Open Heel FAQ

The Open Heel Modification is a modification available on most of Surestep’s lower extremity products. Instead of the standard heel post, the plastic is cut away on the plantar surface of the heel. To reduce the risk of pinching and to maintain compression and calcaneal position, we have added a very thin molded inner boot.

Children with low or high muscle tone (regardless of underlying diagnosis) who have anterior weight lines, sensory deficits and/or a fast transition from initial contact to footflat (including knee extension moment).

Yes! We have compared Standard Surestep SMOs to Surestep SMOs with the open heel modification. There were no significant differences in the calcaneal position – both styles of SMOs controlled pronation. Because of Surestep’s unique plastic and utilization of compression, an SMO with the open heel modification can still correct excessive pronation.

Overall, no. Even though there is an extra layer of material, because it works through compression, the SMOs are nearly identical. We took a series of measurements of both a standard Surestep SMO with a heel post and a Surestep SMO with an open heel. Here’s what we found: At the metatarsals, or ball of the foot, the SMO with open heel was 1/16” wider. There was no difference in width at the malleoli (ankle bones) or in overall foot length. At the instep (measuring diagonal around the heel), the SMO with open heel was ¼” smaller.

Slightly. There is a trick, though. Do not “push” the heel of the shoe on. Rather, use a big twisting motion to get started and over the “lip” of the plastic. Then, you should be able to push it on the rest of the way.

Yes! We are seeing fantastic functional changes in our kiddos wearing Surestep SMOs, Toe Walking SMOs and AFOs with the open heel modification. Kids are now able to shift their weight more posteriorly, can squat more appropriately and are developing heel-toe gait patterns with more extension. We are slowing down the transition from initial contact to footflat, which also helps with posterior balance reactions and improved gait. We have also heard great feedback about the increased sensory input to the heel. See examples in pictures to the right.

You can ask for the open heel modification on our SMOs, Toe Walking SMOs, Pullover AFOs, Advanced AFOs and Hinged AFOs. You can also ask for it on the SMO portion of any Indy 2 Stage AFO.