A Parent’s Guide to Children’s Feet & Shoes

A Parent’s Guide to Children’s Feet & Shoes

Feet are one of the most important yet most abused parts of the human body, designed to take body weight and give mobility essential to quality of life. They carry us the equivalent of four times around the earth in an average lifetime, yet we give them less attention than they deserve, we rarely wear the best shoes for our feet and often don’t give them a second thought until they start to hurt. From birth to early teens, feet are at their most vulnerable so maintaining and caring for a child’s feet will benefit their health, mobility and well-being throughout their entire lives. *There are 26 bones in the foot, and they do not complete ossifying (growing) until around the age of eighteen. *Each foot also contains 19 muscles, 107 ligaments, numerous tendons and 250,000 sweat glands. *Up to the age of 4-5 a child’s foot can grow nearly 2cm in one year *After this their feet grow on average 8-10mm (one shoe size) a year but this is usually in fits and starts, and the width will vary too.

Common Foot Problems

Apart from those caused by the wrong choice of shoe, there are other foot problems often seen in school children:- these can be associated with growth and development as well as overuse, weight gain and postural changes. Some changes in children’s feet are part of natural development and others require professional attention and treatment. A podiatric assessment is available for children on the NHS and can usually be requested by the parent/guardian. Forms are available from GP surgeries or local podiatry clinics/departments. 

Exercise

As children take up a particular sport and become more active at school, foot and lower limb problems associated with unaccustomed exercise can occur. Growth, possible weight gain and increased exercise contrive to cause a wide range of painful foot and lower limb conditions. These complaints should always be taken seriously and a diagnosis made as soon as possible. Failure to recognise and treat these overuse symptoms can lead to long-term problems for the child and an inability to reach their true sporting potential. Most problems can be readily managed by a podiatrist utilising a variety of methods. But the treatment may also require periods of rest and a change to everyday footwear and activity footwear. Often the problem can be solved with footwear advice alone. Always remember to wear the correct footwear for that particular sport. Barefoot activities, i.e. karate, judo are good exercise for the foot but also cause problems due to the foot having a relatively lower heel from what is it is used to. This puts strain on the arch of the foot and the back of the lower leg. Careful training and preparation are essential. If a child indulges in any form of activity, injuries can occur and there will be aches and pains from time to time. Children are no different to adults in this respect but they tend to repair more quickly. Also, they tend not to rest when injured and need to be monitored carefully. Very young children may regard the problem as the norm and not complain. All aches and pains in children should be taken seriously and investigated professionally, particularly during periods of active growth.

Barefoot and happy

Children should spend time without shoes – when safe – as it allows them to wiggle their toes and it strengthens their feet. Taking off shoes gives any sweat time to dry out.

Footwear

Children’s feet are particularly susceptible to footwear related problems due to their soft bones and rapid yet irregular growth rate, so it is vitally important that shoes are checked regularly. Footwear which is too large, too small, or does not fit properly, can cause life-long foot concerns such as deformity, toenail and skin problems. All children’s footwear should be measured for length and width and be fitted by a trained shoe fitter if at all possible. The ideal shoe should have the following features:

*Length: A space of 14mm between the end of the toes and the shoe: 4mm for growth, 4mm for movement and 6mm for styling.

*Height of heel: This can be increased as the child gets older but should be no more than 4 cm (1.5 inches).

*Broad base of heel: This should be as wide as the heel to give stability, and be made of a shock absorbing material.

*Heel stiffener: This is the part of the shoe at the back and sides of the heel. It stiffens the back of the shoe and stops the heel slipping out of the shoe. Along with a broad base of heel, it helps to prevent sprained ankles. It also helps to prevent claw toes, as a shoe which slips at the back will cause the toes to claw to keep the foot in the shoe.

*Retaining medium: This is the term used to describe how the shoe is kept on the foot. Ideally it should be by laces, Velcro or a ‘T’ bar, which acts like a seatbelt in a car, holding the shoe onto the foot. This helps to prevent toe deformities, as a poor retaining medium can allow the foot to slide up and down in the shoe and damage the toes or cause the toes to claw to help keep the shoe on. This is a particular problem with the fashion of not tying shoelaces.

*Sole Material: This should be of a slip-resistant, shock-absorbing material.

*Upper Material: Ideally this should be made of leather. Synthetic materials e.g. plastic, nylon and rubber can cause the foot to sweat excessively and increase the likelihood of athlete’s foot, verrucae and in-growing toenails.

*Lining: The inside of a shoe is just as important as the outside. The lining should be breathable, ideally made of leather or specially designed wicking fabrics, which transfer moisture away from the foot.

*Toe area shape: This should be foot shaped and not pointed. Pointed toe areas may result in the formation of bunions and other toe/nail deformities. It should also be deep enough to allow the toes to move.

Trainers need fitting too!

Stops and starts, running and jumping all put feet under extra stress so correct fit is perhaps even more important in trainers than in shoes. You may think it’s not so important, as trainers are generally softer than ordinary shoes but when you consider that even socks that are too tight can cause damage just think what a poorly fitted trainer could do. Most kids’ trainers (even the very biggest brands) are often just “shrunk down” versions of adults’ shoes. They don’t take into account the differences between kids’ feet and grown- ups’. This can mean they’re the wrong shape for a child’s feet. They may fit professional athletes but they’re unlikely to fit a child. Remember that many trainers are designed for particular sporting activities and may not be suitable for regular every day wear. Children often pick trainers due to peer group pressure and fashion trends to wear the right label or style. You can measure a child’s feet by downloading and printing a foot-measuring guide from www.healthylittlefeet.com – it will give you a rough idea of whether a child needs new shoes, and the size.

Hand-me-downs

Children should never wear hand-me-downs as shoes mould to the wearer’s foot shape and will not fit another person properly. Even if they have been barely worn, you should get a professional to check they are the right fit.