Navigating the World of Orthotic Braces

When you’re told that your child needs to wear braces on his feet, the last thing you’re probably immediately worried about is what shoes to buy. But once you have the orthotics in hand and realize how difficult they are to get into a pair of shoes, suddenly you’re looking for anyone who can give a helping hand. So that’s what I’m here to do, at least as best I can (my son only just got his, but I’ve done a LOT of research already!) 🙂

My son is 20 months old and was recommended for physical therapy (PT) when he was 12 months old and hadn’t even stood up for the first time. He has low muscle tone (hypotonia), especially in his core, and when he finally started PT, his therapist said that his feet are really pronated, which means that they’re flat and he bears weight on the inside of them. She said braces would correct the pronation and help him with balance so that he could concentrate more on developing his walking skills than on trying to keep himself stable.

Now, if you’ve been told your child needs orthotics due to low muscle tone and you’re not sure whether you want to go that route (there is actually controversy about this), please check out this article, which I found very informative: Orthotic Management of Low-Tone Children: The Earlier the Better.

This is also a great page for guidelines about how to wear and care for an SMO orthotic.

Back to the story…Two weeks ago we finally got the braces, Surestep SMOs. They’re adorably covered in dinosaurs, but (not so adorably) difficult to get into a shoe 🙂 I hadn’t realized the orthotist only orders the orthotics, but doesn’t necessarily have anything to do with obtaining shoes. My assumption was that there are special shoes for them and we’d probably order them much the same way. Wrong!! Wrong wrong wrong. So off I was on a mission to find shoes. The first thing I did was take to Google and then to Facebook. And I’m here to let everyone know what I’ve found 🙂

Suresteps SMO

Now, keep in mind that these suggestions aren’t only for children with foot braces, such as SMOs or AFOs. During my search, I also discovered how much some of these shoes can help so many more people, such as those with special needs (children and adults alike) and even people with arthritis. There are sneakers that are just plain wide, ones made especially to fit orthoses, ones that bend in the middle, ones that open at the back. And there are a lot of options for no-tie laces because who wants to loosen the heck out of those in order to cram a brace into a shoe and then have to tie it all up? Here are my favorite options.

Size, Width, Structure, Style

Keep in mind that my son is only 20 months old and wears SMOs, so my bias is toward that type of brace. Older children and adults may have an easier time getting their brace into a shoe, especially depending on the type of brace, but very young children need their parents to do it, which increases difficulty.

Size: It’s important to have your child’s size taken with the orthotic on because it can end up being anywhere from 1-2 sizes larger than without the brace. Some websites, especially those with shoes designed with orthotics in mind, have downloadable size charts that you can print at home.

Width: Wide, wide, wide! Actually, that isn’t even good enough. At Stride Rite, my son’s feet (with orthotic) looked like they were ready to bust through the velcro strap to freedom when he was wearing a shoe in Extra Wide. But this, of course, depends on the brand and even style of shoe, not to mention whether you’ve removed the insole; no two will be the same, which is why it’s important to always try them on.

Structure: Depending on the brace, a lot of people will recommend to get as cheap a shoe as possible because the brace (certainly SMOs) provides the structure and support, so those features in a shoe aren’t as important. At the least, you shouldn’t necessarily worry about buying the best shoe possible, but the challenge can still be the right fit. And the thing, for me, is that I know a lot of parents are buying more “expensive” children’s shoes in the first place, such as Stride Rites, so while my list doesn’t have as cheap of options like shoes from Target or Walmart (because I haven’t tried them or looked into them), they are certainly practical and, very often, right within the price range of shoes a lot of us were already buying.

Style: It’s surprising how the subtlest difference in shoe style can make it easier or more difficult to get a brace into it. When we were trying on shoes, we found that how far the tongue could pull out as well as how the back was shaped made a big difference. Something I would have never noticed before, the backs of some shoes can curve inward toward the heel while others are thick and quite high, both of which get in the way of the heel of the orthotic. And, of course, a removable instep is always a big plus (some just rip out permanent ones anyway)! Though I’m not sure I’d want to do this, myself, a lot of parents cut the tongue out of the shoe to accommodate the orthotic. A clever idea, but I would just die “ruining” a good shoe 😉

Shoes_Not Recommended

Left: Back curves in. Middle: Thick, high back. Right: Elastic can restrict the tongue. Any of these may work for you, but they’re likely to be a more difficult fit, at least for small children whose parents have to basically cram their foot into the shoe (while potentially fighting against a kicking child).

Where to Buy

Stride Rite

A good number of Stride Rite shoes come in Extra Wide (and a small number in Extra Extra Wide). Of course, you’ll find more choice online than in-store, but I highly recommend going to the store to be sized with the orthotic on and to try anything they have in XW, even if you plan to buy online. This will help determine what style of shoe works best for you. One big plus is that you can return any online purchase to the store, which I find a lot more convenient. Unfortunately, though, I don’t know of any styles they sell with a removable insole and it can make the difference between an okay fit and a good one.

Shoes_Recommended

The sandals are sturdy, yet the shoe opens pretty wide because of that strap. The oxford is touted as so wide it’s “ridiculous,” so they’re clearly a good choice without even going XW.

Tsukihoshi

These Japanese shoes come highly recommended as good for children’s feet in the first place (see here), but they’re also made wider than the average shoe and the company touts their wide, curved velcro straps as making it easier to put the shoes on and take them off, both beneficial for accommodating an orthotic. If no stores in your area carry them, there are quite a few online sources, including Zappos and Amazon.

Shoes_Recommended2

Gotta love a loop tab on the back of a shoe to help slip it over the brace!

Plae

Plae shoes aren’t specifically designed for orthotics, but they are designed to help accommodate them! The shoes have a wider opening and toe box, removable insole, a handy loop on the back to help pull it over the brace’s heel, and interchangeable velcro tabs (from sizes small to extra large!). Bonus, not only can you get a percentage off your order and free shipping as a customer with orthotics (check out this guide here), but they have a Growth Spurt Guarantee–you get 50% off the full retail price of the same shoe in the next size up! They’re available in certain stores (such as Nordstrom), but I recommend ordering directly from the site for the best customer service. Don’t forget to print out their size chart to determine shoe size and tab (velcro strap) size!

Shoes_Recommended3

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Fun, interchangeable tabs in any size you need!

Surestep

You might recognize this name because your child’s orthotics may have been made by this company 😉 Luckily, they also sell shoes designed to accommodate! Surestep has the smallest selection, just two styles and only two to three colors in each style (one for boys and one for girls), but they’re certainly cute enough–think a more old school, white sneaker all kids were wearing decades ago 😉 Anyway, the sneakers have a wide, deep heel, toe box, and instep. They are lace-ups, so it’s up to you whether that’s an issue or not. Don’t forget you can always get no-tie laces to replace the standard ones. A bonus, the second shoe style is a sandal! It has the same design to accommodate an orthotic, but they also have a velcro strap along the back, making it even easier to get the brace in and out. Another plus is that Surestep shoes are actually the least expensive option. We’ll definitely be investing in a pair of sandals come summer.

Shoes_Recommended6

They’re not bright and colorful, but they’re classically adorable, practical, and inexpensive.

Hatchbacks

These have a really cool design concept that I think should apply to ALL kids shoes, or at least babies and toddlers. Not only are the heel and toe box wide, but the shoes actually bend in half at the center so that you slip the foot into the toe and then bring the heel up–you can’t get a shoe wider from front to back than that! Like Surestep, the one “downside” is the lack of style choices–it’s basically all the same shoe in a few different, neutral colors. Not the cutest, not the least expensive, but certainly worth it for the ease of use. I have to say, I think the design is genius.

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Seriously, this concept should be applied to all shoes for small children!

Easy Up Shoes

I want a pair of these shoes, they’re so beautiful. Okay, they’re sneakers, but they’re like elite sneakers (with the price tag to boot). Price aside, the technology of these shoes is amazing. They open at the back so that they’re essentially a slip-on, yet they look like a sleek, fashionable lace-up, and they can be made totally custom to fit your needs. You can choose the lining, outsole material, whether the heel is flat or rolling, and the option for a more flexible outsole. Not only that, but there’s a decent variety of styles and they’re made for both children and adults–not just for wearers of orthotics, but for anybody who needs help putting on a shoe from those who are neurologically atypical to people with arthritis. A great feature none of the other shoes have is that they accommodate wearers who use an orthotic on only one foot by using a clever technology that allows the shoe fit to adjust per the foot. They are the most expensive (not surprising as they’re made in Italy), but also the sleekest option, which I think matters for teenagers and certainly adults. For someone whose shoe size isn’t going to change before the seasons do, if you have the money (about 150+ Euros) I say go for it. Don’t worry, they have an American site/shop!

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With the innovative back-lace technology, these shoes can be put on one-handed.

Nike Flyease

These shoes aren’t for really small children (i.e. my 20-month-old) and, actually, are designed for sports (and not for orthotics), but they were specifically made for people with disabilities and have a really innovative design–the zipper runs around the back of the shoe to allow for ease of putting them on, even one-handed. Can you fit an orthotic in it? I don’t know, but a lot of parents recommend Nike brand shoes for just that. Even if they can’t accommodate one, the fact that they’re designed for people with special needs gets them a spot on this list because this is one more place someone can learn about them and get the word out to anyone who would benefit from this groundbreaking athletic shoe.

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One-handed zip for an easy on and off!

No-Tie Laces

Now, if you go with a lacing shoe, you might be interested in laces that don’t tie, so here are a few good options that I’ve found.

Locklaces

These lace up like regular shoelaces, but instead of tying them, there’s a plastic tab for tightening and loosening the laces. What’s great is one size truly does fit all; you simply cut them to fit.

Locklaces.jpg

DooHickies (or just Hickies for teens and adults)

DooHickies are single plastic tabs that snap together. It’s best to just see for yourself how they work than that I try to explain 😉 I will say, though, what’s nice is that even though they’re all one size, the manner in which you “lace” them will make them fit tighter or more loosely, depending on your needs. A downside for those with orthotics, though, is I don’t see it being easy to pull the tongue out as far as it needs to go in order to get the brace in. Nonetheless, these can be great for people with special needs, so I still wanted to mention them.

DooHickies

Laceez

These are kind of my favorite, but they aren’t made small enough for my son. They look like classic shoelaces, though, which I love. As with the DooHickies, I do have to wonder if the tongue can be pulled out far enough to accommodate a brace, but they’re certainly worth mentioning for anyone with other needs.

Laceez

I hope this post eases at least some of the difficulty you may be facing as your child transitions into a brace. And if you have any tips or advice, yourself, please let everyone know!

 

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