Why Do Surestep SMO Braces Look Backwards?

by Aculbertson

Are these on the wrong feet?

If those words have ever come out of your mouth, you’re in good company. Plenty of parents (and physical therapists) have asked that same question.

The confusion comes from the unique Surestep trimlines. Unlike other options, the bottom of our SMO braces do not extend past the toes. Instead, the footplate stops just shy of the pinky toe and then swoops down behind the ball of the foot.

So then why, when they’re on the right feet, do they look backward?

It’s probably because the angle of the brace runs in the opposite direction of your child’s toes. SMOs are longer on the outside of the foot and shorter on the inside. But toes are longer on the inside and then get shorter on the outside.

So why are Surestep SMOs designed like this in the first place? Before tackling that question, it’s important to understand a little bit about pronation.


A Quick Primer On Pronation

Pronation is commonly referred to as flat feet. And it’s easy to see why. The arch collapses inward, forcing kids to walk with their feet flat on the ground.

But pronation is more complicated than it looks. It’s actually a chain reaction that begins in the heel:

  • Calcaneus (heel bone) tilts in
  • Arch flattens out
  • Toes push out

This is why, when looking from behind, you see the little toes on the outside of the foot. We call this the “too many toes sign” and it’s a strong indicator of excessive pronation.

Even though the problem starts in the heel, many orthotics/inserts simply force the arch back up. But that’s addressing a symptom, not the cause.

Surestep SMOs are different.

They’re designed to maximize function and alignment by addressing all three components.


How The Surestep SMO Design Helps Kids

First, by using circumferential compression, Surestep SMOs guide the heel back into place. This helps “pick up” and support the heel. And because all the magic is done through that compression, there’s no need for huge arch supports. Finally, the trimlines keep toes in line with the rest of the foot.

With Surestep SMOs, it’s not all about alignment. In fact, alignment is secondary.

Function is the primary goal. And to maximize that function, we leave the toes free. This allows kids to crawl, stand, run, jump and play. Free toes also improve sensory input because they can better feel the ground beneath their feet. For additional sensory input, learn more about the Open Heel.

To make your child’s Surestep SMO braces as effective as possible, remember to:

  • Trust the L and R stickers
  • Pull the straps TIGHT (compression is key)
  • Get shoes that aren’t too big


You can also reach out to your orthotist any time you have questions or concerns.

I want to learn more about pronation