Notes on shoes for children

Excerpts from Dr. Lynn Staheli, University of Washington, Seattle, WA

For a long time, shoe modifications were a traditional treatment in infants and children for a wide variety of pathological and physiological problem. Because shoe modifications were prescribed for spontaneously resolving conditions, resolution was falsely attributed to the shoe. This led to the concept of the “corrective shoe”. Recently, data base studies have consistently shown that natural history, rather than shoe modifications, were responsible for the improvement. We now know that the term “Corrective shoe” is a misnomer. Barefoot people have been shown to have feet of infants and children do not require support and do best with freedom of movement without shoes.

The selection of shoes should be the same as for other clothing. The shoe should protect the foot from injury and could and be acceptable in appearance. The best shoes are those that interfere least with function and stimulate the barefoot state. Proper fit is desirable, not to promote support but to avoid falls and compression of the toes. Falls are more common if the shoes are too long or have sole material that is slippery or sticky. Some shoe modifications are helpful. These are not for correction but to improve function or provide comfort. Shoe lifts may be useful if leg length difference exceeds 2.5 cm. Orthotics are effective in evenly distributing loading of the sole of the foot. Shock-absorbing footwear may be helpful for the adolescent in reducing the incidence of overuse syndromes.

Shoe Feature – Purpose

  • Flexible : Improve mobility and strength
  • Flat : Distributes weight evenly
  • Foot Shaped : Non-compressive
  • Friction : Prevents slipping
  • Appearance : Acceptable for the child
  • Cost : Acceptable for the parent

NOTES ON SHOES FOR CHILDREN

Barefoot people have the best feet!

Your child needs a flexible, soft show that allows freedom to develop normally.

Adequate size
Shoes are much better too large rather than too small.
A child’s foot needs protection from cold and sharp objects, but it also needs freedom of movement.

Flexibility
Stiff supportive shoes are not good for feet because they limit movement that is needed for developing
strength and retaining foot mobility.

Flat sole
Children’s falls cause many injuries. A flat sole that is neither slippery nor sticky is best.

Soft Porous Upper
A material that breathes is best, especially in warm climates.

Foot Shaped
Avoid odd shapes. It seems reasonable that a shoe be foot-shaped.

REMEMBER: The best shoe keeps the foot warm and protected, but allows freedom of motion and
space to grow.

KAPI’OLANI ORTHOPAEDIC ASSOCIATES
Paediatric Orthopaedics
Spine Deformity
Sports & Dance Medicine
Young Adult Hip Preservation
1319 Punahou Street
Suite #630
Honolulu, Hawaii 96826
Phone: (808) 945-3766
FAX: (808) 942-9837
www.kapiolani.org
Robert C. Drukin, M.D.
Division Head
Paediatric Orthopaedics
Associate Clinical Professor
Department of Surgery, John A.
Burns School of Medicine,
University of Hawaii
William E. Burkhalter, M.D.
Paediatric Orthopaedic Surgeon
Assistant Clinical Professor
Department of Surgery, John A.
Burns School of Medicine,
University of Hawaii
Jennifer R. King, D.O.
Paediatric Sports Medicine
Assistant Clinical Professor
Department of Surgery, John A.
Burns School of Medicine,
University of Hawaii