Common Problems with AFO Braces
AFO braces are excellent walking aids. However, that doesn’t mean the use of these walking aids is always perfect; situations pop up. Such as, what shoes are you going to wear them with? What happens if a child outgrows their AFOs? What do you do if the brace is rubbing on your skin?
Things like this happen and in this article we cover the top 8 potential problems / challenges with AFOs and how to address them effectively. Every company that provides AFOs knows about these issues. They are universal. However, we strive to be 100 percent transparent and as a result, we talk about problems that you may or may not experience. This way you can deal with them in the very best way possible.
Topics Discussed In This Article
1.) AFOs & Shoes – What Shoes Work, Which Ones Do Not
2.) Application Challenges / Solutions & Special Shoe horns
3.) Potential Skin Issues
4.) Outgrowing AFOs – When To Get New Ones & When To Hold Off
5.) Cracks In The Plastic Of An AFO
6.) The Weight of An AFO Can Seem “Heavy”
7.) The Cost Of An AFO Being A Problem
8.) Knowing When To Avoid Using an AFO
As it relates to ratings and reviews of the top challenges that can happen with an AFO, we are not going to say there is one that always comes up. In fact, most of these problems do not happen on a regular basis, but they can. So in no order of importance, we are going to start with shoes.
1.) AFOs & Shoes – What Shoes Work, Which Ones Do Not
Getting a proper pair of shoes that fits with an AFO is very important.
To be honest it is not hard to find a pair of shoes that does work well. You might very well already own the pair you need; so that is the good news.
But if you are in the market to go shopping, read this information below before you go to the store.
In the end, we have to tell you that there is not “one” perfect pair of shoes, because many do exist. We did however take a poll and saw many people had shoe styles they liked more than others. We will list them below along with a price range so you can make some more informed choices.
When it comes to rating and reviewing these shoes, just know that these shoes are in no particular order of preference. Everyone has different preferences and style of shoe is hard rate as it can be a personal choice.
Moreover, we will be talking a little bit about shoe size in a moment. Please remember that every shoe manufacturer has a different last that they make shoes from. This means that their shoes sizes are not going to be equal across the board.
Meaning, a size 9 in “xyz shoe company” is going to be different in length and width potentially than a size 9 from “abc shoe company”. It is our opinion that sometimes people think shoes are all equal when it comes to a size 9 for example. Unfortunately this is not true. Some people like to go a 1/2 size longer and wider, but this is not always needed.
Shoe Styles For AFOs
A.) Billy’s brand of shoes appears to be one of the most well loved amongst the competition. Many people have become loyal to this comfortable style of shoe, running on average somewhere between $25 and $75 dollars. Some claim to only buy shoes to go with their AFOs from Billys so that is worth checking out, if you are in the market.
B.) New Balance is another shoe styles that seem to get good ratings and reviews as well from AFOs users. A pair of those will run you anywhere from $25 to $115 depending on the style potentially. The insert in these shoes can come out easily and help accommodate the room needed for an AFO well in many cases. This can go a long way because the insert is usually about the same width as the AFO. Some shoes have inserts that come out easily, others do not.
C.) Saucony brand shoes. This brand will usually end up costing you similarly somewhere between $40 and $120.
D.) Nike Flyease shoes have also been praised as a favorite among those with AFO braces. The price on these lands somewhere between $60 and $120.
E.) Some individuals prefer Vans in the mid-top style in a size and a half larger. By comparison, Vans are often available for just $30 to $60.
F.) For cute summertime sandals, some people have recommended Wonder Nation, featured at Walmart. An apparently economical choice, a pair of these will only cost you about $5 to $20, and there are so many adorable styles to choose from! To show off your toes and keep feet feeling cool, try cutting the toe portion off of the socks before wearing them.
Please Remember…
Just because the shoes look great on the outside doesn’t mean they’re going to be perfect for your AFO. Also, high heeled shoes for women should be avoided.
Remember, the shoe has to accommodate something more than just your foot now (ie. the AFO brace). The AFO is not that thick, but if your shoe does not have room for anything else but your foot, then you will potentially run into space issues.
An adult custom AFO it is usually the width of 2-3 quarters stacked on top of eachother, just to give you a quick frame of reference.
#1 Safety Rule with Plastic AFOs
Plastic AFOs Do Not Have Tread Under The Foot
Wearing an AFO brace without a shoe is actually dangerous, and can cause you or a loved one to slip. The AFO is designed to help you walk better. If someone was going to review them or rate the device itself, our experience is that the review would be favorable. However, if you do not wear them in a shoe then this becomes the issue, not the AFO itself. This is because the AFO or carbon graphite is made from plastic and there is typically no tread underneath this walking device.
Shoes That Are Too Loose or Too Tight
Wearing shoes that are too loose or too tight can cause obvious problems. If your shoes are too loose and your foot is slipping around, it can cause a “shearing” effect and this might not be good for the skin. If the fit is too tight it can be a deterrent to using the AFO brace in the first place as it is hard to get the AFO into the foot wear.
2.) Challenging AFO Applications – Shoe Horns That Help
A problem that can sometimes come up for people who have an AFO is not being able to get it into their shoe. It is definitely not impossible in most cases, but sometimes people struggle to already put their shoes on in general. Either because their favorite pair of shoes is too tight and they don’t know it (even before the AFO was delivered), or their hand strength and coordination needs assistance.
Perhaps the person is too young (toddler) or they are an older adult that needs help. Either way, a shoe horn can help. What most people don’t know however is that there are different kinds of shoe horns out there that can really make it easier for a person to apply their AFO, even if they have impaired hand strength / coordination.
For example, there are some shoehorns that actually clip on to the back of the shoe and can stay there. This eliminates the need to use both hands to maneuver the shoehorn and AFO simultaneously.
If the shoe horn stayed put, while applying the AFO, would that help you or your loved one? – Just something to think about.
These shoe horns are a few bucks and you can easily find one if you type in “clip shoe horn”, on any major search engine.
Sometimes people do not even need a shoehorn. We are not writing this article to assume that you will have problems. Actually, many AFOs users do not need a tool such as this but it is good to consider a shoe horn if you are in a pinch.
Different Ways To Apply AFOs to Shoes – If You Struggle From Time to Time
2 Helpful Videos Here to Show People How to Put On Their Shoe / AFO Easier! (See Below)
Some people can just rotate the back of their shoe back and forth as you work the AFO into the shoe. Check out this quick video below to learn more about what we are referring to :
It all depends on what you are comfortable with.
Here is another quick video (below) to show you how one gentleman puts his AFO braces inside of his shoes first and slips into the AFO and shoe all at once.
If you were going to rate or give a review on each of these videos, which one would you like the best?
Hand Strength & Coordination
Sometimes people struggle with putting on a shoe with an AFO. It is not super common, but it does happen. The videos we showed above can help you. Also, the clip on shoe horn might be a good thing to research if you or a loved one struggles with applying a brace to a shoe.
Also, maybe you should consider velcro shoes over the shoe laces that are very stretchy. Velcro is basically as easy as it gets with shoes and sometimes the stretchy shoe laces are more of a hassle than you might realize. Stretchy shoes laces make it so you never get a good snug fit around your foot (even if they make it easier to put the shoe on at first).
3.) Potential Skin Issues / Monitoring Your Skin With AFOs
Some people have conditions which make it hard to feel their feet. This is not necessarily your fault, or the AFOs fault, but the issue still can exist.
This means that if there’s a problem with their AFO some individuals might not know always realize it right away. Again, the AFO should not be causing this insensate issue, but the nevertheless, if someone has feet that are numb or partially numb then using an AFO should be monitored.
Your eyes can provide important visual cues if you have little or no sensation in your feet and legs. Check regularly for red marks caused by the AFO that don’t go away within one minute of removing the brace.
If you have an angry red spot on your foot, ankle or other area that the AFO touches be sure to let your orthotist or podiatrist know right away.
In the case of plastic AFOs, the treating orthotist can usually make simple adjustments such as adding pads or something called “heat relieving” the AFO to modify spots in the brace that are causing trouble.
4.) Outgrowing AFOs – When To Get New Ones & When To Hold Off
As we all know, children grown. The AFO stays the same size, however. So at some point decisions have to be made about when to stay with or get new braces.
It is not uncommon to get a new pair of AFOs every year. Some children during a growth spurt may even need to get 2 pairs in one year.
An orthotist though can help give you extra time with a brace however, because they know how to “heat relieve” an AFO (as briefly mentioned earlier).
For example, if the AFO is rubbing on your sons or daughters ankle for example or another part of the AFO is causing an issue the orthotist can still buy you some time.
They can heat up the plastic (only have your orthotist do this please) and then they can gently push out the section that is causing the issue. You could get an added 1/8″ to 1/4″ for example at the ankle and as a result, this could help you get another month for example out of the same AFO. Unfortunately, you can not do this too many times though because the AFO will break due to repeated pressure.
5.) Cracks In An AFO
Does this usually happen? No.
Can it happen? Yes.
Whether an AFO is made from plastic or carbon graphite, cracks can happen. People for example can run marathons in an AFO. Although this is a great accomplishment for anyone, you can now see that certain pressures are exhibited upon the device above and beyond walking for example.
You name it, it can potentially happen. But the good news is that this doesn’t typically happen. So if you are going through it right now, just know it is not likely to happen again in the vast majority of cases.
It if is a super small hair liner type of crack there is a possibility that your orthotist can shave it out the trimline of the brace. Or, perhaps do something else. But if you have a crack in the brace call your orthotist right away.
6.) The Weight of An AFO Can Seem “Heavy”
From time to time we hear this as an issue from people. The device does have weight to it, we are not going to act otherwise. But after you watch this quick video we made, you might think differently about how heavy they really are. We did through in part of the video on the weight of a CAM walker, but if you are getting an AFO, it is likely a different brace.
Check it out. It can help ease your mind on what is “heavy” and what is not. Please remember that you will be using much larger muscles to move around than you do to pick up and hold something. So, the weight of an AFO could easily be negated that way. But, by all means, please watch this video below and see if you think an AFO is heavy or not.
7.) The Cost Of An AFO Being A Problem
For some individuals, the cost of an AFO can be a challenge.
Let’s review this together.
We have a very detailed blog post actually on this entire subject located here, if you want to go deep on the topic :
https://rinellapo.com/how-much-does-an-afo-cost/
But, if you want the short version we are happy to discuss AFO brace prices here.
If you were in a situation where you had to pay cash for an AFO, there are different kinds you can choose from. There are some on sites right now for $60 approximately. While this kind could be all you need, it is very possible that you could be left wondering or even wishing for another option. You can find a lot of stuff online, but not all of it is the best for you.
Sometimes a brace that is custom made to your shape and size is the way to go. Custom AFOs cost more. Your orthotist and podiatrist do not choose the price, it is dictated tom them from insurance / coverages in many respects. Having said that, AFOs of this kind can run up to about $1050 for example (approximately).
The good news is though that your out of pocket costs could be next to nothing if you have insurance / coverage. It all depends on your policy.
Check in with your orthotist and they can help you determine prices and what would be expected financially. Remember, an orthotist can not charge you for anything until they give you a brace. So, a consultation (for better or worse on the side of the orthotist) is free.
Rules do exist about location and this can effect pricing therefore we give estimations. Reimbursement levels also rise and fall yearly so that is another reason we provide the estimation of price for an AFO.
8.) Knowing When To Avoid Using an AFO
We believe that AFOs can help a lot more people walk better but they are under utilized because they are hidden by pants (not good advertising). However, AFOs are not for everyone. They may or may not be the best fit for you.
If you only want to use a cane and you know this already then an AFO is not for you.
If you have no insurance and cost is an issue then an AFO could possibly be out of the equation as well.
It all depends on the person.
Some people do not have help and they would personally require help to apply their brace everyday. That is an issue. While it is not the norm, some individuals are not independent and an AFO is something that needs to be applied.
Are we trying to talk you out of using an AFO? No.
Do they solve a ton of walking mechanics issues that can make someone fall or drag their foot? Yes.
In the end you have to feel comfortable with the process and device you are getting. That’s a fair statement for just about anything you are going to use.
If you have AFO questions or problems and you want to discuss them, then feel free to call us.
We are here to help.
* We hope this information has helped you. Please note that problems with AFOs are not extremely common but situations do happen that you might need to work around. Good luck.
