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Normal development

HOW TO CHOOSE THE RIGHT SHOES FOR YOUR CHILD? – choose function over fashion

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Shopping shoes for your kids can be so overwhelming. There are so many options and it’s tempting to pick the most adorable pair – trust me, I know. But choosing the best shoe for your little one depends more on function than on fashion. Surely there can’t be that much difference between sneakers? And not to mention, kids outgrow them so quickly. But making the effort to buy quality shoes can help develop healthy feet in the long term. And let me stop you right there, before making any assumptions – I’m not going to promote any shoe brand, that’s not my intention. I just want to help you, as a parent, choose the right fit for your little one.

TL;DR – the highlights:

  • shoes should be light and flexible
  • the hell counter of the shoe must be firm
  • most children don’t need a special arch support
  • do NOT buy second-hand shoes as they are worn, providing less support and stability
  • at home, it is recommended to leave your child barefoot to promote the natural development of the feet

Foot does not fully develop until adolescence

The foot is a complex structure of 26 bones and 33 joints, supported by ligaments. Our feet are designed to support the entire body, adapt to uneven surfaces, and absorb shock with every step. Most babies start walking somewhere between 8 and 18 months of age, and most toddlers have flat feet when they start walking or tend to turn their feet inward. This is completely normal, the muscles need to strengthen with walking and activity. A baby’s foot is padded with fat and is highly flexible. And while the structure of the foot is fully developed by age 2, the bones themselves don’t fully develop and harden until around age 18.

That’s why proper shoe fit and function are so critical to the health and proper development of your child’s feet.

The importance of choosing the right shoes

In the short term, shoes that don’t fit properly can cause pain, along with blisters, ingrown toenails, or the formation of hard, thick patches of skin caused by repeated friction, rubbing, or irritation and pressure on the skin. This usually form on bony or bulging areas of the feet.

In the long term, more serious problems such as foot and toe deformities can develop. If your child wears shoes that don’t fit properly throughout their developmental years – especially before age 5 – it can also lead to other long-term problems with posture or walking, or even back pain later in life.

The most important features to look for in a child’s shoe

Children should wear shoes that are flexible and allow the foot to bend and move as if the child were barefoot. You should also make sure that your child’s shoes fit properly and aren’t too small. Here are some shoe recommendations to help you find the right ones for your little one:

  1. shoes should be light and flexible to support the natural movement of the foot with a stable base of support
  2. the shoe should bend at the toe – it should NOT bend in half
  3. the hell counter of the shoe must be solid to hold the heel firmly in place
  4. the heel should not be bigger than one inch as this can cause the foot to slide forward, cramping the toes against the shoe
  5. most children don’t need special arch support – all toddlers under the age of 16 months have flat feet and fully develop an arch by the age of 6–8 years
  6. shoes should be made of breathable materials – preferably leather, canvas, or mesh materials
  7. shoes must have rubber grip soles to prevent slipping or sliding
  8. stiff and compressive footwear may cause deformity, weakness, and loss of mobility
  9. shoes should have good shock absorption, but not too cushioned, with durable soles as children participate in more high impact activities.1
Figure 1: The shoe should bend at the toes and not between the midfoot segment and the rearfoot3

NOTE: Studies on adult men have shown that highly cushioned shoes have an adverse effect in high-impact activities. Running in highly cushioned shoes increases the stiffness of the legs and amplifies impact loading.2

Is it okay to buy second-hand shoes?

I get it – kids grow up so fast. You just bought them a nice pair of shoes and they outgrow them in no time. And you’re thinking of getting your kid a pair of hand-me-down shoes to save some money – think twice! There are several reasons not to do this. Second-hand shoes tend to mold into the shape of the child’s feet who wore them before. Apart from that, the tread and heel counter may be worn down, providing less support and stability. In the long run, this does your kid more harm than good, even if they only wear them for a short time.

Figure 2: Used shoes can cause flat feet in children7

Shoe recommendations for children by age

The pre-walking shoe (0-1 year):

During infancy there is no need for a shoe. During the first few months, a pair of socks provides satisfactory protection against cold and weather factors. In a protected environment, such as indoors, they can be barefoot.3 In case of pre-walking shoes, the shoe should be flexible rather than providing a rigid support, and it is very important that the shoe is shaped like the child’s foot.

The toddler’s shoe (1-6 years):

In the phase of learning to walk, the main purpose of the shoe is protection from the weather and the environment. We must always keep in mind that the foot doesn’t need a shoe for its proper development. So, at this age, shoes must be extremely soft and flexible to allow the feet freedom of movement as if they were barefoot. At this age, children become more active. They begin kindergarten and start attending their first ‘‘sporting events’’.3 In this phase, the physiological flatfoot is most evident.4 The shoes should therefore have a flat, soft sole and good forefoot flexibility. Arch support is not only unnecessary but even dangerous for the normal development of the foot. Due to the fat pad of the foot, a child’s foot has a larger contact surface, compared to adults. There is no need for a special absorption element. Choose a light shoe, as children at this age expend a lot of energy when walking. Shoes should also fit well to prevent falls.3

School aged children’s shoe (6 years and above):

For school-age children, shoe style and fit are important. At this age, they can choose from different options, but the main function of the shoe remains the same – shock absorption and protection. Sports shoes for children do not need a heel.3

NOTE: In addition to the correct shoe size, it is also important to replace worn shoes in time, as the mechanical properties of the cushioning of the shoes decrease over time, and the stiffness of the sole increases, producing higher loading on the joints, especially during high-impact activities as running and jumping.5

Keep in mind

A child learning to walk receives important sensory information from the soles of their feet touching the ground. Therefore, it is recommended to leave your child barefoot at home at any age to encourage the natural development of the feet. Barefoot they can feel what they touch with their feet. It also promotes intrinsic muscle strengthening, addresses alignment and balance reactions. However, when walking outdoors and on uneven surfaces, a good supportive shoe is important to protect their feet. This gives children the proper stability and support they need as they explore the world.

Tips for buying shoes

Check the fit of your child’s shoes once a month. A child can outgrow up to three sizes in only 1 year. When you take of their shoes, check for red marks on their feet. Red marks on the tops of the toes are a sign that the shoes are too short, while red marks on the tops of the toe joints indicate that the shoes are cut too low. If the inside or outside of the foot is red, the shoes are too narrow, and if the nails are bent up or worn, this is a clear sign that the shoes are too short.3

The shoe should be about 2/3 of an inch longer than the foot. This extra space ensures that the toes have enough space and prevents toe malformations.3

It is important that the shoe is not too big either. Shoes that are too large can affect gait parameters, leading to greater instability during walking.6

The best time to try on sneakers is the late afternoon, as feet are swollen after walking and standing all day. This ensures that you don’t buy shoes that are too small.3

REFERENCES:

  1. Hoekelman RA, Chianese, MJ. Presenting Signs and Symptoms. In: McInerny TK, Adam HM, Campbell DE (eds.) American Academy of Pediatrics Textbook of Pediatric Care, 5th edition, American Academy of Pediatrics, Elk Grove Village, IL, 2009, p. 4. Walther M, Herold D, Sinderhauf A, Morrison R
  2. Kulmala, JP., Kosonen, J., Nurminen, J. et al. Running in highly cushioned shoes increases leg stiffness and amplifies impact loading. Sci Rep 8, 17496 (2018). https://doi.org/10.1038/s41598-018-35980-6
  3. Walther M, Herold D, Sinderhauf A, Morrison R. Children sport shoes–a systematic review of current literature. Foot Ankle Surg. 2008;14(4):180-9. doi: 10.1016/j.fas.2008.04.001
  4. Staheli LT. In-toeing and out-toeing in children. J Fam Pract. 1983 May;16(5):1005-11. PMID: 6842143.
  5. Herbaut A, Chavet P, Roux M, Guéguen N, Barbier F, Simoneau-Buessinger E. The influence of shoe aging on children running biomechanics. Gait Posture. 2017 Jul;56:123-128. doi: 10.1016/j.gaitpost.2017.05.011
  6. Imaizumi K, Akimoto M, Kobayashi Y, Hobara H, Kouchi M. Effects of oversized footwear on gait parameters in children. Footwear Sci. 2015;7(sup1):S16–8 Available from: http://www.tandfonline.com/doi/full/10.1080/19424280.2015.103693
  7. Venezuela JP. The best shoes for kids with flat feet.

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