It’s back to school season! Time for parents to fret about their children’s backpacks, their dentist visits, their eye exams... but what about their feet? The very feet that carry their entire body weight throughout their lifetime?
As children grow and increase activity, their muscles strengthen, their ligaments tighten, and their bones harden. These natural changes are strongly apparent in the human foot—a highly complex structure comprised of 26 bones embedded within a network of muscular, ligamentous, nervous, and vascular supplies. These structures are soft and highly flexible in the developing foot; consequently, abnormal pressures and forces can easily lead to deformities. Much like how a good helmet can better protect the head from injury, a good shoe can protect the progression of biomechanical abnormalities in your children’s feet.
“A good school shoe provides a stable home for immature bones” – Charlotte Bodell, Podiatrist
At Align, we understand the added pressure that comes with back-to-school shopping. To help you in this annual dilemma, here are some tips to remember when looking for those new school shoes:
1. Get an accurate measurement.
The best time for shoe-shopping is at the end of the day, as children’s feet tend to swell from AM to PM. When at the store, be sure to have them measure your child’s feet twice before any purchase. In addition, the Brannock device (the metal foot measuring tool used in shoe stores) gives the most accurate reading when the child is standing as opposed to sitting. Don’t forget about their foot width as well!
2. No tightness in the toe box.
Be sure to choose a pair of shoes that are wide and deep enough to house the forefoot. The toebox, the front of the shoe that covers and protects the digits, should be rounded and roomy to accommodate the width and length of the toes. If you notice any bony prominences in the upper material of the shoe during wear, this is a likely indicator that the shoe is too tight. Always remember the “rule of thumb”—quite literally, ensure that there is a gap of about half the width of your thumb between your child’s longest toe and the end of the shoe. Ask your child to flex their toes upward while wearing the shoe to accurately gauge where the longest toe sits (the big toe is not always the longest). Alternatively, drawing an imprint of your child’s foot and placing the shoe on top can assist with length and width estimates.
3. Sole flexibility depends on age.
Indeed, a stable and stiff sole (the rubber outer-bottom part of the shoe) generally offers better support for your foot. Toddlers (ages 1-3) on the other hand are quite different, as they are first adapting to walking and running. Always remember that toddlers’ bones are much softer than an adult, and hard-soled shoes can cause them to develop differently. In an early-walker, hard soles are restricting and will prevent your child’s feet from developing naturally; conversely, soft soles are less likely to inhibit their ability to walk. Soft sole shoes can also help toddlers improve their coordination and balance as they transition into running by the age of 4. When your child can comfortably walk heel-to-toe on their own for a period of time, they can begin to progress into a firmer soled shoe. A good hard-soled shoe should only bend at the balls of the foot, and no where else along the sole.
4. Pain-free and comfy.
Although there is a break-in process for shoes, your child should be immediately comfortable when wearing them for the first time. The sock liner or insole must be soft and comfortable, ideally made from an absorbently breathable material to reduce sweating. The most common shoe complaint from children is that they’re too tight, which is best addressed immediately. Prolonged periods of wearing tight footwear can lead to excessive soreness, pain, and blistering. Some children may not notice or vocalize painful symptoms immediately, however it is important to monitor signs of limping or decreased activity involving the footwear.
5. The Goldilocks Principle of sizing.
The harms in wearing smaller shoes are obvious, but what about the opposite? Parents are often tempted to buy a larger size so their child can “grow into the shoes”, however excess room can cause the foot to slide within the shoe itself. Constant shuffling in an oversized shoe can cause trauma to the nails since the toes are “sliding inside the shoe” rather than “moving with the shoe”. For instance, jamming the toes into the distal tip of the toebox due to excess space can result in a “subungual hematoma”—in which blood fills the space between the nail bed and toenail. Moreover, an oversized shoe can encourage the foot to slip out, which may force your child to harshly grip the insoles with their toes. Prolonged tension in the toes can lead to long-term deformities such as “hammered” or “clawed” digits. So remember: not too small, not too large, make sure it fits “juuuuuust right”.
On that final note, don’t always treat “back-to-school” September as the only time to purchase new shoes. Let’s face it, our kids grow up fast and it is not unusual for their feet to grow up to two sizes in one year. Consider shoe size changes every 4-6 months if your child ranges from the age of 3-6 years old. In toddlers, we recommend a sizing every 3 months to keep up with their rapid growth and milestone of walking. In adolescents and beyond, foot sizing should be assessed every six months until your child stops growing.
Have any questions? Visit Align Custom Fit Footwear & Footcare for your free pediatric assessment today!
By Catherine Duong, D.Ch
This information is provided for general health and wellness awareness and does not constitute as medical advice. It is not meant to be used, diagnosed or treat medical conditions. For diagnosis or treatment of a medical condition always consult your Physician.