Guest Columnist: Janet Caputo, PT, DPT, OCS
Babies celebrate their FIRST birthday, take their FIRST step, say their FIRST word, and cut their FIRST tooth. For the most part, Mother Nature drives all these firsts. Yes, parents do encourage their babies to say their first word and take their first step, but the child must develop the appropriate amount of neuromuscular control in order for these events to occur. Recently, a new mom asked me if one type of footwear would be best to encourage the neuromuscular development of her 3 month old baby’s feet to foster walking. There is much more to this simple question than one might think…
Retail stores entice mothers to buy adorable outfits for their babies complete with matching footwear. How many of these mothers consult their pediatricians before purchasing footwear for their babies? Actually, mothers should take time to inquire and consider the type and timing of their babies’ footwear!
Experts believe that footwear during infancy may constrain the child’s foot growth and development. Placing your baby in footwear too early denies his body physical contact with his environment, retards the development of his balance responses, and impedes the natural development of his foot. Scientists compared adult American feet to those of adult African natives who had never worn shoes. The African natives maintained a straight big toe, while the big toes of Americans developed a bunion deformity. Poorly fitting children’s shoes can cause many other problems in adulthood: hammer toes, ingrown toenails, corns, and calluses. Some researchers suggest that adults who have flat feet can trace their condition back to inappropriate footwear during childhood.
My feet are the perfect example! As an infant, my mother always had me in socks and booties, and bought me my first pair of shoes (i.e. the typical high-top, lace-up with a hard outsole) as soon as I started walking. She noticed my “flat feet” at 3 or 4 years of age. Concerned, my mother sought advice from our family doctor who suggested exercises for my foot muscles (e.g. picking up pencils with my toes). Because of my “flat feet”, she always bought me “good shoes” with “arch supports” during my developmental years. QUESTIONS: Despite all these efforts, why do I still have flat feet? Did my mother unknowingly adversely affect the development of my feet?
My father, at 81 and mother at 78 years young, enjoy perfect arches. Then, there is me, their daughter, with flat feet! What difference might have caused my flat feet? My parents grew up during the Great Depression! Shoes, at that time, were a luxury not a necessity! As children, my parents played and ran around barefoot and only wore shoes for school and church. Their feet were allowed to develop normally without constraint of socks and shoes.
Parents should not compare their children’s feet, legs, or style of walking to that of mature adults, because they are supposed to be DIFFERENT! As toddlers begin to walk, they exhibit a flat-footed pattern with their hips and knees bent, and legs turned outward. This “odd” walking pattern actually allows normal development of the child’s leg and foot and the child’s arch will not fully develop until 6 to 10 years of age. Children may also walk with knock-knees, bow-legs, or toes turned inward. These variants of lower leg development typically resolve by 8 years of age. Research demonstrates that shoe inserts, corrective shoes, or other interventions do not enhance the normal development of children’s legs and feet, and that they can be potentially harmful. Over-treatment of mild to moderate “deformities” can perpetuate the “problem” by decreasing normal muscle activity resulting in weakness. However, if a child has pain with walking or has difficulty with walking (e.g. constantly tripping or falling), experts recommend consultation with a pediatric podiatrist or pediatric orthopedic surgeon.
In summary, babies and crawlers do not need shoes, but, even socks and booties limit a child’s ability to spread and wiggle their toes. To encourage proper muscular development while providing warmth, select loose fitting booties that are soft and supple. At about one year of age, children begin to walk and finally need footwear. I love ending on a cliff-hanger, so please join us next week for some tips on selecting shoes for your children.
Visit your doctor regularly and listen to your body.
CONTRIBUTING AUTHOR: Janet Caputo, PT, DPT, OCS is clinical director of physical therapy at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton where she practices orthopedic and neurological physical therapy.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in the Scranton Times-Tribune. Next Week: Part 2 – Best Baby Shoes.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: email@example.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in Scranton, PA. He is an associate clinical professor of medicine at The Commonwealth Medical College.