What is an ankle foot orthosis (AFO in short)?
It is a special splint to support your child’s ankle and foot. The splints are usually made of hard thermoplastic to make it strong enough to support your child.
There are different types of splints. The most common type goes from your child’s toes all the way up to just under their knee. Some children may have a smaller splint that is worn inside their shoe and stops just under their ankle. These smaller splints may be made of thermoplastic or very dense foam. Some children may need to wear an AFO over one foot but some may need the splints for both feet. It is a joint decision made by you and your child’s specialist team, usually including your orthopaedic surgeon/ rehabilitation consultant/ paediatrician, the orthotist and the physiotherapist with you.
Why does my child need to wear it?
As your child keeps growing, their bones and muscles may get the splints which can make sure their joints and muscles stay at a good length and they don’t get any tightness.
If your child is learning how to stand and walk, wearing the splint helps your child to have a good posture, protects the joints in their legs and can make standing and walking a little easier for them, giving them more energy for the other things they enjoy doing.
When does my child wear the splint?
We usually recommend wearing the splint for about 6 to 8 hours per day as the research evidence has shown we need a long period of time to stretch the joints and muscles and keep them flexible.
Your child should wear the splint whenever they are on their feet and active. We often ask for splints to be worn in physio too.
Some children find that they can play and move around better without the splints on. It is OK to take them off for a little while when playing sport! Just remember to put them back on when your child is finished. Do discuss the best wearing routine with your physiotherapist.
How do I put the splint on my child?
Putting on AFOs can seem daunting at first, there are lots of straps and the left and right foot look the same. We have written some handy tips and tricks to help make putting splints on easier. Soon you’ll be a pro and giving your physio tips on how to get your child’s splints on! Try following these steps:
- If your child’s feet are a bit stiff, you may need to do some stretches first to make sure your child feels comfortable with the splints.
- Before you start, make sure you put the right one on the right leg and the left one on the left foot. Normally you can tell as the end of the splint is longer on the big toe side. If your child’s splints are difficult to tell apart, try writing an L and R on the left and right sides in permanent marker.
- Bend your child’s knee and hip up, turn the foot/toes inwards, and pull the ankle right in so there is no space between their heel and the splint. Putting splints on while sitting is normally easier than lying as you have better control of the leg/foot.
- First do up the strap around the ankle, then do up the other ones.
- Make sure the straps are attached firmly and do not loosen them off as they will not work as well. Generally, you should be able to just about put 1 finger between the ankle and the strap.
If your child complains some areas on their feet or legs are sore, or you have found some skin breakdown after wearing the splint, please keep an eye on it and talk to your Physiotherapist. Generally, there will be redness around the ankles and straps for 10-20 minutes after wearing the splints, but this should fade. If you have concerns, please speak with your Physio.
We hope this has helped and you feel more confident with putting on your child’s AFOs.