Ankle-Foot Orthosis (AFO) can make a life-changing difference if you struggle with walking, balance, or stability. Whether due to injury, a neurological condition, or muscle weakness, the right AFO can give you the support you need to move confidently. But with so many types and fitting options, how do you know which one is best for you?

This guide breaks down everything you need to know about AFOs—when they’re used, how they’re made, and how to wear and care for them. Keep reading to learn how an AFO can improve mobility and make daily activities easier.

What is an AFO (Ankle-Foot Orthosis)

An ankle foot orthosis (AFO) is one of the most commonly prescribed lower limb braces. It is a custom-made orthotic device that envelops the foot and ankle, providing much-needed support to these areas.

These braces keep your foot in a stable position, making movement safer and easier. Doctors often recommend them for conditions that affect walking and balance.

AFOs come in different types and materials, designed to meet individual needs. They can also be adjusted over time, especially for children, as they grow and develop.

Many are made from thermoformed plastic, allowing for modifications when needed. In some cases, AFOs are used as night splints to prevent contractures, a condition where muscles and joints become stiff due to prolonged immobility.

AFOs help manage various conditions that affect mobility. You might need one if you have:

• Neurological disorders such as stroke, spinal cord injury (SCI), or cerebral palsy, affect movement and control.
• Musculoskeletal conditions like foot drop or weak ankles cause instability.
• Injury or surgery recovery, where extra support is required to regain mobility.

Types of AFOs

AFOs come in different styles to provide various levels of support. The right type depends on your mobility needs, comfort, and lifestyle.

Traditional Plastic AFO

These AFOs offer strong support and are often used for short-term needs. They provide excellent medial or lateral joint stability, keeping the ankle in place.

Many prefer them because they are affordable and can be customized with heat molding. However, they can be difficult to fit inside shoes, which may require adjustments.

Swedish AFO

A Swedish AFO has a lower profile than the traditional plastic version, making it easier to fit into shoes. It provides moderate lateral stability and helps with static ankle dorsiflexion (a stretch where you keep your foot lifted upward toward your shin), which is important for people with mild foot drop.

The open design leaves space for the heel and calf, making it more comfortable. This type is best if you have moderate activity levels..

Carbon Fiber AFO

These are lightweight, semi-flexible, and designed for dynamic movement. The footplate tilts 10-15 degrees at the metatarsal heads (five elongated bones in each foot), helping with a more natural step.

The open-heel design reduces pressure on sensitive areas while offering excellent support. Carbon fiber AFOs help control ankle instability, pronation (inward rolling), and eversion (outward rolling).

They are ideal if you're active as they encourage a normal walking pattern while reducing strain on the foot and ankle.

How to Select the Right AFO

Choosing the right AFO requires careful evaluation of your condition and mobility needs.

Here’s a step-by-step process to ensure the best fit for your situation:

1. Consult with a Healthcare Provider – A doctor or physical therapist will assess your specific condition and recommend the most suitable AFO. They will also explain the purpose of the device and how long you may need to wear it.
2. Review Your Medical History – Your healthcare provider will consider your primary diagnosis, past injuries, and underlying conditions. This helps determine whether an AFO is the right solution and what type will be most effective.
3. Assess Daily Activities and Mobility – Your occupation, level of independence, and daily movements play a role in selecting an AFO. Some designs work better for highly active individuals, while others provide more stability for those with limited mobility.
4. Perform a Physical Examination – A detailed physical exam checks for skin conditions, swelling, wounds, scars, or bony landmarks that might affect comfort. Any edema (swelling) or sensitivity will also be considered when selecting an AFO.
5. Test Muscle Strength and Joint Stability – Your provider will assess muscle strength, range of motion (ROM), and joint stability. They will check for any nerve-related issues that might impact movement or responsiveness.
6. Evaluate Posture and Balance – Both static (standing) and dynamic (moving) balance will be analyzed. Your provider will look at how your joints align in different positions and how your posture deviates from a normal stance.
7. Analyze Walking and Functional Movement – Your gait (walking pattern) will be evaluated to see how your body moves with and without support. The ability to transfer from sitting to standing and maintain balance will also be considered.

By following this process, healthcare providers can determine the most suitable AFO to support your mobility, enhance rehabilitation, and improve overall comfort.

How is an AFO Made

Most AFOs are made from thermoformed plastic, which allows for modifications and adjustments as needed. The process follows these steps:

1. Preparing for the Casting Appointment – Wear clothing that allows easy access to your lower leg, such as shorts or pants that can be rolled up above the knee. The clinician will assess your leg movement, walking pattern, and range of motion to determine the best fit for your AFO.
2. Creating a Custom Mold – A plaster bandage will be wrapped around your leg to create a negative cast. This mold takes 3-6 minutes to set before it is removed carefully. The cast captures the exact shape of your foot and ankle, ensuring a custom fit.
3. Manufacturing the AFO – This process typically takes 3-4 weeks as the brace is shaped, refined, and prepared for fitting.
4. Fitting Appointment – Ensure your lower leg is easily accessible. Bring knee-high socks that fit snugly and regular shoes, like runners or school shoes. The AFO will be trimmed and adjusted for comfort. Straps will be added, and modifications may take 40-90 minutes. You may want to bring a book or device while waiting. Once complete, your AFO will be ready for daily use and support.

Your AFO is made to provide the right level of support, stability, and mobility for your needs.

How to Wear Your AFO

Wearing your AFO correctly ensures comfort and effectiveness. Follow these steps for a proper fit:

1. Wear a Sock Under the AFO – Put on a knee-high cotton sock that extends past the top of the brace. This helps prevent rubbing and irritation.
2. Loosen All Straps – Before putting on the AFO, undo all straps to make it easier to slide your foot in.
3. Position Your Foot Correctly – Bend your knee to 90 degrees (a right angle). Slide your foot into the AFO, ensuring your heel is fully down in the heel section. Gently lift your toes upward to check that your heel is in the correct position.
4. Fasten the Straps Securely – Tighten the ankle strap first to prevent the heel from slipping. Then, secure the calf strap for a snug and stable fit.
5. Put on Your Shoe – Slide your foot and AFO into your shoe, ensuring a secure fit. Tighten the shoe properly to prevent movement inside. A wider or larger shoe may be necessary for a comfortable fit. Shoes with Velcro closures and a wide-toe box work best for easy adjustment. Unless using the AFO in bed, always wear shoes for proper support and stability. Runners are ideal as they provide extra width and depth. If needed, remove the insole for more space.

By following these steps, you ensure that your AFO fits well, stays comfortable, and provides the best support for daily activities.

Getting Used to Your AFO

Adjusting to an AFO takes time, but a gradual approach helps your body adapt while preventing discomfort.

1. Start Slowly – Begin by wearing your AFO for no more than one hour on the first day, engaging in light to moderate activities.
2. Increase Wear Time Gradually – Each day, add 30 minutes to an hour until you can comfortably wear your AFO for a full day.
3. Expect Some Muscle Soreness – Mild muscle aches are normal as your body adjusts to the AFO’s support. If discomfort becomes severe, take a break for two to four hours before trying again. If pain or discomfort persists, stop wearing the AFO and schedule an appointment with your orthotist for adjustments.
4. Follow Your Orthotist’s Instructions – In some cases, you may only need to wear your AFO at night or during physiotherapy sessions based on your orthotist’s guidance.

For the best results, wear your AFO regularly as prescribed. Consistent use helps improve mobility and long-term comfort.

How to Take Care of Your AFO

Proper care ensures your AFO stays effective and comfortable for daily use. Regular cleaning, inspection, and professional adjustments help maintain its durability.

1. Clean Your AFO Daily – Wipe down your AFO at least once a day using a damp cloth and mild soap. This prevents bacteria buildup and skin irritation. Let it air dry completely before wearing it again. Do not use heat sources like a hair dryer or tumble dryer, as they can damage the material. Avoid soaking the AFO and try to keep the straps dry—if they do get wet, towel dry them gently.
2. Check for Wear and Tear – Inspect your AFO regularly for cracks, worn-out areas, or loose straps. Over time, straps and padding may wear out. Contact your provider for repairs instead of attempting to fix them yourself.
3. Monitor Skin for Irritation – After removing your AFO, check your skin for any red marks, pressure spots, or blisters. A light red line is normal but should disappear within 30 minutes. If redness persists or blisters develop, consult your orthotist for adjustments.
4. Wear Proper Socks – Always wear smooth and wrinkle-free socks underneath your AFO to prevent rubbing and discomfort. Avoid socks with thick seams or a rough texture.
5. Schedule Appointments in Advance – If you or your child are outgrowing the AFO, contact your provider early to schedule a new fitting. Appointments and production can take several weeks, so plan ahead to avoid delays.
6. Avoid DIY Adjustments – Never cut, heat, or modify your AFO yourself. Filing, reshaping, or using heat can damage the structure and affect its function. If you experience discomfort or notice damage, seek professional help.

By following these steps, your AFO will remain comfortable, effective, and long-lasting, providing the support you need every day.

Frequently Asked Questions

What does AFO stand for?

AFO stands for Ankle-Foot Orthosis. It is a commonly prescribed lower limb brace to support the foot, ankle, and lower leg. Custom-made for each person, an AFO extends from the foot up to just below the knee, helping with stability, mobility, and proper alignment.