AFOs and Shoes for Kids with Spina Bifida

Spina bifida affects the spinal cord, and its impact on the legs and feet varies a lot depending on the level involved. Many children use ankle-foot orthoses to stand and walk, and footwear choices carry an extra responsibility here: protecting skin that may have reduced sensation.

Why fit and skin protection matter most

Where there's muscle weakness or paralysis, an AFO provides the stability to bear weight and walk. But many children with spina bifida also have reduced or absent sensation in their feet, which means they may not feel a rubbing seam, a tight spot, or a pressure point before it becomes a sore. A shoe that fits cleanly over the brace - no pinching, no pressure - isn't just about comfort; it helps prevent skin breakdown.

What to look for in a shoe

• A full opening so the brace seats without forcing, which scrapes skin.
• Smooth interior and roomy depth to avoid pressure points.
• Adjustable width and removable insoles to dial in a clean fit over the AFO.
• A secure closure so the foot doesn't slide and rub.

How BILLY helps

BILLY's zip-around opening lets the braced foot set in without dragging against the upper, and the CPMA-certified Goat and Classic D|R II offer the depth and width to fit cleanly. Browse Kids' AFO Shoes.

Check skin, and work with your team

Make a habit of checking your child's feet for red marks after wearing shoes, especially when they're new - and report any persistent redness or breakdown to your care team. Your orthotist and clinic guide brace and footwear decisions; fit shoes with the brace on and their input.