A Pediatric PT’s Perspective on Shoes

One of the simplest investments we can provide for our children is proper footwear. Footwear options these days are very varied as far as quality, support and appearance. Sometimes the cutest shoes are the worst support for your growing child’s feet. As the mother of a girly girl, I know the struggle is real in finding supportive shoes that are still kid-approved. 

Here are some other areas to consider when purchasing your little one’s next pair of shoes.

• Children’s feet change with age. Infants do not need shoes and being in bare feet or socks allows their foot to develop. Each person’s foot is made up of 26 bones that are designed to support the entire body, adapt to uneven surfaces and absorb shock with each step. Your infant’s foot contains more cartilage than bone. The structure of the foot develops fully by 2 years of age, but the bones don’t finish hardening until 18 years of age. Therefore what a baby needs in footwear is different than what a toddler or pre-schooler may require.
• Never use hand-me-down footwear. Each child has a different “wear pattern” for their shoes, and this can cause problems or be uncomfortable for the second or third wearer.
• Examine the sole of the shoe. Child can wear through the heels or toes of their shoes quicker than they outgrow them. Uneven wear patterns may indicate a foot alignment that needs to be addressed by orthotic supports.
• Include your child in shoe shopping. Present them with viable options and have them try them on to walk around, run, jump, etc to make sure they don’t aggravate feet and can perform their necessary gross motor skills. Make sure to pack their regular socks.

Recommendations for Infants

• The AAP recommends a flexible, non-skid or skid-resistant sole known as a “pre-walking shoe.” The main focus here is warmth and protection. This shoe should allow the child’s foot to bend and move as though the baby is barefoot. Also, remember to allow your child plenty of barefoot time to develop the intrinsic muscles of the foot.

Recommendations for Toddlers/ Pre-Schoolers

• Since more energy goes into this stage of walking, it is best to choose a light weight shoe that is made of a sturdy material that can be fastened on easily to be more secure and accommodate varying widths of feet more easily. If you have concerns about your child’s foot alignment, talk to your pediatrician or physical therapist. This is a good time to assess for orthotics inside of shoes to promote good development of the alignment of the child’s feet. 

Recommendations for School Aged

• The focus at this stage is shock absorption, support and protection. Choosing the right type of shoe for the right activity is important. A flip flop is fine for a trip to the pool, but sneakers are a better fit for the playground or a soccer game. Look for something flexible, with ventilation, room to grow and a small arch support. 

I feel like a broken record, but a Physical Therapist can really help you in finding the right footwear for your child, especially if your child is experiencing issues.

Practically yours,

Dr. Mo