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What is the Best Way to Measure Shoe Size for Patients Wearing an AFO?

Arizona AFOMost any AFO makes shoe fitting more challenging; the bulkier the device, the harder to fit shoes. The most important concept is the importance of fitting from the inside out. That is, the shoes must accommodate the foot, insert and AFO. Shoe design is as significant as size for effective fitting.

Features of shoes best to fit over an AFO:

  • Incorporate rocker sole if propulsive gait and AFO limits ankle and STJ sagittal joint motion
  • Full contact sole that does not taper in midsection.
  • Firm heel counter that do not twist easily.
  • Removable footbed
  • Removable spacers

Shoe styles determined to fit best over AFOs are indicated in the SafeStep shoe catalog and on the website with an AFO icon.

When sized properly:

  • There should be 1/2″ space between the end of the longest toe and the end of the shoe.
  • Ensure that the shoes are wide enough such that the foot does not bulge the lateral side.

Fitting will be best accomplished in the office with the use of a display stand or with pairs of shoes to try on. When the fitting is challenging or if one foot is significantly different in size or shape than the other, its best to refer patient to store where shoes can be tried on over AFO.

Fit may be best accomplished by removing spacers from shoe with AFO and adding to shoe without.

If foot with an AFO much larger and different in shape from contralateral side, best option is custom molded shoes made over AFO. Entails first molding for AFO and then for shoes afterwards. Custom shoes are only covered by Medicare for patients with diabetes or if AFO attaches to shoe. Alternatively, Arizona AFO makes a custom shoe with built in brace called the Closed Toe Walker.