Specialized or adjusted shoes and orthotics can make a world of difference in the life of a child with cerebral palsy. Read on to learn all about the best shoes and orthotics and how they can most benefit your child.

Selecting the Best Footwear

If your child requires a lower-body brace, it can be challenging to find footwear that fits, is comfortable, and provides support. The right shoes will make it easier for your child to walk, improve their gait, and ensure proper joint alignment. When fitting your child with shoes, you have two options: you can buy shoes off the shelf or buy custom cerebral palsy shoes.

Tips for Choosing Shoes Off the Shelf

If your child wears a foot brace (also known as an ankle-foot orthosis) on both feet, there are a few things to look for when buying shoes off the shelf:

• Look for a wide toe box, which will provide the needed space for your child’s brace as well as room to grow. Avoid shoes with pointy or narrow toe boxes, as they decrease walking stability.
• Shoes should be made from flexible, soft materials that stretch to accommodate their brace and movement. Breathable mesh fabric will also help keep feet cool.
• Heel pulls are helpful. A simple tab or other pull at the heel of the shoe will make it easier to pull the shoe over a braced foot.
• Insoles should be removable to allow room for your child’s brace. Look for insoles that are not stitched or glued into the shoe itself. Removable insoles can be taken out to provide more room for your child’s brace.
• Shoes with ties or Velcro straps are easier to fit around braces. Once tied or strapped, these shoes will remain secure over the instep.
• Look for an extended and/or wide tongue. Shoes with extended or wide tongues open wider, making it easier to don shoes.

If you buy shoes off the shelf, you may need to buy multiple sizes to find ones that fit properly. A shoehorn can be helpful when sliding a shoe over a brace, so consider buying this assistive tool to help you or your child put on their shoes.

If your child wears a brace on one foot only, it may be necessary to buy two pairs of the same shoes: a larger size for the braced foot and a smaller size for the unbraced foot.

Custom Shoes

If you aren’t having any luck with shoes off the shelf, there are many custom cerebral palsy shoes that provide the support of, or for, a brace within the shoe. Custom boots include a sturdy body, built-in orthotics, and Velcro straps running from the instep to the shin to provide brace-like support. Custom athletic shoes have open/close heel flaps that make putting shoes over a braced foot easier.

Cerebral Palsy Orthotics

Many children with cerebral palsy use orthotics as part of their treatment plan. Orthotics are braces or splints used to correct posture, improve gait, decrease pain, and provide support. Orthotics are available for the lower and upper body.

Lower Body Orthotics

Lower body orthotics correct positional and functional issues on the lower half of the body, including the hips, knees, ankles, and feet. These orthotics are especially helpful for children with spastic cerebral palsy. There are several kinds of lower body orthotics:

• Foot orthoses (FO): The primary purpose of an FO is to improve the foot’s contact with the ground by providing stability and cushioning. These are generally simple insert orthotics.
• Ankle foot orthoses (AFO): As the most common orthosis used by children with cerebral palsy, the AFO improves foot positioning, provides support, improves gait, and prevents foot drop, the inability to raise the front of the foot while walking. Ankle foot orthoses may be static or dynamic. Static AFOs are rigid to provide stability, and dynamic AFOs are custom-made and allow motion at the ankle.
• Knee orthoses: There are two kinds of knee orthoses — the knee immobilizer prevents the knee joint from moving, and the plastic knee-ankle-foot orthosis (KAFO) runs from the hips to the toes and helps stabilize both the knee and ankle joints.
• Hip abduction orthoses: These run from the hips to just above the knee to help prevent dislocation in the hip joint and improve walking.

Upper Body Orthotics

Upper body orthotics focus on the arms and hands. These orthotics are used to prevent spastic movement and lengthen/strengthen hand muscles. There are two primary types of upper body orthotics:

• Arm immobilizers: Immobilizers are used to keep a child from irritating stitches after surgery. Immobilizers can also prevent muscle weakness or unwanted movement at night.
• Hand splints: These run from the lower arm/wrist to the fingers and are either non-functional or functional. A non-functional hand splint stretches the hand to lengthen muscles and prevent contraction. A functional hand splint supports joints to improve motor skills, such as eating with utensils or writing.

Although a multitude of specialty products are available for children with cerebral palsy, the financial and emotional burden on families can be daunting. If you think your child’s cerebral palsy may be the result of medical malpractice, you may be entitled to compensation. Contact the Cerebral Palsy Family Lawyers today at Janet, Janet & Suggs, LLC, and let us help you decide how best to move forward.