Guide to buying the best pair of children's shoes.
There should be a thumbs width of space between the longest toe and the front of the shoe.
Photo/COURTESY
When we think about foot issues such as bunions and heel pain, we generally think of them as an adult problem.
However, children and teens can have foot problems as well. So just like you would take your children to the eye doctor or dentist for preventative care, parents should also consider taking their kids to a podiatrist to ensure optimal foot health.
Adult foot problems begin in childhood, said Toronto podiatrist Dr. Hartley Miltchin, and it's better to address those problems sooner rather than later.
"A lot of adult foot problems can be prevented in childhood so the earlier you get to it, the better your chances of actually correcting it. The later you get to it, the more difficult it is to correct," Miltchin said.
Parents should take their children to the podiatrist if they themselves have foot problems rather than waiting for their child to complain of pain.
"There are some parents (who) know that they have foot problems and want to have their kids feet checked, and I give them credit for that, but that's the minority," he said. "When adults come to me with a problem, I tell them it's a genetic hereditary imbalance and chances are your children have it as well."
Flat feet, he said, are pretty normal until about age two, which is why Miltchin said that age is an idea time for a child's feet to be checked out by a podiatrist.
"There are a lot changes that take place as they grow. They crawl, they stand, they learn to walk, and there are a lot of rotations that take place not only in the feet (but also)...in the legs, and that should all be checked," he said.
Some kids don't have proper hip motion so the hip rolls out and children end up walking like a duck. Children can walk either inward or outward, known as in-toeing, where children often trip over themselves, or out-toeing. Children can also have over-pronation, where the foot rolls into the arch and big toe area, and problems such as bunions, arthritic joints, heel pain, shin splints, knee and low back pain, which stems from the imbalance.
"If it (legs and feet) isn't balanced then you're using muscles and joints unevenly, there is wear and tear and things like this (bunions, pain) begin to happen," he said.
Like adults, kids need to be properly diagnosed and then steps need to be taken to correct the issue.
Miltchin said this can be anything from wearing a special brace to orthotics and from special exercises to simply wearing the proper shoes.
Many parents like to put cute shoes or booties on their babies and toddlers, but Miltchin said there is no need to put footwear on kids until they begin to walk outside.
"It's preferable to let them walk barefoot around the house because they're developing a relationship with the nervous system; it (walking barefoot) gives them some feedback and they adjust according to the surfaces, so really children who aren't walking don't need shoes."
A mistake many parents make is putting their children in leather, ankle-high booties. Miltchin said these types of shoes are restrictive. He said it is really easy to deform children's feet. Even pajamas with feet, if they're too tight or too small, can cause damage.
"Between birth and age six, their (children) feet are really growing and developing...There are 28 bones in the foot and they go through growth using what's called a growth plate, and the growth plate changes at various times through that period so you don't want to disturb that," he said.
Children's feet don't finish forming until their early teens and the heel bone doesn't close until a child is about 14 years old, he said.
When children do start walking, Miltchin suggested putting them in a well-made supportive athletic sneaker, not the popular canvas shoes that are out there.
The shoes, he said, must have a strong heel counter or stiffness in the rear that holds its place and prevents the shoe from wobbling. Shoes should also have some stability and support in the arch area. A good test is to take the shoe and bend it upward at the toe area. It should bend under the ball of the foot. If it bends anywhere else, it's not bending in the proper position for gait, our walk or step cycle, he said.
When fitting the length of a shoe, make sure there's a thumbs-width space from the longest toe, which is not necessarily the big toe, and the shoe.
Miltchin said parents should look for soles that are either made of rubber or crepe because leather don't absorb the shock. He likens walking on leather soles to walking on a bare floor. Parents can also look for soles that have a material called EVA that comes in different densities and is a great shock absorber.
As far as older children and teens go, improper shoes don't cause foot problems but aggravate them.
Miltchin said don't wait until a child complains of pain, but rather be proactive because the longer you wait, there is less of a chance to reverse or correct the problem.