First Shoes for AFOs

I’m trying to pick out Pooka’s first pair of shoes for wearing over her AFOs.  MrsK, do I remember correctly that you just bought Z some Tsukihoshi shoes?  If so, how do you like them?

Any other recommendations?  So far I’ve looked at Robeez and Tsukihoshi.  My concerns are 1) That they will protect her toes.  They are pretty beat up from crawling in her Ponsetti boots.  2) That they will hide dirt well.  Her Mitchell’s are filthy from her crawling around.

We had our first appointment with our local orthotist on Tuesday.  He is THE BEST!  After months of dealing with Drs. Doom & Gloom, he is so refreshing.  He is open to discussing all options and willing to try almost anything.  He himself has a prosthetic leg, which is carbon fiber.   So he was very encouraging when I brought up the Phatbraces and carbon fiber.  For now, we are doing traditional AFOs per the script from Shriners, but I think we will really be able to play with a lot of options in her future.  I’m so thankful to have found such a great orthotist.  He was friendly, funny, knowledgeable, flexible and just great in every way.  Three cheers for a good orthotist!!!


  • So glad you like your orthotist–he sounds very open minded! Stride Rite worked for us for the first several pairs of braces and they were pretty durable. The last couple braces have been more challenging. Our orthotist suggested Wal-Mart and, oddly enough, they do seem to fit better than most. I think because they are made cheaply, they are wide and less fitting–which works better with braces. I bought like 8 pairs of a shoe I found at Wal-Mart that fit really well but if she crawls outside (which she often does), they ruin after one use. In dept. stores, I’ve also noticed the cheapest pairs fit the best. Currently, she wears and The second pair are more durable. Laces work much better than velcro but are very hard to find in the smaller sizes. Both shoes are 1 size bigger than what she would wear without braces.

  • Yes, you remember correctly. We did just buy the Tsukihoshi. I L. O. V. E. them. They are supportive,flexible and super, super light. Totally washable, though I haven’t done that yet. And, like the Stride Rites, they are a bit wider than average with a very accommodating toe box. Her brother has some Stride Rites, and we like them, but they are not as light and for her, to me that’s a big deal. Her feet are so dang small and she is still scooting everywhere (like greased lighting!), I worried shoes would be a hazard. But these have been great and seem very durable.

    We were sized for DAFOs on Monday and I’m planning to get another pair of the Tsukihoshi for her to use when she needs to wear those. The insole comes out easily, if need be. I’m planning to go up 1 1/2 sizes to start. I like that’s they make a half size. I think they will work well and, since we won’t be using the braces full time I hope they will last until eventually she can grow into them for regular wear. There are so many color choices and combos that I bet you could easily find something that won’t show dirt.

    How exciting to have such a partner in your orthotisit! Must be totally refreshing!!

    Let us know what you decide about the shoes. This seems to be a real issue for a lot of folks.

  • Ooooh, Dynamic AFOs. Never heard of them. Do tell. . .

  • Well, I really don’t know a thing. I’d never heard of them either and, of course, this is all new to me. I know they are coming from Cascade, if that helps. My understanding is that the brace material is somewhat flexible to allow for more natural movement when they are worn. Its what our Ortho doc wanted, and since we aren’t going to be wearing them full time, and because we trust him, I just sort of took his word for it. We weren’t totally sure we would even get them. We are supposed to pick them up on the 22nd. I’ll get more detail then.

    If there’s something particular you want to know, ask me and I’ll be sure to ask. I really liked the orthotist. He was my age, with kids my age, and many years of experience. He’d worked in a hospital setting doing serial casting for a while as well, which gives him a broader perspective.

    It was a very interesting experience, having her fitted. And he pointed out some things no one else had. In particular he asked if we were doing any stretches with her toes. We weren’t. No one ever mentioned it, and though she does always seem to be curling them, I never paid it much attention. But one pinky toe in particular he pointed out was starting to really make an impression in her foot. I’m glad he said something!

    Anyway, happy Saturday. Hope you guys are warm!!

    • Here’s what Wikipedia says.

      A DAFO (Dynamic Ankle Foot Orthosis) is a brand name for some lower extremity braces that provide thin, flexible, external support to the foot, ankle and/or lower leg. Designed to help a patient maintain a functional position, a DAFO can improve stability for successful standing and walking.[1][2]

      Different from a traditional Ankle Foot Orthosis (AFO), which is typically stiff and rigid, a DAFO is characteristically thin, flexible and wraps around the patient’s entire foot in order to provide improved sensation and alignment. Initially designed for use by pediatric patients but now sometimes used by the adult population, a DAFO encourages range of motion, allowing children to learn movement by moving and providing minimal support, only where the patient needs it. DAFOs are frequently prescribed to assist with mobility and motor skills of children with cerebral palsy,[3] spina bifida, muscular dystrophy, clubfoot[4] and autism.[1]

      The concept for the original DAFO was developed in 1985 as collaboration between Don Buethorn, CPO, and Nancy M. Hylton, PT, LO.[5] The two worked together to create a thin, flexible brace that would meet the needs of pediatric patients with neurodevelopment challenges and the result was the creation of a Washington state-based company, Cascade Dafo, Inc.

  • Very interesting. I wish I had known about them before my appointment. Well, I will ask him about them at our next visit. Some of the pictures make it look like they are hinged at the ankle. Yes, some of them have hinges. Very interesting. Thanks for sharing.

    We’ll have to swap AFO pictures when we get ours in a few weeks.

  • Its a deal! When are Pooka’s supposed to be in?

  • Got the call this morning. We get them next Friday at 9:30am. I will report back then.

  • Ooooh! Exciting. I can’t wait to see!

  • Once the child is walking, support is so important. Finding that in a wide shoe is expensive and difficult- at least for us! We do have friends who remove the insoles and are able to wear whatever shoes they want, but that has never worked for us. We use Hatchbacks, Keeping Pace, or whatever I can find after HOURS and many shoe stores visited. Really hard when it’s a girl- there just aren’t cute boots and pink shoes out there for AFO wearers.

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