Right Shoe Size for Kids Who Wear One SMO and One AFO

August 21, 2026 AFOs Juan Valenzuela 0 - Comments

Does your child wear an SMO (supramalleolar orthosis) on one foot and an AFO (ankle-foot orthosis) on the other? Feeling overwhelmed trying to figure out what shoe size will fit both braces comfortably? It’s a common source of confusion — should you buy two different shoe sizes, one for each brace, or will the same size work for both feet? Many parents also aren’t sure exactly what separates an AFO from an SMO in the first place, so let’s start there before getting into sizing.

What 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 an SMO without a footplate extending over the toes — notice how compact and streamlined it is.
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 of what that looks like.

What Does an AFO Look Like?

An AFO is a taller brace that typically reaches just below the knee, offering strong support for the leg and foot. Notice how it includes a footplate that extends past the toes — this is exactly what makes finding the right shoes more challenging.

As you can see, AFOs and SMOs take up very different amounts of room inside a shoe. In my experience, finding shoes for kids who wear SMOs is usually much easier than for kids who need AFOs — the extra height and bulk of an AFO can turn shoe shopping into a real puzzle.

Finding the Right Shoe Size for One SMO and One AFO

AFOs and SMOs each offer their own advantages, and for some kids, the ideal solution isn’t one or the other — it’s both, working together to improve mobility and control. Here’s how to figure out the correct shoe size for each foot.

Step 1: Measure Your Child’s AFO Footplate

AFOs always have a footplate that extends past the toes, so this step is required. Measure from the back of the heel cup to the tip of the longest part at the front. Note the measurement — or email me a photo of it — and I’ll help you get the exact fit right.

Step 2: Measure Your Child’s SMO Footplate (If Applicable)

Find out what shoe size you should order for your child's SMOs.
Only follow this step if your child’s SMO has a footplate that extends over the toes. If it does, measure it the same way described in Step 1. If your child’s SMO doesn’t have an extended footplate, you can skip straight to Step 3.

Step 3: Measure Your Child’s Foot Length

Measure both feet to the tip of the longest toe while your child is standing — the foot lengthens under weight-bearing, so this gives you an accurate reading. This step helps you avoid buying shoes that are unnecessarily large for the SMO side. Record the longest measurement in inches or centimeters, or email me a photo for accuracy. You can also follow along with this instructional video for a clearer visual.

Step 4: Email Me the Measurements

The final step is to email me your child’s foot measurements along with the AFO and SMO footplate measurements. I’ll help you figure out the exact shoe sizes your child needs and get back to you with personalized advice within 24 hours.

Once you know whether your child needs the same shoe size for both feet, or a larger size for the AFO side and a smaller one for the SMO side, you’re ready to start shopping.

If you do end up needing two different shoe sizes, don’t worry — some shoe brands and retailers offer the second pair at 50% off, so you can keep both feet comfortable without paying double.

Best Sneakers for Kids Who Wear AFOs or SMOs

If you’re still unsure which specific shoes will work best with your child’s braces, I’ve put together dedicated guides for each: the best adaptive shoes for AFOs, and the best shoes for SMOs.

There’s a wide variety of AFOs and SMOs, each designed for a specific purpose — no single style is universally “better.” It all comes down to your child’s unique needs. Braces and shoes work hand in hand to support and treat your child’s foot condition, and getting the fit right matters. If the shoes don’t fit properly, your child may not get the full benefit their braces are designed to provide.

I know how overwhelming and time-consuming it can be to track down the right pair of shoes for a child who wears an AFO on one foot and an SMO on the other. I hope this makes the search a little easier — feel free to reach out anytime if you have questions.