surestep smo fitting guide

by Aculbertson

There’s a right way to put on your child’s Surestep SMOs. And plenty of wrong ways. Whether you need a refresher or want to pass this along to friends and family, here’s a step by step guide.

To download a PDF version, click here.

 Step 1

Open the Surestep SMO from behind and underneath the foot, then pull the brace forward onto the foot.

Step 2

While cupping the heel of the SMO in one hand, rotate the foot outward by lifting under the ball of the foot. At the same time, lift up on the front of the foot. This will allow you to look down into the device under the foot and see that the heel is properly touching the bottom surface.


 Step 3

Push the foot back into the brace until you feel contact at the back of the heel.

Step 4

Maintain this position by squeezing the device while you begin to fasten and tighten the straps. Your orthotist may have marked the straps for proper tensioning.

Trim Lines

After you put on the SMO properly, it’s important to take a few seconds to check the trim lines:


On the inside of the foot, Surestep SMOs should be trimmed behind the big toe and the ball of the foot. It is important that this edge is back far enough so that it does not overlap on the boney part of the ball of the foot.



·         On the outside of the foot, it should be trimmed just behind the pinky toe. However, the metatarsal head behind that toe should be covered with the brace. The simplest way to check this is to extend or push up on the pinky toe. This will simulate the movement the toe experiences during walking. The plastic edge of the brace should not restrict this movement. If it does, it should be trimmed by your orthotist.


·         Over the top of the foot, you should see a gap between the edges of the device. This gap can be as narrow as 3/8” (about the width of a pinky finger) on smaller kids or as wide as 1” (about as wide as a thumb) on larger children. These plastic wings should never touch or overlap. If so, please schedule an adjustment appointment with your orthotist.



·         Along the bottom of the foot, the braces should be trimmed behind the ball of the foot on the inside and right to the base of pinky toe on the outside.

 SMO Tips & Tricks

Sit Down

To ensure the product is properly put on and secured, your child should sit down facing you. This will keep their knees and hips flexed. We recommend your child sit somewhat elevated to you, either on a chair or safely on the edge of a table, which helps relax the feet and ankles.

Trust The Stickers

Don’t let your instincts mislead you! Although your braces may appear mislabeled, they have been correctly marked with “Left” and “Right” stickers. The outside of the Surestep SMO is longer than the inside. Remember that the buckles face out.



Surestep SMOs must be TIGHT to provide the compression and support your child needs to be stable. Snug is not enough. If the device is tightened properly, there should no blistering or severe redness


Surestep developed a line of footwear specifically designed for children who wear orthoses. Additional width, depth, and flexibility accommodate orthotic devices and ensure a comfortable fit. Our shoes and sandals are available to purchase directly through your orthotist or online.


Some redness is okay! When the Surestep SMO is properly worn, it is normal for slight redness to appear in areas where the brace surrounds the foot. This redness should disappear within 20 minutes of removing the SMOs. However, if blistering or severe redness occurs, please notify your orthotist.


Use mild soap and water to clean the plastic and Velcro straps. We recommend using isopropyl alcohol to clean the foam liners. Allow the device to air dry.


In order for the Surestep system to be effective, it must fit your child properly. On average, children outgrow braces in one year, but every child develops differently. This time frame may vary. If you notice issues with the fit, please schedule an evaluation appointment with your orthotist.

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