www.apma.org

Take the 1, 2, 3 Test

Look for a stiff heel cup.Press on both sides of the heel counter. It shouldn’t collapse.

Check toe flexibility.The shoe should bend with your child’s toes. It shouldn’t be too stiff or bend too much in the toe box area.

Select a shoe that’s rigid in the middle.Does your shoe twist? Your shoe should never twist in the middle.

Playing Sports Sports play a significant role in millions of Americanchildren’s lives, whether on a team or played asindividuals. Parents should be mindful of sports thatrequire a substantial amount of running and turning, orinvolve contact. These can easily translate into injuries.Protective taping of the ankles is often necessary toprevent sprains or fractures. Parents should considerdiscussing these matters with their family podiatricphysician if they have children participating in activesports. Sports-related foot and ankle injuries becomecommon as children increase their activities in sports.

Heel pain is one of the most common complaintsamong growing children who play sports. Physicalactivity, particularly jumping or activities requiringcleats, irritates the growth centers of the heels and ispainful with side-to-side pressure. Reducing activities,immobilization and orthotics are often needed toresolve the episodes of pain. Heel pain can also becaused by foot type, and your podiatric physician willbe able to determine proper treatment.

Don’t Forget the Socks!Without the right sock, even the best athletic shoewon’t score points on or off the field. If your child exhibits signs of hyperhydrosis(excess sweating) or bromhydrosis (footodor), selection of the appropriate athletic sockmay reduce incidences of these conditions.

The right athletic sock should:Be made of a natural/synthetic blend, asthis helps “wick” away moisture best.

Not contain any large seams that cancause blisters or irritation.

Advice for Parents Problems noticed at birth will not always disappearby themselves. You should not wait until the childbegins walking to take care of a problem you’venoticed earlier. It is best to take action when thechild is a toddler to ensure better responsiveness toconservative treatment options.

Remember that lack of complaint by ayoungster is not a reliable sign. The bones ofgrowing feet are so flexible that they can betwisted and distorted without the child beingaware of it.

Walking is the best of all foot exercises,according to podiatric physicians. They alsorecommend that walking patterns be carefullyobserved. Does the child toe in or out or haveknock knees or other gait abnormalities?These problems can be corrected if they aredetected early.

With the exception of infancy, going barefootis not encouraged among children. Walkingbarefoot on dirty pavements exposeschildren’s feet to a variety of dangersincluding sprains, fractures and infection fromwounds. Another potential problem is plantarwarts, a condition caused by a virus thatinvades the sole of the foot through cuts andbreaks in the skin. They require extensivetreatment and can keep children from schooland other activities.

Be careful about applying home remedies tochildren’s feet. Preparations strong enough tokill certain types of fungus can harm the skin.

Doctors of podiatric medicine are physicians and surgeonsqualified by their education and training to diagnose and treatconditions affecting the foot, ankle, and where appropriate,leg muscle, tissues and bones of the leg. Podiatrists are theonly doctors to receive specialized medical training and boardcertification solely in the lower extremity care. The preparatoryeducation of most Doctors of Podiatric Medicine (DPMs) includes four years of undergraduate work, followed by fouryears in an accredited podiatric medical school, followed by ahospital-based residency. DPMs are licensed in all 50 states,the District of Columbia, and Puerto Rico. As with all qualifiedhealthcare professionals, podiatrists should be credentialed toperform services for which their education, training, and experience have qualified them to provide to their patients inthe same manner as their allopathic colleagues.

Sport Physical Requirements Possible Injuries Shoe Attributes

Basketball

Tennis

Running

Soccer

�Running �Jumping

�Shifting of weight

�Leg extension�Force on the heel and the

ball of the foot

�Running�Lateral movement�Jumping

Sport-Specific Shoes

�Ankle sprains�Plantar fasciitis�Tendinitis

�Ankle sprains�Plantar fasciitis�Corns/calluses

�Shin splints�Heel pain�Blisters�Arch pain or

plantar fasciitis

�Heel pain�Shin splints

�Thick, stiff sole�High ankle support�Shock absorption

�Support on bothsides of the foot

�Flexible soles

�Shock absorption�Motion control�Flexibility�Room for orthotics

�Multiple cleats inthe heel area

�Enough room forthick soccer socks

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*3.

1-800-FOOTCAREAmerican Podiatric Medical Association

9312 Old Georgetown RoadBethesda, MD 20814

www.apma.org

Sponsored by

Correct

Correct

Correct

Incorrect

Incorrect

Incorrect

*Step three does not apply to toddlers’ shoes. For toddlers, shoes should be as flexible as possible.

What you should know.Children’sFoot Health

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hether it is a precious baby’s

first steps or aquick-maneuveringteenager’s winningsoccer goal, healthy feetand sure-footednessmake milestones in achild’s life possible.Starting at birth, payingclose attention to yourlittle one’s feet from propergrooming to gait will ensurea solid foundation as youryoungster grows. After all,their feet are meant to last a lifetime!

Your Baby’s Feet The human foot—one of the mostcomplicated parts of the body—has 26 bones,including an intricate system of ligaments,muscles, blood vessels and nerves. Becausethe feet of young children are soft andpliable, abnormal body forces can cause deformities.

A child’s feet grow rapidly during thefirst year. For this reason, podiatric

physicians, also known aspodiatrists, consider this period

to be the most critical stage ofthe foot’s development.

Cut along the dotted line and keep as a reference.

As a child’s feet continue to develop, it may benecessary to change their shoe and sock size everyfew months to allow room for the feet to grow.Although foot problems result mainly from injury,hereditary factors, deformity or illness, improperfootwear can aggravate pre-existing conditions.

Before parents invest in a new pair of children’sfootwear, some foot factors need to be considered:

Shoes that don’t fit properly can aggravatethe feet. Always measure a child’s feet beforebuying shoes and fit the shoe to the foot.

Never hand down footwear. Just because ashoe size fits one child comfortably doesn’t mean itwill fit another the same way. Sharing shoes canspread fungi like athlete’s foot and nail fungus.

Watch for signs of irritation. Redness is a suresign that a shoe is too tight or too loose. If yourchild always wants to remove one or both of theirshoes, this may be an unspoken sign that the shoesdon’t fit properly.

Examine the heels. When children begin to showin-toeing, they may wear through the heels of theirshoes much quicker than outgrowing the shoesthemselves. Uneven heel wear can indicate a footproblem that should be checked by a podiatrist.

Here are some suggestions to help ensurenormal development:

Look carefully at your baby’s feet. If you noticesomething that does not look normal to you,contact an APMA podiatric physician. Manydeformities will not correct themselves if left untreated.

Keep your baby’s feet unrestricted. No shoesor booties are necessary for infants. These canrestrict movement and can inhibit toes andfeet from normal development.

Provide an opportunity for exercising the feet.Lying uncovered enables the baby to kick andperform other related motions that preparethe feet for weight bearing.

Change the baby’s position several times aday. Lying too long in one spot can putexcessive strain on the feet and legs. Be sureto limit how much time your baby spendsstanding in an activity center to no more than15 minutes at a time.

Baby’s First Shoes It is ill-advised to force a child to walk. When physicallyand mentally ready, the child will walk. Comparisonswith other children are misleading, since the age forindependent walking ranges from 10 to 18 months.

When a baby first begins to walk, shoes are notnecessary indoors. As a toddler, walking barefoot allowsthe youngster’s foot to grow normally and to developits musculature and strength, as well as the graspingaction of toes. Of course, when walking outside or onrough surfaces, babies’ feet should be protected inlightweight, flexible footwear made of natural materials.

Walking Warning SignsOnce your baby is on the move, assess your child’swalking pattern or gait. It is not uncommon for littleones to walk on their toes. However, persistenttoe-walking is not normal. An APMA podiatricphysician can examine a child to make a properdiagnosis and determine the best treatment option.Abnormal walking, including toe-walking, can lead tofoot and ankle problems later in life. Flat footednessbeyond the early years can lead to bunions,hammertoes, heel pain and tendon problems. Childrenwith a family history of foot problems should see apodiatric physician once the child begins walking toensure the feet are developing normally.

Other common childhood walking irregularities includein-toeing and metatarsus adductus (MTA).In-toeing occurs when one or both feet point toward theother due to a rotation in the foot, leg, thigh or hip.Often children will sit on their legs in a W-shapedposition. This can also cause feet to point inward.Excessive tripping, like many walking irregularities, canoften reveal a more serious condition such as in-toeing.Ways to combat in-toeing at home include having thechild stand in ballet’s first position with heels touchingand feet pointing outward, as well as sitting with legs“crisscrossed.” Since it should never be assumed that achild will grow out of a foot condition such as in-toeing,

an APMA podiatric physician can prescribe moreaggressive treatment options such as a cast or brace.metatarsus adductus, a bending of the foot inward atthe instep resembling the letter “C,” is also prevalentamong early walkers. Tripping is also a warning sign ofMTA. In addition, parents need to pay close attentionto their child’s foot formation and walking pattern. AnAPMA podiatric physician can diagnose and treat MTAwith serial casting and in more severe cases, surgery.

Since not all childrenare quick to tell theirparents when theyare experiencingfoot pain, parentsshould pay attentionto unspoken signssuch as a child’slimping, tripping,taking their shoes offfrequently orunevenly wornfootwear. The feet ofyoung children may be unstable, which can makewalking difficult or uncomfortable. A thoroughexamination by an APMA podiatric physician maydetect an underlying defect or condition, which mayrequire immediate treatment or consultation withanother specialist. To find a podiatrist in your area,visit www.apma.org.

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Take your child shoe shopping.It’s important to have your child’sfeet measured before buying shoes.Every shoe fits differently. Letting achild have a say in the shoe-buyingprocess promotes healthy foothabits down the road.

Shop for shoes laterin the day. Feet tendto swell during the day;it’s best to be fittedwhile they are larger.

Buy shoes that do not need a“break-in” period. Shoes shouldbe comfortable immediately.

Always buy for the largerfoot. Feet are seldomprecisely the same size.

Have your child tryon shoes with socksor tights, if that’show they’ll be worn.

Children’s Shoe Shopping Guide

W

Metatarsus Adductus

Toe-walking

In-toeing

Five shoe-buying tips for children:

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