California Podiatric Medical Association: Saving Our Children's Soles

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California Podiatric Medical Association

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The key issue is proper fit. Back in the 1950's standing on a fluoroscope at your local shoe store to determine the foot's internal structure was considered one of the ways to buy proper-fitting shoes. Today, many parents who struggle to ensure their kids have proper-fitting shoes find that, for many children, fashion often takes precedence over buying shoes that promote good foot health.

According to the National Shoe Retailers Association, some 495 million Americans are spending $32 billion dollars on shoes each year, and of that, 172 million are purchasing children's shoes. "We are very concerned about these statistics because the majority of foot problems begin in childhood," says Noreen Oswell, DPM, who also is President-elect of the California Podiatric Medical Association.

Most children's feet grow throughout the first 18 years of their life; most podiatrists consider the first year the most important in the proper development of the feet since by the age of six, about 30 percent of all children have foot disorders which require professional treatment.

The CPMA recommends several things to consider when buying children's shoes:

* Shop for shoes at the end of the day. Feet are 5 percent to 8 percent larger than in the morning.

* Make sure both feet are measured.

* If one foot is slightly larger than another -- which isn't uncommon -- always fit to the larger size.

* Allow one-half inch of room between the longer toe and the end of the shoe.

* Feel along the sides of the shoe while on the foot to make sure the widest part of the foot corresponds with the widest part of the shoe.

* When trying on shoes, have your child wear the socks they would expect to wear most often with the shoe.

* Have your child walk around to make sure the shoes have flexibility and the foot doesn't step in and out of the shoe.

So, "if the shoe fits," is one pair enough? According to Dr. Oswell, sometimes it is better to buy more than one pair of the same shoe. That way the shoes can be rotated to avoid rapid wear deterioration.

When should shoes be replaced? "A good rule of thumb," says Oswell, "is to look for excessive wear on the outsole, loss of shoe counter support or wearing out on the midsole. And remember, kids' feet constantly are growing, so check for proper fit every few months."

More importantly, says Dr. Oswell, children rarely complain about foot problems. So, observe your child's walk for abnormalities; watch for bowlegs, flat feet, over or underlapping toes and pidgin toes. "The child who doesn't want to go out to run and play, or who wants to be carried all the time, should be examined for foot problems that may originate in the feet."

And, if your child will be participating in sports, sport-specific shoes may be needed. In young children an "all purpose" sports shoe works well for most sports, says Dr. Oswell.

However, after the age of 10, according to the American Podiatric Medical Association, a sport-specific shoe can help improve performance and protect the feet. With the exception of a running shoe, a degree of crossover between sports shoes usually is appropriate for the young athlete.

A good sturdy running shoe is critical because of the tremendous amount of pressure put on the foot. For example, when a teenage runner weighing 150 pounds running three miles, the cumulative impact is about 150 tons on each foot.

And if the shoe doesn't fit? Improperly fitted shoes can lead to serious foot or ankle problems, stresses Dr. Oswell. Some common problems associated with improperly fitted shoes include bunions, contracted toes, blisters, calluses, painful tendonitis and even inflammation of the growth centers of the bones. These are all foot deformities caused or exacerbated by poor-fitting shoes.

If these problems are identified early enough, many of them can be corrected with early treatment and proper footwear advice, exercises, or custom-fit orthotics made by a podiatric physician. If left untreated, these problems can cause serious foot problems later in life, says Dr. Oswell.

"The bottom line to remember," says Dr. Oswell, "is that for good foot health, a properly fitted shoe is much more important than the price tag or the brand name."

CONTACT: Barbara Lindburg of Hedicke & Associates Public Relations, 916-641-6115, for California Podiatric Medical Association