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Athletic Shoes

Choosing the right shoes for child is a common concern for parents. In general, shoes and shoe inserts do not change the shape of the foot but provide a supportive surface for walking. Thus, the goal is to select a well-fitting and comfortable shoe. The toe end of the shoes should have some extra space, so it does not press on the toes or toenails. If shoes are too tight, children can have problems with their skin, toes, and toenails. The back of the shoe should fit the heel snugly and comfortably to ensure the stability of the foot during activity. If the heel is too tight, it can cause pressure on the back of the foot.  If the heel is too loose, the shoe can easily come off or it may rub the heel as it moves up and down.  Shoes should have breathable material, as children’s feet can sweat a lot.
Figure 1- Soft shoes for early walkers.jpgFor young children who are not yet walking, shoes are not needed. Socks and booties are sufficient to provide protection from cold. If shoes are worn, they should be flexible and not pinch the feet or toes. Once children are walking, it is okay for them to walk barefoot. Again, shoes should be well fitting. Make sure that the shoes are wide and long enough because young children’s feet grow quickly. For the new walker, shoes that provide too much grip may cause them to fall. Early on, shoes with a flat smooth bottom and less grip may be helpful (Figure 1).

Figure 1- Soft shoes for early walkers

If your child has problems with ankle sprains, high top shoes such as those made for basketball, football, and soccer can be useful. These shoes cover the ankle, provide additional ankle stability, and might help reduce future sprains. If your child has problems with heel pain, especially with shoes such as soccer cleats, shoes with more of a cushion at the heel can be useful. For children with a low arch or flatfoot, shoes with a built-in arch support can provide comfort with activities.

When trying on shoes, it is important to note that later in the day feet tend to swell after a period of standing. Shoes that are old, even though they are not worn down, might not provide as much support as the cushioning mechanism might be affected. In addition, looking at the wear pattern on the sole of older shoes may help in determining both the foot position and appropriate type of shoe. 
For older children, the rules are the same. Well-fitting shoes are the goal. Properly selected shoes provide comfort, prevent injuries by absorbing impact, and may improve performance. When selecting an activity specific shoe, there may be additional considerations. When trying on shoes, especially if a child has a wide or “flat” foot or a “bunion” type foot appearance, use the following tip. Take the opposite side shoe and place it upside down under your child’s foot (for example, if checking the right foot, use the upside-down left shoe). Place the widest part of the foot over the widest part of the shoe. If the shoe shows tread/sole on both sides of the foot, then the shoe is wide enough to fit the foot and allow for comfort (Figure 2).

Figure 2 - Blue arrows outline appropriate shoe overlap to accommodate foot.

Q: Do shoes change the shape of feet?
In general, shoes do not change the shape of a person’s feet unless they are tight or narrow in the front part of the shoe, called the toe box. Wearing narrow toe box shoes can cause changes at the big toe joint over time, which is also known as a “bunion.”

Q: What’s the difference between a flat foot and cavus foot (high arches)?
The difference is that in a flatfoot, there is no arch when standing. A cavus foot is a high arched foot. A flatfoot is a loose type of foot whereas a cavus foot is more rigid. Severe flatfeet or cavus feet, especially with a tight calf muscle, can lead to overload and pain on the inner (flatfoot) or outer (cavus foot) parts of the foot.

Q: What about using insoles? Should I have them custom made or get them over the counter?
In-soles are used solely for comfort. For children with low arches, or flatfeet, arch supports may provide comfort with shoe wear and activities. Insoles can be over the counter or custom made and which one is appropriate for a given patient is best discussed with your physician.

Q: Are there certain brands of shoes that are better?

If shoes are well fitting and comfortable for a child’s activities and offer protection for a child’s foot from the environment, they are equal. There is not a name brand of shoe that is necessarily better than another. It is recommended to try on multiple shoes when purchasing them to see which ones are the best fitting and most comfortable.

 [dyc1]I’m not sure I agree with this.  I think chronic tight shoes can lead to deformity, especially with bunions.