Back to School: are your child’s feet ready?

Categories: gait analysis, Foot care, Musculo-skeletal podiatry (biomechanics), Biomechanical issues, Heel pain.

As schools re-open and our children get ready to go back to school, many of them will have spent the summer in sandals and, with lockdown, not had shoes on their feet for some months.  Getting new shoes for school is an age-old tradition that can fill a parent with dread.

Our blog this month aims to make the job just that little bit easier, at a time when getting the kids to the shoe shop is more difficult than ever.

At the same time, many podiatric problems in adulthood are caused by ill-fitting footwear in childhood, so ensuring your child’s shoes fit correctly is very important.

How to check for a good shoe fit

Ideally you will have your child’s foot measured and the shoes fitted by a qualified shoe fitter.  However this is not always possible.  So, here are some tips to help you ensure a correct fit:

  1. Hold your child’s ankle with one hand and grip the heel of the shoe with the other.  Pull the shoe down to ensure it is gripping the heel well.
  2. With your child standing, check the edges where the shoe meets the foot.   There should be no gaps. 
  3. Use your thumb to press the top of the shoe to feel for the longest toe to check the toe is not pressing against the end of the shoe and that there is sufficient growing room. 
  4. Check that the ankles are clear of the collar of the shoe, unless it is padded. 
  5. The toe-box should mimic the natural shape of the child’s foot, so soft rounded edges are ideal.
  6. Check the foot is fitting snuggly within the shoe, with no pressure or bulging on the sides or at the top.
  7. Shoes with adjustable straps such as laces or Velcro will help accommodate your child’s constantly changing feet and provide support.  

The best time to arrange your shoe fitting is in the afternoon, as our feet naturally swell throughout the day.  Get your child to walk, run and skip in their shoes to ensure they are comfortable whatever movement the foot is making inside them.

Does my child need orthoses/insoles?

One of the most common musculoskeletal pathology we see in the practice is Pes Planus (flat feet) which is normally characterised by a lack of or fallen arch and pain around the ankle.  Flat feet are normal in very young children and do not always cause problems, even in older children.

However sometimes when the foot rolls in, it can result in discomfort in the heels, knees and hips during physical activity.  Orthoses are a great and painless way to reduce discomfort by aligning your child’s foot so that muscles groups in the foot and leg are being used properly, reducing the risk of injury during activities. 

Orthoses provide control for the foot and help to maintain the arch of the foot and improve the muscle function.  For children with flat feet, orthoses aim to provide a platform from which their feet can develop and the muscle groups can strengthen evenly as they grow older and into their teens.  This may remove the need for wearing orthoses when they are older. 

Orthoses can be customised or “off the shelf”.  “Off the shelf” orthoses may well provide sufficient control to improve the functionality of the feet, however may not perfectly fit to the patient and their feet.  Customised orthoses are moulded and measured exactly to the specific patient and their feet which will give the optimal control and functionality.  

Orthotic therapy is usually combined with exercises to strengthen the relevant muscles.

If you are concerned about your child’s feet, or if they are experiencing pain in their feet or legs, our podiatrists can advise you further.  Give us a ring on 020 8693 6000 to make an appointment.

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