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Your Child’s Ankle Foot Orthosis (AFO)

What is an AFO?

AFOs or ‘Ankle Foot Orthoses’ are plastic splints which are made to keep feet and ankles in a good position for standing and walking. Children may wear them on one foot or both feet. They may have a joint or hinge at the ankle or they may be fixed in one position. They come in lots of different colours and patterns.

What should be worn under the splint (AFO)?

Your child should wear long cotton socks or tights under the AFO which are:

  • Well fitting.
  • Smooth fabric – no raised patterns.
  • Made from cotton rich material.
  • Long enough to cover all the areas of the skin, which come into contact with the splint.
  • Pulled up firmly to eliminate creases.

Do I need to buy special shoes?

You will need to buy some shoes to fit over the AFO. This often means buying shoes that are bigger than your child’s usual shoe size. They do not need to be expensive, ordinary trainers or shoes are fine.

  • Look for shoes with laces that reach down as far to the toes as possible or shoes that are deep and have adequate width (sometimes taking the inside sole out creates extra space).
  • Take your child’s AFO with you when you buy shoes.
  • Do not allow your child to wear their AFO without shoes as they can be slippery or hazardous.

Putting on your child’s AFO:

  1. Sit your child in front of you with their hip and knee bent. Pull up their socks and make sure there are no wrinkles in them.
  2. Turn the foot towards the middle before bringing the foot up towards the knee.
  3. Place your child’s heel at the back of the AFO, then fasten the heel retaining strap snugly. Check that the heel is in place by lifting the toes up to see.
  4. Finally fasten the top strap and put on the shoe.

How long should it be worn?

At first, the AFO may feel uncomfortable so they should be worn gradually using the following schedule.

Day 1: 30-60 minutes

Day 2: 1-2 hours

Day 3: 3-4 hours

Day 4: 4-5 hours

Your Orthotist will tell you how long you should build up to, or what activities to wear them for. Some children wear them for a few hours, while others wear them all day or at night.

What about red marks on the skin?

  • Check the skin around the foot and ankle every time you take the splints off.
  • It is normal to see red marks where pressure has been applied. These should disappear within 30 minutes.
  • If you notice any sores or blistering you should stop using the splints and contact your Physiotherapist or Orthotist for advice as they may need adjusting.

Care of your AFO:

You can clean AFOs by wiping with a damp cloth. Dry it with a towel or leave it to dry naturally. The straps may discolour with use but this does not affect the function of the splint. If you have any problems with your AFO contact your Physiotherapist or Orthotist.


The Ankle Foot Orthosis supplied is considered the most appropriate for your child’s condition.