Will SMO Orthotics Help My Child’s Development?

by Aculbertson

Child walking with SMO orthotics

SMOs. Orthotics. Braces.

If these words recently entered your vocabulary, your head is probably swimming with more questions than answers.

Will my child ever catch up with peers?

What will the future look like?

How can I help?

Educating yourself is a great first step. This post gives you an overview of what SMOs are, who they’re intended for, and how they might be able to help your child.



What Is An SMO?

SMO stands for supramalleolar orthosis.

Put more simply, it’s a foot and ankle brace. Unlike its taller cousin, the AFO, SMO orthotics for kids don’t extend much higher than the ankle. And when worn with shoes, they’re barely visible.

Difference between SMOs and AFOs

Who Should Wear SMOs?

SMOs are most often worn by kids who pronate. This is also called walking flat footed. The braces guide feet into proper alignment while also helping your child feel more confident and stable.

Is there a specific age to get started?

Not necessarily. Kids can begin wearing SMOs as soon as they begin to bear weight or attempt to cruise. But older kids can also get great benefits. Options such as Big Shot SMOs are designed with bigger kids in mind.

Example of Surestep BigShot SMO

Along with pronation, SMOs are often linked to a variety of diagnoses and challenges:

Some SMOs can also be adapted to address other obstacles. For example, Surestep SMOs can be modified to treat toe walking, clubfoot, and metatarsus adductus.


What Should I Know About Pronation?

It’s important to understand that pronation is triplanar. Basically, there are three components:

  • Heel
  • Arch
  • Toes

Explanation of three components of pronation

Although it looks like an arch problem, pronation starts in the heel. That bone, the calcaneus, tilts inward. This starts a chain reaction which causes the arch to collapse and the toes to shift out.

You should also know that the impact of pronation isn’t limited to feet. If left untreated, pronation can lead to lifelong alignment problems and pain in your child’s knees and hips.

Children’s orthotics for flat feet are designed to alleviate these short-term and long-term issues.



How Do SMO Orthotics Help?

They’re not all the same. Some are custom-made. Others are off-the-shelf.

But the biggest differences come down to treatment philosophy.

Some SMOs (and similar devices such as shoe inserts) treat pronation by immediately jumping to that second component. They force the arch back up. Visually, that seems to fix the problem. But this approach is treating a symptom, not the root cause. Many of the kids who wear these types of devices are actually still pronating. They’re just doing it on top of a brace.

Surestep SMOs are different.

The Surestep approach is to use circumferential compression. You can think of it as a bear hug for your child’s foot. The heel is brought back into proper alignment, the arch is lifted and supported, and the toes move back in line with the rest of the foot.

This is a whole foot solution and it treats pronation at the source.

How Surestep SMOs treat pronation

How Long Do Kids Need To Wear Them?

This varies a lot from child to child and diagnosis to diagnosis.

For some kids, all they need is a single pair to get them caught up with peers. Other kids will wear and outgrow multiple pairs before graduating on to a simpler type of orthotic.

Typically, starting at a younger age is better. But the length of time shouldn’t be the main concern. Instead, it’s more important that your child has the help he or she needs.

Toddlers playing together while wearing SMO orthotics


How Can I Get SMOs For My Child?

To get a pair of custom SMO orthotics for your little one, the first step is getting a prescription from your doctor. At that appointment, be sure to share any concerns you have about mobility and gross motor delays.

Next, you’ll take that prescription to a local orthotist. This is a specialist who works with a variety of orthotic braces. He or she will measure your child’s feet. You’ll then return for a second visit for the actual fitting of the braces. If any minor adjustments need to be made, your orthotist can make them.

If you need help finding an orthotist near you, you can contact the Surestep customer service team at 877-462-0711 or email us at info@surestep.net.

How can I get SMOs for my child?