Frustrated Mothers Come Together for Shoe Solutions

By Tina Eichner
Hilory Paster, VP Sales & Marketing; John Wall, PT, CPO, FAAOP; Lori Watson, Founder & President. Children: Samuel Paster, Hilory's son and William Watson, Lori's son.
Hilory Paster, VP Sales & Marketing; John Wall, PT, CPO, FAAOP; Lori Watson, Founder & President. Children: Samuel Paster, Hilory's son and William Watson, Lori's son.

Driven by the challenge of finding functional, durable, comfortable, and fashionable shoes for their children to wear with AFOs, Lori Watson and Hilory Paster joined together in late 2002 to create a shoe solution for children with cerebral palsy and other conditions that require adaptive shoes.

During a visit to my son's orthotist, I became frustrated that the new shoes I had purchased were the wrong size for his new braces," says Watson, founder and president of Keeping Pace Inc., Boston, Massachusetts. She continues, "In a somewhat off-handed remark, I stated I was going to have molds made for William's foot which would allow for the required extra depth, a cut-line for leg length discrepancy, a durable toe-cap and much more. The orthotist encouraged me to meet a specialty footwear design team in Salem, Massachusetts." At that point she brought Paster, who became the company's vice president of sales and marketing, into the conversation. The two knew each other from working together at an early childhood therapy center for their children.

"One conversation led to another, and before long, a strategic partnership was developed between SoleTech and Keeping Pace," adds Watson. SoleTech, a specialty footwear designer, manufactures the shoes for Keeping Pace, and Keeping Pace handles, sales, marketing, and distribution. SoleTech had received similar requests for shoes before, but the company was impressed with the clear interpretations and real-world understanding that the two women brought to the table.

According to United Cerebral Palsy (UCP), an estimated 800,000 people in the US are afflicted with cerebral palsy. Ten thousand more babies are born each year with this condition. An estimated 70 percent of these children require some type of orthotic supportfoot/leg brace/ankle-foot orthoses or adaptive shoes.

In most cases, AFOs are custom-fabricated and fit to the specific individual's needs as prescribed by medical personnel. Orthotists and physical therapists often think outside the box and explore available options that will help the child utilize most of his or her capabilities. The practitioners strive to assist the weak muscles, control abnormal muscle tone, improve alignment, and increase stability. The ultimate goal is to enhance and improve the child's abilities to walk.

After AFOs Fitted, Search Begins

Once the prescribed AFOs have been made to the child's particular specifications, the daunting task of finding shoes begins.

"Shopping for shoes has never been easy," says Paster. "Since my son has needed to wear AFOs, I have dreaded going into the stores to find shoes. I would travel from store to store, maneuvering my physically challenged child, looking for a pair of shoes that would fit the braces. They needed to be deep enough, long enough, and wide enough. To ease the process, I began to travel with the braces in hand. In desperation, I must have bought more shoes than could have possibly been worn, hoping to find that magical pair.

"In the end, I ended up buying shoes that were two sizes larger than the shoe size that was actually needed. I would force the shoe to work by taking out the inner sole, stretching the material, and praying that they would last at least a month before I needed to start the process all over again."

But often normal wear and tear on these "adapted" shoes meant it would only be weeks or a month before the child would wear holes in the shoe.

Getting the Right Shoe

Watson and Paster explain that a properly designed shoe must have a depth that will enable the hinges, posterior stops, and/or Velcro® straps to sit well below the heel counter. The shoe should securely support the brace and not break down or collapse from its pressure. A shoe that has more than one insole does not necessarily mean that it is deeper and will accommodate the AFO. It is necessary to take a good look at how much depth is actually gained upon removing the insole and what happens to the integrity of the shoe once the insoles are removed.

Exposing the natural internal sole of the shoe will tell you a great deal about the manufacturing quality of the product. Look for a smooth surface that is free of glues, rough spots, or exposed materials that can cause abrasions, breakdown, and discomfort. Closely examine the shoe to see what role the insoles play in creating a firm, supportive cavity. The support and strength of the shoe should be provided by the quality of the materials and construction, not by the use of the insoles.

Pay close attention to the materials used in manufacturing the shoe. Unfortunately, the "typical" shoe manufacturer cannot address the specifics of specialty shoe design; most off-the-shelf shoes are not created for children with toe drag, scissoring, or challenging gait patterns.

Watson and Paster also stress the importance of style. "Children who need specialty shoes want to be as fashionable as their peers," comments Paster. "Just because a shoe fits an orthosis does not mean it has to be unattractive or clunky. Our shoes offer contemporary fashion and stylish looks as well as well-engineered design."

Finally, the company's founders are focused on providing an affordable product for families whose budgets are taxed with so many other costs of caring for a child with special needs.

They are off to a great start. Keeping Pace substantially increased its manufacturing production since it started selling shoes in January 2005 and distributes in the US as well as Europe, Australia, and Singapore.

"With proceeds from our sales, Keeping Pace will be donating financial resources to fund research programs," says Watson. "Today, Keeping Pace is run by parents of children with special needs. Supporting our team are orthotists, specialty footwear designers, friends, and family. It is because of their skills and encouragement that Keeping Pace thrives today."

For more information, visit