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Health & Exercise Forum

How to Choose the Best Baby Shoes - Part 2 of 2

May 28, 2013

Dr. Mackarey's Health & Exercise ForumGuest 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:

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.