New School Year, New Shoes!

With fall approaching and the start of school already here for many Hoosiers, many parents have already been hunting for the perfect bargain for school supplies and clothes. While we start early, many parts of the country are not starting until after the upcoming Labor Day holiday weekend.  Among the bustle of supply searches and new outfits to impress comes shoe shopping. Shoe shopping can be challenging, as parents have to weigh between fashion and function.  The most common question I get is what are the best shoes for children and how often do shoes need to be changed?

To answer that question, one must consider the anatomy of a child’s foot in combination with recess and after school activity.  The bones of children are different from those of adults.  Growth plates in children’s bones do not close until age 15-17 in boys and age13-15 in girls.  Repetitive overuse can cause inflammation of the growth plates causing heel pain. This is most commonly seen in children who participate in multiple sports or have long or frequent practice schedules after school, but can also be seen in children whose only activity is recess or after school play.  Additionally, growing feet are at risk for skin irritation from poorly fitting shoes.  This includes skin pressure damage and pain in the case of tight shoes, and skin blistering from shoes that have been ‘over-sized’ to permit growth throughout the school year.  A larger, floppier shoe can also lead to sprains and other injuries from the unstable shoe.

When looking for shoes, the shoe itself should have several characteristics that provide support to the growing foot.  Unfortunately, many children’s shoes available in retain stores are cheaply made and offer little support.   A quality shoe should have a firm heel counter (material in the back of the shoe) that does not easily compress or break with pressure, and the shoe should not slip at the heel.  A shoe that can twist like a wringing towel is also not very supportive, and should be avoided.  The shoe should have adequate cushioning of the insole to help absorb the shock of activity, and some children with flat feet may need additional arch support in the form of a quality insert or custom orthotic.  The initial shoe purchase should be based on the child’s current shoe size, and ideally only a half size increase should be considered to give ‘room to grow’ if these can be found.  Children’s feet should be measured monthly as they can grow quickly.  From a simple space perspective, there should be about one-half inch (1 cm) of space between the tip of the toes and the end of the shoe.   As this decreases while there is foot growth, the shoes will begin to become uncomfortable.

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Parents should avoid the use of ‘hand-me-down’ shoes from older siblings, as the internal structural wear and tear will likely be substantial, even if externally the shoe looks fine.  Conversely, a new shoe should be comfortable from the start.  The concept of breaking-in a shoe is outdated and not healthy for the feet.

Overall, a parent should certainly look for a shoe that their child likes and will want to wear, but the shoe needs to provide support and stable structure. Not only is this necessary for comfort, but it may help prevent or sow the progression of adult acquired foot deformities in the future.

I hope your kids have a great school year, and that you find a shoe your child likes and feels comfortable in!

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