Understanding Options for Leg Braces
- trayloramandan
- Jan 18
- 3 min read
Key Takeaways:
Leg braces, orthoses, can be helpful to assist with mobility, correct a deformity, or prevent pain and injury.
Different trims and components are available to tailor braces to the need of the user, best determined with the assistance of a Physical Therapist, Orthotist, and/or Physiatrist.
There are many brace-friendly shoe options to make brace wear easier and more convenient.
Leg braces—also called orthoses—are medical devices designed to support, align, prevent, or correct deformities of the lower extremities. They can improve walking efficiency, reduce pain, prevent injury, and enhance overall mobility for children and adults alike.
Different braces serve different purposes depending on the joints involved, the amount of support needed, and the underlying diagnosis. Below is an overview of common lower-extremity braces, how they help, when they are indicated, and the conditions most often associated with each.
Foot Orthosis (FO)
How it helps
Foot orthoses (custom or prefabricated inserts) support the arch, improve foot alignment, and redistribute pressure within the shoe.
When it is indicated
Foot pain or fatigue
Abnormal foot mechanics
Mild alignment issues
Common diagnoses
Plantar fasciitis
Flat feet or high arches
Overuse injuries
Mild gait abnormalities
Supramalleolar Orthosis (SMO)
How it helps
An SMO supports the foot and ankle just above the ankle bones (malleoli). It primarily improves foot alignment and stability without significantly restricting ankle motion.
When it is indicated
Mild to moderate foot instability
Excessive pronation or supination
Balance difficulties
Common diagnoses
Severe flexible flat feet
Hypotonia
Mild cerebral palsy
Developmental delay
Down's Syndrome
Carbon Fiber AFO
How it helps
Carbon fiber AFOs are lightweight and energy-storing. They enhance push-off during walking and reduce fatigue by improving gait efficiency.
When it is indicated
Active individuals needing dynamic support
Foot drop with good overall alignment
Desire for a low-profile brace
Common diagnoses
Stroke
Peripheral neuropathy
Charcot-Marie-Tooth disease
Incomplete spinal cord injury
Chemotherapy effects
Posterior Leaf Spring Orthosis (PLSO)
How it helps
A PLSO is a flexible AFO designed to assist with lifting the foot during walking. It stores energy during stance and releases it during swing, aiding foot clearance.
When it is indicated
Foot drop with minimal spasticity
Need for light support rather than rigid control
Common diagnoses
Peroneal nerve injury
Mild stroke
Chemotherapy effects
Multiple sclerosis
Brain tumor
Early neuromuscular disease
Hinged Ankle Foot Orthosis (Articulated AFO)
How it helps
A hinged AFO allows controlled ankle motion—typically permitting dorsiflexion (toes up) while limiting plantarflexion (toes down). This supports a more natural walking pattern while still providing stability. It can also be helpful in preventing excessive knee hyperextension (bending backward or double-jointed position).
When it is indicated
Some active ankle movement is present
Need for stability without fully restricting motion
Difficulty clearing the foot during swing phase
Controlling knee hyperextension ("double-jointed" position of the knee)
Common diagnoses
Mild to moderate cerebral palsy
Stroke recovery
Multiple sclerosis
Incomplete spinal cord injury
Down Syndrome
Severe cases of Ehler's Danlos Syndrome (hypermobility type)
Solid Ankle Foot Orthosis (Solid AFO)
How it helps
A solid AFO holds the ankle in a fixed position, limiting movement in all directions. This provides maximum stability to the ankle and foot and helps control abnormal movement patterns.
When it is indicated
Significant weakness or paralysis of ankle muscles
Poor ankle control or instability
Need to prevent deformity progression
Severe spasticity or tone abnormalities
Common diagnoses
Cerebral palsy
Severe peripheral neuropathy (chemotherapy side effects, diabetes)
Brain tumor
Stroke
Traumatic brain injury
Spinal cord injury
Knee Ankle Foot Orthosis (KAFO)
How it helps
A KAFO stabilizes both the knee and ankle. It can lock the knee in extension or provide controlled knee motion, helping prevent knee buckling during walking or standing.
When it is indicated
Significant knee instability
Weak quadriceps muscles
Inability to safely bear weight through the knee
Common diagnoses
Spinal cord injury
Muscular dystrophy
Osteosarcoma after limb salvage procedure
Hip Knee Ankle Foot Orthosis (HKAFO)
How it helps
An HKAFO provides support and alignment from the hip down to the foot. It is typically used for individuals with very limited or absent lower-extremity muscle control.
When it is indicated
Minimal voluntary control of the legs
Need for upright positioning or therapeutic ambulation
Severe neurological involvement
Common diagnoses
High-level spinal cord injury
Spina bifida
Osteosarcoma after limb salvage procedure
Severe neuromuscular disorders
Brace-Friendly Shoes
There are a lot of great shoe options for brace-wearers that make getting ready easier and more convenient.
Post contains affiliate links
Final Thoughts
Leg braces are not one-size-fits-all. The right orthosis depends on the individual’s diagnosis, muscle strength, joint mobility, and functional goals. When properly prescribed and fitted, braces can significantly improve mobility, safety, and quality of life.
If you or your child may benefit from a brace, consultation with a physical therapist, orthopedic specialist, physiatrist, and/or orthotist is essential to ensure the most appropriate device is chosen.
