Guest Columnist: Janet M. Caputo, PT, DPT, OCS
Part 2 of 2 (If you missed Part 1 you can go back and read it at this link.)
When children begin to walk, they need shoes for protection not stability or motion control! Children deserve the BEST shoes, which are not always the most expensive! Selecting appropriate shoes for children assists the development of their feet as well as improves their balance responses.
Measure your child’s feet every 3 months: Since children’s feet grow rapidly, they may require new shoes every 3 months! Footwear with sufficient growing room allows a thumb’s width between the shoe and the longest toe which is not necessarily the Big Toe! Shoes with leather uppers are the most durable and the most expensive, but not the most economical, because children outgrow shoes before they can wear them out. Shoes made of cloth or canvas, such as sneakers, are just as good and much less expensive.
Select footwear with uppers made of breathable, lightweight materials: Children’s feet perspire heavily because they go non-stop. Therefore, breathable materials (e.g. leather, cloth, canvas, or the newer mesh materials) are ideal for the upper part of your child’s shoe but you should avoid synthetic materials, especially plastics. To absorb excessive perspiration, the insole, which is inside the shoe, should be made of absorbent material. Because children also expend a great deal of energy walking, their shoes should be lightweight. Sneakers are typically made of cloth, canvas, or mesh material which makes the shoe not only lighter but also breathable.
Select a “rounded” toe “box”: Children’s toes need room to move for proper growth and development. Do not cramp their toes with a narrow toe box. Allow their toes freedom to wiggle!
The “sole” is the “soul” of the shoe: The sole of the shoe provides flexibility, stability, and traction. Since a child’s foot should not be constrained, flexibility is the most important quality. Shoes should not need to be “broken in”. The sole should bend in the ball area with little effort and but should be firm in the arch area where the foot does not bend. Smooth soles offer less friction and will not catch on the floor causing a child to fall. Grooves in the sole provide better traction and would be appropriate for wet or winter weather. Sneakers offer flexibility, stability, as well as traction.
Heels must HEEL: Toddlers need flat soled shoes, like sneakers, to make walking easier. Most leather shoes have heels which can encourage toe-walking, tighten the calf muscles, and shorten the Achilles tendon. Heeled shoes can also cause the foot to slide forward which can cramp the toes against the toe box.
Do not “counter” the “counter”: A child’s shoe requires a stable but padded heel counter. To determine if the counter is stable, squeeze the back of the shoe. If the counter deforms easily, it is not firm enough to withstand abuse. Most children, and some adults, fail to take the time to unfasten their shoes, but rather hastily slide their feet into their shoes allowing their heels to squish the counters! The inside of the heel counter should be smooth to avoid irritation to the back of the child’s heel.
By 6 to 10 years of age, children develop gender differences (i.e. boys have a wider mid-foot than girls). At 9 to 12 years of age, children develop walking patterns SIMILAR to that of adults but their feet continue absorb shock differently. A girls’ foot typically stops growing at 12 years, while a boy’s foot will not complete development until 15 years. However, even though their feet may be fully GROWN, they are not fully MATURE! Therefore, even though children at this age may fit into adult footwear, the adult version may not be the BEST choice for your child!
Children’s feet differ from their adult counterparts and change constantly. Poorly fitting or inappropriate shoes for children can cause foot problems in adulthood: hammer toes, ingrown toenails, foot corns, calluses, and bunions. Rather than asking relatives, friends, or the local shoe salesman, consult your pediatrician before purchasing footwear for your child. Appropriate prescription for your child’s footwear may not be easy given the immense variability in manufacturer’s choices!
Most importantly, don’t be in a hurry to buy shoes for your children! Wait until they begin to walk (i.e. 11 to 15 months). Even then, keep your children barefoot as much as possible to encourage proper development of muscles and ligaments, as well as good balance. Remember, the “BEST” shoes for children are “NO” shoes!
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.
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: drpmackarey@msn.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.
