How to Order the Correct Shoe Size for Your Child’s SMOs – Follow These 4 Simple Steps

June 17, 2023 SMOs Juan Valenzuela 0 - Comments

Does your child need to wear Supra-Malleolar Orthosis (SMOs) and are you having a hard time finding shoes to accommodate their SMOs? Are you frustrated about buying shoes in multiple sizes and having to return them all? Before we dive into how to order the correct shoe size for your child’s SMOs, I would like to go over some key information that will hopefully provide you with further insights and steer you on the right path.

What is the Supra-Malleolar Orthosis (SMO)?

Supra-Malleolar Orthosis is short for SMO, and it supports the foot just above the ankle bones or malleoli. SMOs are mainly used to control subtalar joint alignment, which is usually described as the joint in the foot located at the heel bone. In simple terms, an SMO is a foot and ankle brace.

Unlike AFOs, SMOs for children don’t extend much higher than the ankle, and when worn with shoes, they are less visible. In addition, most SMOs don’t have a footplate that extends over the toes as shown in the image below:

There are certain SMOs that do have a footplate that extends over the toes as shown in the image below:

Whichever one your child might need depends on the degree of your child’s foot or leg condition.

If your child is fit in the wrong pair of shoes, he or she will not receive many of the benefits the brace has to offer, even if you invest in a good pair of SMOs or AFOs.

How to Order the Correct Shoe Size for Your Child’s SMOs

To help parents figure out exactly what shoe size they need to order for their child’s SMOs, I have created a free online resource.

➡️ Step Number 1: Measure Your Child’s SMO Footplate (if it extends over your child’s toes).

You only need to do this step if your child’s SMOs have a footplate that extends over the toes as shown in the image below. If your child wears SMOs with a footplate that extends over the toes you need to measure from the back of the heel cup to the longest front part of the brace as shown in the image below. Make note of that measurement or email me the image showing the measurements to avoid confusion with the measurements:

➡️ Step Number 2: Measure Your Child’s Foot Length

Measure your child’s feet while standing, as on weight-bearing the foot becomes longer. Thereafter, measure both feet up to the tip of your child’s longest toe and make note of the longest measurement in centimeters or inches or email me the image showing the measurements to avoid confusion with the measurements:

➡️ Step 3: Take photos to Retrieve the Exact Foot Shape (Narrow, Medium, Wide, Extra Wide)

To retrieve your child’s exact foot shape, please take two photos of your child’s feet as shown below.

➡️ Step 4: Send All the Information Via E-mail

As a last step, email us your child’s feet and SMO measurements so we can tell you exactly what shoe size you should order for your child. Once we receive your child’s measurements we will respond within 24 hours.

Thereafter, with accurate measurements of your child’s shoes and SMOs, you’ll have a reliable reference point for shopping online. That being said, sometimes even when you know the exact shoe size you need to order, you might have to end up ordering more than one shoe, as there is a lot of trial and error when fitting shoes for orthotics and generally shoes fit differently.

Is this Service Free of Cost?

Absolutely, this service is completely free. I am passionate about fitting children’s shoes as I truly believe that the correct type of shoes can be life-changing. Children’s feet are constantly developing, and what happens to their feet during their childhood will affect their physique as they grow older. 

If you wish to support the work of Fitting Children’s Shoes, you can Donate Here. Your support helps the community as we thrive to assist families around the world to find the correct shoes for their children, regardless of their foot shape or condition.

Key Points and Suggestions on The Use of SMOs

➡️ On How to Fit the SMOs

  • Make sure to fasten the ankle strap firmly, then the calf strap. Also ensure that all the straps are fastened securely. Thereafter, your child’s shoe can be worn over the orthoses.
  • I suggest that your child wears cotton socks under the SMOs as this can reduce the constant rubbing. 
  • If your child has an SMO for each foot, make sure that you are putting them on the correct foot.

➡️ On How to Remove the SMOs

Don’t forget to check your child’s skin when you remove their SMO. I say this because SMOs (similar to AFOs) can cause a slightly red line around the edge of the orthosis, but this should usually disappear within half an hour approximately. Note, if your child has any pain or skin marks that do not disappear within half an hour or they develop blisters, please contact your medical professional at the earliest to make sure they can promptly evaluate the situation and advise accordingly. 

➡️ On Care Instructions for the SMOs

Bear in mind that the SMOs should be cleaned regularly by wiping them with a damp cloth and soapy water. Once the braces are clean, they should be completely dry before being reapplied. Please refrain from using direct sunlight or a hair dryer and tumble drier to dry your SMOs.

Simply because you find a shoe that fits over the SMO it doesn’t mean that they are the best option for your child’s feet. I also want to point out that allowing your child to walk around in shoes that are too large might compromise your child’s stability and make your child more prone to falling. One of the main purposes of wearing an SMO is to provide stability, but if your child wears shoes that are too large you will be defeating the whole purpose of wearing the brace.

Additional Resources for Children Who Wear SMOs

If you are looking for additional information and recommendations on shoes for a child who wears SMOs in your family, please take a look at the articles below. Note, that the most important pair of footwear for a child who wears SMOs is everyday sneakers. Children should wear sneakers most often with their ankle braces for them to be most effective and comfortable. Here is an additional resource that describes the best sandals for SMOs.