Shoe Orthotics and Inserts for Kids

As a physical therapist, I have worked with a wide variety of shoe orthotics and inserts. Often times, I have worked with different orthotists to find the right fit for the kiddo I’m working with. 

Today, I want to talk about a personal experience with my own son and the shoe orthotic that finally worked for us!

Shoe Orthotics For Kids

In January of 2021, my son broke his leg sledding. He fractured his tibia and fibula and had what they call a Cozen’s phenomenon. I was warned this may be a possibility due to his type of fracture on day one.

Never heard of it? I hadn’t either and I had experience working in both orthopedics and pediatrics. It is something that may happen when a proximal tibia metaphyseal fracture occurs.

Fast forward 8 weeks and the cast is off, weight bearing has resumed, and slight knee valgus is already there. I was prepared for this to happen, but what I wasn’t prepared for was the increase in in-toeing that I also saw on his left side.

I should rewind a bit and mention that he previous to breaking his leg he had a very mild in-toeing gait pattern, not affecting function, but not to the extent of what was happening after the fracture.

This picture was shortly after his cast was off. You can see the increased knee valgus on the left leg.

We worked on all the traditional core, hip, and lower extremity strengthening and lots and lots of swimming. His strength was good, but given the increased valgus of his knee he continued to have an abnormal gait pattern. We still continue to work on all things strength through play.

In the following videos he is aware he is being recorded so I’m not getting quite the gait pattern I would see naturally. He is trying to walk with less in-toeing due to being on video.

I tried many different over the counter foot inserts and orthotics without any great success. I even tried some kinesiotaping and he seemed to respond even worst to kinesiotaping.

The more I looked and analyzed his gait and slowed down the videos, I realized that he needed more control at his heel.

Enter In littleSteps Gait Plates

littleSTEPS are a line of over the counter foot orthotics from the company Nolaro24. This company has a wide selection of foot orthotics for the entire family.

The littleSteps Gait Plates were the game changer for us. They provided that control at the heel that I needed in an over the counter orthotic with the emphasis on reducing in-toeing.

With a Cozen’s phenomenon the maximum valgus deformity is often observed at 12-18 months that in most cases will gradually resolve within 3 years. So, I knew for right now, I knew his leg alignment wasn’t going to change for the better.

Below is a picture of his knee valgus about 11.5 months after the fracture. We are approaching the time where we will be seeing the maximum deformity. That being said, thanks to littleSTEPS gait plates his gait looks so much better!

I took pictures in single leg stance of the unaffected leg (his right leg) and the affected leg (his left leg),so the knee valgus difference wasn’t exaggerated by how he was standing.

Unaffected Side (Right Leg)
Fracture Side (Left Leg)

Below is the video of him walking with the gait plates 11.5 months after his fracture (near the time the knee valgus is the worst on average).

I think that his barefoot gait has improved, even with an increase in his knee valgus, after the use of the gait plates.

Barefoot Gait Before Gait Plates

Barefoot Gait After Gait Plates

Where I really could see the huge immediate difference was in his soccer league. His running pattern was even worst than his walking. The first day he wore his littleSteps Gait Plates on the soccer field I could see an immediate difference in his running.

He wears the inserts in his shoes everyday and I have a pair for his boots as well. I have been absolutely thrilled what these have done for my own son.

Update – 2 years out

At two years out we are still thrilled with littleSTEPS. In my son with the fracture, there is still some valgus at the knee, but the gait plates have kept the in-toeing on that side minimal. He has no in-toeing on his non-involved side. He continues to wear them and will eventually graduate into a regular orthotic. My older son continues to wear the regular orthotics in his shoes on a daily basis with no complaints!

In Conclusion

The littleSTEPS gait plates are exactly what we needed to help my son with his in-toeing gait pattern.

Looking back, due to his very mild in-toeing gait pre-fracture, I wish I would have used these when he was younger for a more optimal pattern.

With any in-toeing pattern I would encourage trying a pair of gait plates out! These work by utilizing a semi-rigid shell that effectively alters the break of the ball of the foot during propulsion to encourage the re-alignment of the hip during gait. They go even further to address foot pronation by incorporating the features of a foot orthosis including a deep heel cup, medial rearfoot posting, and skive to control subtalar joint pronation during contact and midstance phases.

To learn more about littleSTEPS, go to If you decide to purchase a pair, get 10% off by entering PINK1121 in the discount window.

More From littleSTEPS

Gait plates aren’t the only thing in the littleSTEPS line. They also carry over the counter foot orthotics for the flat foot.

Enter in my oldest son. His entire life has had flat feet. Without some type of support, he would complain of his feet aching if he was on them for too long. We had been using over the counter orthotics that I had purchased that were okay.

Since I had such success with the Gait Plates, I decided to try the orthotics from littleSteps for him. Success again!

His alignment looked great and he liked how they felt on his feet. After wearing them for some time, we have had not complaints from him on comfort and not complaints of aching feet.

These over the counter orthotics give you.

  • Deep 30mm heel cup for maximum control.
  • Deep medial and lateral flanges to align the foot.
  • Medial rearfoot posting.
  • Medial Skive for enhanced control

Once again, littleSteps for the win.

This isn’t a picture of my son, but a picture from their website. I wanted to show you what the little steps orthotics looked like.

To learn more about littleSTEPS, go to If you decide to purchase a pair, get 10% off by entering PINK1121 in the discount window.

littleSTEPS for Providers

As a provider, you can work with littleSTEPS right in your practice.

Practitioners who dispense littleSTEPS often purchase a Fit Kit to validate fit/size for their patients, giving the patients an opportunity to try before they buy.. Pairs are not dispensed form a Fit Kit, but re-used for sizing patients.

This is a great alternative to sending patients to orthotists, dispensing expensive devices, customs, etc. 

If you’re interested in learning more about dispensing littleSTEPS to your patients, call Nolaro24 at 203-725-6179 to learn about dispensing, pricing, and Fit Kits, which assure accurate fitting and eliminate returns/exchanges/refunds.  Mention my name for a special discount on littleSTEPS Kits.

Nolaro24 Education

Another reason I love the Nolaro24 company besides their line of littleSTEPS, is the fact that they offer education opportunities. They have a very nice assortment of classes dedicated to feet. Check out their course offerings here.

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