Children's Feet...

Why is foot care and shoe choice so important?

Many foot problems are very easily fixed but if they are neglected, can cause life-long problems. Remember that if young people have aspirations of a future job or activity that requires them to be on their feet all day, good foot health will be very important.

What’s important when buying children’s and teenager’s shoes?

• Length: the shoe should be approximately 12-16mm longer than the longest toe.
• Width: adequate width: you should be able to grip a slight fold of upper between your thumb and index finger when the shoe is secured on your child’s foot.
• Heel height: no more than 15mm. Zero mm heels to 6mm for younger children like toddlers. N.B. Avoid heels higher than 15mm for girls under age 16 to prevent possible bone deformity, muscle imbalances, incorrect development and potential problems with spinal alignment.
• Heel type: broad base for stability and made from shock absorbing material and/or design.
• Uppers: natural material uppers and linings are best, e.g. leather.
• Toe shape: the toe area of the shoe should be foot shaped.
• Toe depth: deep enough toe area to allow all toes to move freely and not be squashed. Ask the child to wriggle all their toes in the shoes - if unable to, go to the next size up.
• Fastening: shoes should be held on the foot with laces, straps or velcro fastenings across the top of the foot, and a closed heel or heel strap across the back of the foot.
• Sole: Must be very easily flexible, to at least 55 degrees in the ball of the foot area.
• Lightweight: Infants 30g, Toddler 110g, Child and Adolescent under 220g per shoe.

What style of shoe is best?

Either a style that grips across the top (instep) of the foot and across the back of the heel OR low across the toes but combined with an ankle strap and fastening across the back of the heel. Avoid backless styles as they force the foot and toes to curl to keep the shoe from falling off. The objective is to have a shoe that follows the foot in any movement in space without needing effort from the foot to keep it on.

What should I avoid when buying children’s and teenager’s shoes?

• Heel height: heels higher than 1.5cm under age 16 can lead to developmental deformities.
• Heel type: little stiletto or narrow heels interfere with natural foot biomechanical development.
• Uppers: avoid plastic shoes as they can promote risk of infection.
• Toe shape: avoid any toe shape that does not match the outline shape of the foot.
• Toe depth: avoid if child is unable to wriggle toes, especially the little toe in the shoes.
• Shoe style: avoid slip on or backless styles. These alter muscle action and affect development.
• Sole type: avoid all rigid or hard, inflexible soled shoes. These affect foot and leg muscle development since they compromise natural foot muscle action.

How often do i need to change my child’s shoes?

This depends on the child and their rate of growth. On average, children’s feet grow at two sizes per year in the first four years of life. After age four, growth is one and a half sizes per year thereafter until growth finally stops in adulthood.

A child’s foot may not grow for a considerable period of time and then grow several sizes in a relatively short period. This might mean changing shoes twice in one year, three times in another year or once in a year - not when the shoes are worn out. Feet should be checked for length and width by a parent every school term or every 3 months. In general, the main period of rapid growth in girls is between 8 and 13 years, peaking at about age 12. In boys, this is slightly later between age 10 and 16, with the peak rate at about age 14, corresponding roughly with puberty.

How should I inspect my children’s feet and toenails?

At least once a week, inspect children’s feet for inflamed nails; red, white or brown pressure marks on the top of the small joints of the toes, below the ankle bones and at the back of the heel. If they complain of itchy or painful sites or you may see any rashes or hard, raised areas on the skin, seek professional advice immediately.

Toenails must be inspected regularly and trimmed as required. A good investment is a pair of handled style nail clippers from your local chemist. The small guillotine style is better suited to fingernails not toenails. Never cut down the side of nails nor cut them too short. It is not true that you must always cut toenails “straight across”. When cutting, follow the shape of the toe and always leave the corner of the nail just ahead of the fleshy part of the toe. Leave at least 1mm of white of the growing nail showing.

Remember that teenagers in particular can be secretive about foot problems and a trivial, easily rectified problem can be more serious if neglected.

What’s the best daily hygiene for children’s feet?

Wash feet daily with simple soap and water and dry well, particularly between the toes. After drying, a small amount of plain talcum powder should be used, especially between toes. Unless the child is immune compromised, it is not necessary to use anti-bacterial soap. Children should remove their shoes as soon as possible after school hours and be barefoot or in lightweight open sandals.

My child’s feet are terribly smelly, what can I do?

Children have naturally sweaty feet, but smelly feet may be an indication of poor hygiene or wearing shoes that do not allow the feet to “breathe” (such as wearing takkies outside of winter). If possible, do not put your child in the same shoes every day. Alternate shoes to allow the shoes a full 24 hours to dry out, particularly if the foot is sweaty. Direct sunlight is the best way to dry out shoes. For the South African climate (even in winter) avoid nylon socks that encourage perspiration. Natural fibres or specially marked athletic moisture wicking socks are better. Avoid the use of sneakers or takkies all day every day. Lightweight flexible sandals that allow the foot to breathe naturally or barefoot play is best.

What can teachers do about promoting good foot health?

Set an example with your own choice of footwear. Review school guidelines on shoes. Discuss foot health and foot issues with the children. The Froggie Foot Facts series can be used as an outline for child foot health lessons. Regard foot health with the same gravity as other health issues. Watch the way children walk and if you notice an imbalance co-ordinate a foot screening day with your local podiatrist. Use your local podiatrist to provide educational input to the children. Contact the SA Podiatry Association on 0861 100 249 or visit www.podiatrist.co.za

My teenage daughter insists on wearing high heeled, pointy shoes and I’m worried. Can this do long term damage to her feet?

You are absolutely right to be concerned - the long term effects are not only to the feet but also to posture in general with the possibility of future knee, hip and back problems. In the short term, foot damage can result in resricted ankle joint movement, toe deformities, corns, callus and increased risk of ingrown toenails. The South African Podiatry Association and our orthopeadic colleagues are extremely concerned about the dangerous trend for little girls as young as age 8 to wear heels.

A girl’s feet are still growing and maturing internally up to the age of 18, even though her foot length growth may have stabilised by age 16. We advise the use of flat or low heels (definitely no more than 20mm) between the ages of 16 to 18 for everyday use. The South African Podiatry Association condemns the use of high heels as part of school uniform for matric or college students under the age of 18.

What can parents do to promote foot health?

Set an example with your own footwear. Talk about foot health and foot issues with your children. Ask them for their opinions and find out how much they know. Where there is conflict regarding style and fashion, it may be necessary to compromise, as long as you are well informed about the consequences of your choices. For both teenage daughters and adult women, limit the use of high heels to one or two hours such as for special occasions. The latest health and fitness guidelines advise men and women to walk 10 000 steps per day. Look for shoes that have a low heel (no more than 35mm), internal cushioning and are foot shape friendly so that you can stride easily through the day.

What can children do to promote foot health?

Try to be sensible with the shoes that you wear most often. If you have a problem with your feet, get it seen to right away. Many foot problems are very easily fixed but if neglected, they can cause life long problems. Remember that if you have aspirations to a job or activity that will need you to be on your feet all day, good foot health will be very important. Remember to wear the correct shoes for what you are doing. You wouldn’t play tennis in football boots or football in heels. In the same way, different types pf sports shoes or trainers are needed for different sports. Barefoot execise like karate and judo are good exercise for the foot. The best exercise for your feet is walking and jumping.

Click here:     to find out more about our range of children’s school shoes

Call the SA Podiatry Association 0861 100 249 to locate your nearest podiatrist.

Foot Facts brought to you by Froggie 031 450 0207, in the interest of better footcare.