longest toe while your child is standing, as on weight-bearing the foot becomes longer. This helps avoid buying shoes that are unnecessarily large for SMOs. Record the longest measurement in inches or centimeters, or email me a photo to ensure accuracy. You can follow the instructions in this video for better visualizations purposes.

Step Number Four: Email Me the Measurements

The final step is to e-mail me your child’s foot measurements along with the measurements of their AFO or SMO. I’ll help you figure out the exact shoe size your child needs. Once I get the details, I’ll get back to you with personalized advice within 24 hours!

Once you confirm whether you need to buy the same shoe size to accommodate both feet or if you need one shoe size for the AFOs and a smaller one for the SMOs, you will be ready to start looking for shoes.

If you end up needing two different shoe sizes for your child, don’t worry—some shoe brands offer the second pair at 50% off, helping you save while keeping both feet comfortable!

What Are the Best Sneakers for Kids Who Wear AFOs or SMOs?

I’ve also put together some additional resources that might be helpful if you’re feeling unsure about which specific shoes will work best with your child’s braces. One guide covers the best adaptive shoes for AFOs, while another focuses on shoes designed for SMOs.

It’s important to know there’s a wide variety of AFOs and SMOs, each designed for a specific purpose. No single style is universally “better”—it all depends on your child’s unique needs. Braces and shoes work hand in hand to support and treat your child’s foot condition, and the right fit is crucial. If the shoes don’t fit properly, your child may miss out on the full benefits their braces are meant to provide.

I know how overwhelming and time-consuming it can be to track down the perfect pair of shoes for a child who wears an AFO on one foot and an SMO on the other. I hope this information makes your search a little easier. Please feel free to reach out if you have any questions—I’m always here to help!