Shoes for Children With an AFO (Ankle-Foot Orthosis): UK Parent Guide

A simple insole sits flat on the bottom of the shoe and only occupies the floor area of the footbed. An AFO is a fundamentally different device. It wraps around the lower leg, the ankle, and the sole of the foot, occupying height, width, and depth inside the shoe.

This means an AFO-compatible shoe needs to accommodate significantly more volume than a shoe for a simple insole. The collar of the shoe must be wide enough for the brace to pass through. The heel area must accommodate both the foot and the AFO material sitting behind and around the heel. The shoe needs to be substantially larger overall.

Finding shoes that work with an AFO is, without question, the hardest orthotic shoe challenge most parents will face. But compatible options do exist, and understanding what to look for makes the process far more manageable.

This cannot be overstated. You must physically try the AFO inside every pair of shoes you are considering. What fits one child's AFO may not fit another, even at the same shoe size. AFOs vary in thickness, rigidity, trim lines, and profile, and every one of these factors changes how the device interacts with the shoe.

Do not order shoes without trying them with the AFO first, unless you have a guaranteed returns policy. Do not assume that a shoe which worked last time will work again, because your child's foot and AFO may have changed.

For most children with an AFO, you will need to go at least one full size bigger than the measured foot length. Some children need up to two sizes larger, depending on the bulk and design of the AFO.

Your child's orthotist should be able to give you specific guidance on how much extra room to allow. If they have not mentioned this, ask directly at the next appointment.

If your child wears an AFO on only one foot, you will be sizing for two different feet. The AFO foot will need the larger shoe. Read our sizing guide for children with orthotics for advice on managing split sizing.

Every AFO-compatible shoe needs the following features:

• Wide collar: the opening of the shoe must be wide enough for the AFO to pass through without being forced. High-cut trainers with full lacing from toe to collar are the most practical option, because the lacing opens the shoe wide enough for the brace to enter easily.
• Extra depth: the shoe must have enough internal volume to accommodate the foot sitting inside the AFO, which is thicker and taller than a foot alone.
• Laces or Velcro: adjustable fastening is essential. The fit needs to be snugged around the AFO at multiple points to prevent movement inside the shoe.
• Firm heel counter: squeeze the back of the shoe. It must resist compression. The heel counter has to hold both the foot and the AFO securely in place during walking, running, and play.
• Flat, firm sole: the sole provides the platform for the entire AFO and foot assembly. It must be flat, firm, and stable. Avoid squishy or rocker soles.

Not all shoe styles are equally compatible with AFOs. The following table gives a general guide:

Shoe Style	AFO Compatibility	Notes
High-top lace-up trainers	Excellent	Deep, wide collar that opens fully with lacing undone
Low-cut lace-up trainers	Good	Check that the collar is wide enough for the AFO to pass through
Lace-up walking shoes	Good	Can work well if the collar opens wide enough
Traditional school shoes	Often poor	Low collar, stiff upper, shallow depth
Lace-up or zip boots	Variable	Check that the opening is wide enough and the boot is not too rigid
Sandals	Generally unsuitable	Open construction cannot secure the AFO in place

If you have tried multiple high street options and nothing accommodates your child's AFO, you have several routes to explore:

1. Ask your child's orthotist about specialist paediatric orthotic footwear. There are UK retailers and manufacturers who specialise in shoes designed specifically for children with AFOs. Your orthotist will know the options available in your area.
2. Request a specialist fitting appointment. Some NHS orthotics departments and private clinics offer appointment-based fitting sessions where a trained fitter selects shoes from a range of known AFO-compatible styles. This is the most reliable way to find shoes for complex AFOs.
3. Ask about NHS-prescribed footwear. For children with complex needs where no commercial shoe can accommodate the AFO, the NHS can provide prescribed footwear at no cost. Your orthotist can advise whether your child qualifies.

For a full overview of purchasing options, read our guide on where to buy children's orthotic shoes in the UK.

My child wears an AFO on one foot only. Do both shoes need to be the same size?

Both shoes should be the same style, but the AFO foot may need a shoe one full size larger than the other foot. Ask about split-size purchasing at specialist retailers, or size both shoes to the AFO foot and adjust the fastening on the smaller foot. Read our sizing guide for more detail.

My child hates their AFO shoes. What can I do?

This is common, especially as children get older and become more aware of differences. Read our guide on helping your child accept their orthotic shoes for practical strategies, from involving them in the choice to finding the most fashionable compatible option.

My child has grown and the AFO no longer fits in the shoes. What should I do?

You probably need both new shoes and a new AFO. Contact your child's NHS orthotics department to request a review. Do not wait until the device is completely outgrown, as an ill-fitting AFO can cause pressure injuries and pain.

How often will I need to replace AFO shoes?

Potentially every 3 to 6 months for younger children during peak growth years. Rapid foot growth means shoes are outgrown before they wear out. Read our guide on how quickly children outgrow orthotic shoes for advice on managing this.

Browse our full Children's Orthotic Shoe Buyer Guide