Surestep SMO

The Surestep supramalleolar orthotic (SMO) is a specialised orthotic device designed to provide stability and support to children with foot and ankle issues, such as flat feet, pronation (inward rolling of the foot), and other conditions that affect their gait and overall foot alignment. 

The Surestep SMO is custom-made to fit each individual's unique foot shape and provides targeted support to specific areas, including the arch, ankle, and heel. It helps improve foot alignment, enhances stability, and promotes proper walking mechanics, allowing children to participate in daily activities with increased confidence and reduced discomfort.

What is an SMO?

SMO stands for a supramalleolar orthotic, which is a type of orthotic that focuses on providing support and control specifically above the ankle joint, as well as to the foot and ankle itself. It extends just above the ankle bones (malleoli) and typically covers the foot arch. The primary goal of an SMO is to address issues related to foot alignment, stability, and pronation (inward rolling of the foot). 

Some of the benefits of an SMO includes that it tends to offer a greater range of motion at the ankle joint, helping support a child’s growth and development as they run, jump and skip throughout their days without being overly restrictive or limiting what they can do on a daily basis. The slimline design also means that they are more compatible with a wider range of footwear, so tend to be much more comfortable for children.

This differs from a traditional AFO (ankle foot orthotic), which tends to extend further above the ankle (in some cases even to just below the knee, depending on the conditions they are prescribed for) and tend to be bigger and bulkier, with less visual appeal for kids. While AFOs definitely have a place in helping manage children’s foot problems in certain circumstances, the majority of our paediatric patients will far prefer to consistently wear a Surestep SMO.

Who is the Surestep SMO for?

The Surestep SMO is indicated for children with foot and ankle issues that require targeted support, such as those that: 

  • Pronate (excessively roll their feet inwards) and have flat feet
  • Have low muscle tone (hypotonia)
  • Are unstable on their feet
  • Cannot stand independently
  • Display mild toe walking
  • Have developmental delays due to a variety of causes, including delays in acquiring gross motor skills
  • Have poor coordination or balance
  • Are hypermobile
  • Have mild to moderate foot and ankle conditions, such as mild foot deformities or alignment abnormalities

How do SMO orthotics help children?

SMOs are prescribed for very specific purposes and foot conditions. As such, they work very specifically by helping with:

  • Improved foot alignment: SMO orthotics are designed to promote proper foot alignment by providing support to specific areas, such as the arch and ankle. They help address conditions like flat feet or excessive pronation, helping to align the foot into a more optimal position.
  • Enhanced stability and balance: SMO orthotics offer stability to the foot and ankle, helping children maintain balance and reducing the risk of falls or injuries. By providing support to the joints, ligaments, and muscles, they assist in improving overall stability during walking, running, and other activities.
  • Correction of gait abnormalities: children with foot and ankle issues may exhibit gait abnormalities, such as toe walking or an uneven gait pattern. SMO orthotics can help correct these abnormalities by providing proper support and alignment, leading to more efficient and natural walking mechanics.
  • Increased comfort and reduced pain: SMO orthotics are custom-made to fit each child's foot shape, ensuring a comfortable and snug fit. By providing support and cushioning, they can reduce discomfort and alleviate pain associated with foot and ankle conditions.
  • Facilitation of normal development: for children with developmental delays or motor coordination difficulties, SMO orthotics can assist in promoting normal development. By providing stability and support, they help children participate in physical activities, improve their motor skills, and enhance overall functional abilities.
  • Compatibility with regular footwear: SMO orthotics are designed to fit inside regular shoes, allowing children to wear them with a variety of footwear options. This promotes greater compliance with orthotic use, as children can maintain their preferred style of shoes while still receiving the necessary support.

Getting The Surestep SMO: Our Process

As the Surestep SMO is a medical device, it can only be prescribed on a case-by-case basis by one of our qualified podiatrists following a comprehensive assessment of the feet and legs. After your assessment with us, your podiatrist will discuss all of your treatment options, and talk about whether Surestep could be right for your child. From here, we fill in a comprehensive prescription and measurement form, including a 3D foot scan, after which your brace will be sent to be made. Once it arrives back in our clinic, we’ll get you in to ensure a perfect fit, and talk you through everything you need to know about caring for your SMO.


How long do kids wear the SMO?

The duration for which children wear their SMO varies depending on the child's specific needs and condition. In general, SMOs are typically worn consistently during weight-bearing activities for an extended period, often ranging from several months to a few years. The duration of SMO wear depends on factors such as the severity of foot and ankle issues, the child's growth and development, and the progress made with the orthotic intervention. We see you periodically for follow-up appointments to monitor your child's condition, assess the effectiveness of the SMO, and make any necessary adjustments. As the child's foot alignment and stability improve, we may recommend gradually reducing the duration of SMO wear or discontinuing its use altogether. Your podiatrist will be able to give you specific advice based on your child’s circumstances at their appointment.

Is an SMO or AFO covered by medicare?

No, however it is covered by the NDIS.


Monday 7:30am - 6:30pm
Tuesday 7:30am - 6:00pm
Wednesday 7:30am - 6:30pm
7:30am - 6:00pm
Saturday CLOSED

Ground Floor, 344 Queen Street,
Brisbane City QLD 4000



Monday 7:30am - 6:00pm
Tuesday 7:30am - 6:00pm
Wednesday 7:30am - 6:00pm
7:30am - 6:30pm
Friday 7:30am - 5:30pm
Saturday 7:30am - 4:30pm

Newmarket Village, 114/400 Newmarket Rd, Newmarket QLD 4051