Your Child’s Equipment
How to wear an ankle foot orthosis
Putting on an ankle foot orthosis (AFO)
Step 1:
Put long socks on your child. If they wear AFOs on both feet, make sure you have the correct AFO for that foot. You may want to mark the AFOs with a R (right) and L (left) to make this easier.
Step 2:
Have your child sit or lie down and bend their knee to help the muscles relax. It’s easier to put on the AFO with their knee bent.
Hold your child’s foot in 1 hand and the AFO in the other hand. Bend their ankle so their toes point up. Flex the ankle this way as much as possible. Place your child’s heel into the back of the AFO.
Step 3:
Hold your child’s ankle firmly into the back of the AFO. Make sure their heel doesn’t lift out of the AFO while you fasten the straps (Step 4).
Step 4:
Fasten the straps. Do the ankle strap first.
Straps need to be snug so the heel can’t lift out of the AFO. Make sure straps don’t dig into the skin.
If the ankle strap has padding, make sure it’s tucked under the plastic at the sides of the brace so your child’s skin doesn’t get pinched.
Some parents have their orthotist or physiotherapist mark a line on the strap to show how snug it should be.
Step 5:
Check to make sure that your child’s heel is in place. There should be no space between the heel and the AFO.
If the AFO has a hole in the bottom of the heel, you can look to make sure their heel is down. You can also shine a light at the side of the AFO to see if their heel is down all the way. Talk with your orthotist or physiotherapist for more strategies if you’re struggling to know if your child’s heel is in place.
Step 6:
Put on your child’s shoe. Using a shoehorn can make it easier. Having a shoe that fits your child’s AFO is important. Refer to Buying shoes to fit an ankle foot orthosis for more information.
It can be hard to get an AFO into a shoe. Your child may need help to do this, even if they’re older.
After removing the AFO
When your child takes off their AFO, it’s important to check their skin. Any areas of the skin that are red or dark from the AFO or straps should disappear within 30 minutes. If your child has any areas of skin that remain red or dark after 30 minutes, they can become a pressure injury.
Pressure injuries can occur anywhere the AFO touches your child’s skin, but common areas include:
- ankle bones
- heel
- outer edge of the foot
- along the arch of the foot
If there are any red or dark areas after 30 minutes, or raw or blistered skin, the AFO should be left off until the skin heals. Contact your child’s orthotist as soon as possible to have the AFO adjusted.
Cleaning the AFO
It’s important to wash your child’s AFO.
- Clean the AFO once a week. Wipe it with a damp cloth and soapy water.
- Do not submerge the AFO in water.
- Let the AFO air dry. If you’re in a hurry, you can wipe it dry. It needs to be completely dry before your child wears it again.
- Do not use a hair dryer, home heater vent, or clothes dryer to dry the AFO. Heat can change its shape.
When should you call for help?
Contact your child’s orthotist if:
- Any parts of the AFO are broken or the straps aren’t holding well.
- You notice red or dark marks that don’t go away after 30 minutes.
- It looks like the AFO is too small.
Contact your child’s physiotherapist if:
- Your child’s walking or standing ability has changed while wearing the AFO.
To see this information online and learn more, visit https://MyHealth.Alberta.ca/health/aftercareinformation/pages/conditions.aspx?hwid=custom.ab_childs_equip_wearing_afo_inst.
Related to Ankle foot orthosis:
For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: May 9, 2025
Author: Pediatric Rehabilitation Services, Alberta Health Services
This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.
