Many adult foot problems can have their origins in childhood, so attention to footwear in children can minimise the risk of these problems in adults. It is essential that children have their feet assessed on a regular basis & to identify, as soon as possible, any problems that might need specialist podiatry treatment in order to prevent problems later in life.
While the joints, muscles & bones are the major areas requiring scrutiny, it is also fundamental to regularly assess the child’s footwear. Poorly fitting children’s shoes can cause a number of problems in their adult life such as arch collapse, hammer toes, ingrown toenails, pressure lesions & bunions. Given the high level of pain & discomfort that these problems can cause, it is important to ensure that the child’s shoe is fitted correctly. Problems in children’s feet are usually preventable.
Before purchasing any type of footwear, parents should consult a podiatrist for a footwear assessment in which the child’s gait, muscle strength & flexibility & joint range of motion can be evaluated. Furthermore family history & the child’s level of activity would be considered when suggesting footwear specific to the child’s needs.
- Childrens footwear doesn’t need to be expensive – you just need to know what features to look for.
- Generally, for a shoe to be correctly fitted there should be a thumb width between the end of the shoe & the end of the longest toe on the longer foot. The child should be able to wriggle their toes freely.
- The last of the shoe should be relatively neutral & straight.
- The laces, velcro, or buckles should not allow the foot to slide forward in the shoe and should hold the heel firmly into the shoe.
- Thongs or Flip Flops should be for occasional use only.
- The heel counter (back part of the shoe) should be strong & stable.
- The shoe should bend across the forefoot at the level of the metatarsals & not in the arch of the foot. This ensures adequate midfoot support.
- Check that the shoe has a deep & broad toe box as to prevent the chance of ingrown toenails developing.
- An absorbent insole may be helpful to prevent fungal infections & ingrown toenails.
- Encourage your child to undo the laces everytime they remove the shoe – it helps the arch area from stretching and makes the shoe last longer.
- Many parents buy the kids’ shoes too large thinking they’ll grow into them. It’s a common mistake. Overly large shoes can cause the foot to roll excessively inside the shoe. Unlike an adult’s foot, a child’s foot elongates & spreads upon impact. Warm weather play can even expand their foot up to half a size.
Growth of the child’s foot:
Those under the age of 16-18 months grow more than half a foot size every two months. Toddlers from the ages of 16 to 24 months grow an average of half a foot size every three months. When they are 24 to 36 months old they grow approximately half a foot size every four months. Over the age of 3 years of age, they increase half a foot size every four to six months.
Types of children’s footwear:
Pre-walkers (babies and those still crawling) do not need shoes – they need booties or pre-walking shoes that do not restrict the foot’s movements. They should be flexible & not supportive, & conform to the shape of the foot.
The first “real” pair of shoes can be used when the child first starts to walk unaided (usually around ages 9 to 18 months). Fitting toddler’s shoes should follow the guidelines above. Encourage bare foot in protected environments (eg. indoor). A soft & pliable sneaker is usually ideal footwear for children at most ages, as long it has plenty of room for the toes.
Most children should have their feet measured & assessed every 6 – 12 months, whilst others need more regular checks.