First steps: does a child need shoes?

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

We bring to the attention of our readers a translation of an excerpt from the book "Pediatric orthopedic secrets". Its author is Lynn Stahely, MD. You can read more about him here (follow the link - biography in English).

Chapter 20. Shoes for children

1. Is it normal for children to walk without shoes?

"No shoes" is a normal and healthy condition for the foot at any age. People who walk barefoot have stronger legs and are less likely to have foot deformities than people who wear shoes. Shoes can also cause skin problems such as plantar hydradenitis and allergic reactions.

2. Are there any benefits from shoes?

Like other types of clothing, people wear shoes for beauty and protection. Shoes protect feet from contact with cold and sharp objects, and also hide feet from the eyes of those who do not like the look of bare feet.

3. What harm can wearing shoes cause?

It depends on the type of shoe. Stiff footwear weakens the feet and leads to an increased incidence of flat feet. Tight shoes can cause deformities in the foot.

4. Does the stop need support during the formation period?

No. The supportive shoe limits the movement of the foot, weakens it and leads to a flattening of the arch of the foot. The foot should not be pinched in order to move freely and develop mobility and strength. Agree, it would be ridiculous to put on a rigid glove over your hand?

5. Can the shoe perform a "corrective" function?

The shoe has no "corrective" function and has never helped to correct any deformation.

6. At what age should a child choose their first shoes?

Usually, parents buy their child's first shoes somewhere in the first year of his life. It is purely a matter of what to put on the child. At home, the child will calmly manage with socks. Soft shoes can be worn on the child for beauty or to protect the feet while walking.

7. What shoes are best for a young child?

Soft, flexible shoes work best. Since babies' legs are chubby, high-toed shoes can come in handy - purely because they stay better on the foot.

7. What shoes are best for a teenager?

Shoes with good shock absorption help to avoid traumatic overstrain. Shock cushioning shoes make walking more comfortable.

8. What kind of footwear should be avoided?

Today, children's shoes are made better than they used to be. Tapered toes and high heels for girls and cowboy boots for boys are the main problems now. In shoes with a raised heel, the foot slides forward and the toes are squeezed into the narrow nose. This can lead to discomfort, calluses, deformities of the toes and problems with bumps on the feet.

9. What are the characteristics of good footwear?

The best footwear is the one that brings the foot closer to barefoot conditions.

She must:

* Be flexible. Shoes should allow the foot to move as freely as possible. To check, make sure you can easily bend your chosen shoe in your hand.

* Have a flat sole. Avoid high heels, from which the foot slides forward, as a result of which the toes can be deformed.

* Follow the contours of the foot. Avoid tight noses and other shapes other than the normal shape of the foot.

* Have a good headroom. It is better for shoes to be large than small.

* Provide surface grip about the same as leather. Too slippery soles or, conversely, soles that grip too much, the child may fall. Try sliding the soles of your chosen shoe on a flat surface, then compare the sensations by running your hand over the same surface. The slip resistance should be approximately the same.

11. How do you know if a new shoe is the right size for your child?

It should be comfortable, and there should be room for the growth of the foot, approximately equal to the width of the toe. It is preferable that the shoes are somewhat large rather than small. Sometimes shoes are sold without a significant stock in length, which significantly reduces their useful life.

12. How often should my child buy new shoes?

Children grow up quickly, and a child almost always grows out of a shoe before the shoe wears out. The growth of the foot occurs at a faster rate than the growth of the rest of the body, and ends in adolescence.

13. Can the child's shoes be used for younger siblings?

You can inherit shoes. A slight difference in the shape of the shoe will not hurt a younger child's foot. However, fungal infections can be transmitted through footwear.

14. Is the high cost of shoes a guarantee that these shoes are the best for the child?

If a shoe meets all the criteria by which we define a shoe as "good", the price is not important. It is useful to emphasize this to parents, as some tend to equate the quality of parental care the child receives and the quality of the shoes.

15. If shoes wear out asymmetrically, does this indicate a child's foot problem?

Not necessary. When shoes wear out asymmetrically, look at the feet of a particular child. It often happens that in children with perfectly normal feet, shoes wear out unevenly.

16. Can stiff shoes, orthoses or orthotics prevent or correct flat feet?

No. Previously, it was widely believed that the foot needed support and that the arch of the foot would sag if nothing was placed under it. We now know that this idea was wrong. In fact, stiff footwear promotes flat feet. As you might expect, stiff shoes, limiting the mobility of the foot, weaken it. The result of this weakness is the loss of the dynamic component of arch support in the flattened foot.

17. Do arch supports and orthopedic inserts help to solve the problem of clubfoot?

No. In the past, countless children have worn a variety of orthopedic inserts to correct rotational deformities. When we conducted a study using different shoe liners and measuring their effect on the forefoot adduction angle, we found that the use of the liners had no effect on how much a child's forefoot was flexed in or out.

18. Do instep supports and orthopedic inserts help solve the problem of O-shaped and X-shaped curvature of the legs?

No. In the past, orthopedic insoles were often prescribed for children to treat these conditions. We now know that the improvement in the leg situation in these cases was the result of natural development.

19. Do orthoses help solve the problem of corns in children?

No. Their influence has been investigated, and the results of the study have shown that they are useless for this purpose.

20. Can giving children shoe modifications cause any harm?

Yes. Modified shoes are often uncomfortable, interfere with the child's play, and can make the child feel ashamed of their appearance. In addition to everything, the use of such shoes can instill in the child the idea that something is wrong with him, that he is somehow worse than others. We found that adults who wore modified shoes as children had much lower self-esteem than those who did not. They recalled the experience of wearing such gadgets as unpleasant.

21. Do orthopedic liners help to reduce abnormal wear and tear of shoes?

Sometimes. Liners such as cup-shaped heel liners can help the shoe last longer. The high cost, discomfort, inconvenience for the child and the possible impact on the child's self-image make this approach to solving the problem of increased wear and tear of shoes questionable. Usually, the best option for parents is to purchase more durable shoes.

22. When can orthopedic inserts be useful?

Orthopedic inserts and orthoses can help redistribute the load on the sole of the foot. For children with inflexible, deformed feet, orthoses placed under the projections of the foot can help. This can be most useful for children with clubfoot, in whom the area under the 5th metatarsal joint is overloaded.

23. Do instep supports or orthoses help with neuralgic pain that may occur in the limbs of a growing child?

That's a moot point. These pains are common and usually resolve on their own over time without treatment. The ability of orthoses to change the natural history of development has never been studied. I do not use braces for growing pain because of the potential for long-term harmful effects on the child, the cost to the family, and doubts about their effectiveness.

24. What if the family insists on treatment?

Write down a healthy lifestyle for the child (maintaining physical activity, limiting the time the child spends in front of the TV screen, healthy food, etc.). Avoid mechanical intervention, as they can not only be unpleasant to the child, but also have a long-term adverse psychological effect on him.

The opinions of foreign experts on this matter:

Dr. Lisa C. Moore, Doctor of Chiropractic Medicine

“During pedicle development, it is important that bones, muscles, nerves and blood vessels can grow without any restriction.

During the first steps, it is important to grip the baby's fingers on the floor to help the baby feel in control and properly distribute his weight. If the feet are wrapped in stiff shoes, the toes cannot work, and thus the muscles in the foot and ankle cannot develop the strength necessary to support them.

Throughout life, foot health depends on footwear. If a person wears excessively stiff shoes, bones cannot move freely, and as a result, arthritis can develop.

As a chiropractor, I can say that healthy legs affect all joints above, including the spine. Fallen feet or metatarsal bones can cause imbalance in the pelvic region. Therefore, the first steps of the baby are so important.

The soft sole allows the child to feel the maximum contact with the floor, and also develops the ankle and foot bones. This creates a solid foundation for the formation of bones and muscles in the rest of the body, especially the spine."

Dr. Carol Frey, Associate Clinical Professor of Orthopedic Surgery, Manhattan Beach, California

“For the proper development of legs, a person does not need shoes. Walking requires constant communication between the brain and the legs. The nerves in the bottom of the foot need to feel the ground and send signals to the brain that help it distribute weight correctly with each new step. Hard-soled shoes break this bond.

Shoes are not necessary to support and develop the arch of the foot, they only protect the child's foot from the environment. Children taking their first steps should only wear booties or warm socks in order to keep their feet warm. When they are in a safe environment, walking barefoot is advisable. This allows you to develop stronger and more coordinated foot muscles."

Excerpt from an interview with the head of the Australian Pediatric Association

“Children's bones are too soft and fragile, they are easily compressed, while the child does not feel pain, despite the harm done …”