For anyone wearing an ankle-foot orthosis (AFO), the right shoes aren’t a luxury—they’re essential. AFOs provide critical stability and alignment for those recovering from stroke, managing drop foot, or living with conditions like multiple sclerosis or cerebral palsy. But if the shoes don’t fit properly or accommodate the brace, every step can feel uncomfortable—or even unsafe.

Physical therapists often emphasize the importance of pairing AFOs with the right footwear. The right design not only helps the brace function correctly but also promotes natural movement, reduces skin irritation, and boosts patient confidence. For patients, this means walking with less effort and more freedom.

One of the most practical yet overlooked features in shoes for AFOs is ease of entry. Traditional shoes can be frustrating to put on when dealing with braces, stiffness, or limited dexterity.

Adaptive shoes are designed with wide openings, zippers that open around the shoe, or adjustable hook-and-loop straps that make it simple to slide the foot and brace in without strain.

For example, a senior recovering from a stroke or a person with neuropathy may struggle to bend down or handle tight laces. A wide-opening shoe eliminates that barrier, helping them stay independent and avoid relying on a caregiver for daily dressing.

Shoes that accommodate AFOs need extra internal depth to prevent pressure points and allow the brace to fit securely without squeezing the foot.

Extra depth ensures there’s enough room for both the AFO and the foot, while removable insoles give physical therapists and orthotists the ability to customize the fit—adding or removing inserts as needed to balance alignment and comfort.

A removable insole also allows space for custom orthotics or pressure-relief padding. This flexibility can make a noticeable difference in reducing rubbing and discomfort during long periods of wear.

Finding the balance between flexibility and stability is crucial. AFO users often rely on their shoes to complement the brace’s motion control, and the wrong sole can throw off balance or limit gait progress.

The best shoes for AFOs have lightweight, supportive midsoles that encourage smoother heel-to-toe movement. The sole should flex enough to allow a natural stride while providing structure to keep the brace stable.

Physical therapists often recommend shoes with rocker soles, as they help propel the wearer forward with less effort—especially beneficial for those recovering from neurological or muscular conditions that cause fatigue or limited mobility.

When wearing a brace, toes often press against the front of the shoe, leading to friction, calluses, or pain. A wide toe box gives the foot room to spread naturally and minimizes pressure on sensitive areas.

This feature is particularly important for patients with neuropathy, drop foot, or muscle tightness from cerebral palsy. Allowing toes to move freely can prevent skin irritation and improve circulation, which supports both comfort and foot health.

AFOs can already add weight to the leg, so heavy shoes make walking unnecessarily tiring. Lightweight construction reduces the strain on muscles and joints, making every step easier and more energy-efficient.

Modern adaptive shoes often use engineered mesh uppers, foam midsoles, or synthetic blends that combine durability with minimal weight. This can be especially beneficial for individuals with multiple sclerosis or post-stroke fatigue, who need every bit of energy conserved during therapy or daily routines.

Physical therapists frequently stress the importance of traction for AFO users. Shoes with non-slip, textured outsoles provide the stability needed to navigate indoor and outdoor surfaces safely.

Instead of claiming that shoes prevent falls outright, it’s more accurate to say they help reduce the risk of accidents, trips, slips, and falls by improving ground contact and balance. This is a key factor in maintaining independence and confidence, especially for seniors or those undergoing gait retraining.

Pressure sores or irritation can develop quickly when an AFO rubs against the skin. Shoes designed for AFOs should have smooth interiors, padded linings, and minimal stitching to prevent friction.

For patients with decreased sensation due to neuropathy or nerve damage, this feature is especially important. It helps protect against blisters and hotspots that may go unnoticed until they cause real harm.

Comfort and clinical function are vital—but so is how a person feels wearing their shoes. Many people using AFOs want footwear that doesn’t look “medical.”

Today’s adaptive footwear combines supportive features with modern, everyday designs—from sporty sneakers to casual slip-ons. When patients like how their shoes look, they’re more likely to wear them consistently, which can improve outcomes in both mobility and therapy adherence.

Physical therapists often note that confidence plays a huge role in rehabilitation. If a patient feels good about what they’re wearing, they’re more willing to walk longer distances and participate in therapy exercises.

Whether you’re a physical therapist recommending footwear or a patient searching for the right fit, consider these practical steps:

• Check compatibility with the AFO’s shape and size before purchase.
  
• Choose shoes with removable insoles for adjustment flexibility.
  
• Prioritize non-slip, lightweight materials for everyday wear.
  
• Always test shoes with the brace in place to ensure true comfort and balance.

The best shoes for AFOs don’t just make walking possible—they make it comfortable, safe, and empowering. With the right design features, both patients and therapists can focus less on frustration and more on progress.

If you or your clients are exploring adaptive footwear that combines clinical functionality with real-world comfort, explore cadense.com for AFO-friendly designs built to support mobility, confidence, and independence.