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 American
children’s lives, whether on a team or played as
individuals. Parents should be mindful of sports that
require a substantial amount of running and turning, or
involve contact. These can easily translate into injuries.
Protective taping of the ankles is often necessary to
prevent sprains or fractures. Parents should consider
discussing these matters with their family podiatric
physician if they have children participating in active
sports. Sports-related foot and ankle injuries become
common as children increase their activities in sports.
Heel pain is one of the most common complaints
among growing children who play sports. Physical
activity, particularly jumping or activities requiring
cleats, irritates the growth centers of the heels and is
painful with side-to-side pressure. Reducing activities,
immobilization and orthotics are often needed to
resolve the episodes of pain. Heel pain can also be
caused by foot type, and your podiatric physician will
be able to determine proper treatment.
Don’t Forget the Socks!
Without the right sock, even the best athletic shoe
won’t score points on or off the field.
If your child exhibits signs of hyperhydrosis
(excess sweating) or bromhydrosis (foot
odor), selection of the appropriate athletic sock
may reduce incidences of these conditions.
The right athletic sock should:
Be made of a natural/synthetic blend, as
this helps “wick” away moisture best.
Not contain any large seams that can
cause blisters or irritation.
Advice for Parents
Problems noticed at birth will not always disappear
by themselves. You should not wait until the child
begins walking to take care of a problem you’ve
noticed earlier. It is best to take action when the
child is a toddler to ensure better responsiveness to
conservative treatment options.
Remember that lack of complaint by a
youngster is not a reliable sign. The bones of
growing feet are so flexible that they can be
twisted and distorted without the child being
aware of it.
Walking is the best of all foot exercises,
according to podiatric physicians. They also
recommend that walking patterns be carefully
observed. Does the child toe in or out or have
knock knees or other gait abnormalities?
These problems can be corrected if they are
detected early.
With the exception of infancy, going barefoot
is not encouraged among children. Walking
barefoot on dirty pavements exposes
children’s feet to a variety of dangers
including sprains, fractures and infection from
wounds. Another potential problem is plantar
warts, a condition caused by a virus that
invades the sole of the foot through cuts and
breaks in the skin. They require extensive
treatment and can keep children from school
and other activities.
Be careful about applying home remedies to
children’s feet. Preparations strong enough to
kill certain types of fungus can harm the skin.
Doctors of podiatric medicine are physicians and surgeons
qualified by their education and training to diagnose and treat
conditions affecting the foot, ankle, and where appropriate,
leg muscle, tissues and bones of the leg. Podiatrists are the
only doctors to receive specialized medical training and board
certification solely in the lower extremity care. The preparatory
education of most Doctors of Podiatric Medicine (DPMs)
includes four years of undergraduate work, followed by four
years in an accredited podiatric medical school, followed by a
hospital-based residency. DPMs are licensed in all 50 states,
the District of Columbia, and Puerto Rico. As with all qualified
healthcare professionals, podiatrists should be credentialed to
perform services for which their education, training, and
experience have qualified them to provide to their patients in
the 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 both
sides of the foot
Flexible soles
Shock absorption
Motion control
Flexibility
Room for orthotics
Multiple cleats in
the heel area
Enough room for
thick soccer socks
1.
2.
*3.
1-800-FOOTCARE
American Podiatric Medical Association
9312 Old Georgetown Road
Bethesda, 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’s
Foot Health
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hether it is a
precious baby’s
first steps or a
quick-maneuvering
teenager’s winning
soccer goal, healthy feet
and sure-footedness
make milestones in a
child’s life possible.
Starting at birth, paying
close attention to your
little one’s feet from proper
grooming to gait will ensure
a solid foundation as your
youngster grows. After all,
their feet are meant to last
a lifetime!
Your Baby’s Feet
The human foot—one of the most
complicated parts of the body—has 26 bones,
including an intricate system of ligaments,
muscles, blood vessels and nerves. Because
the feet of young children are soft and
pliable, abnormal body forces can
cause deformities.
A child’s feet grow rapidly during the
first year. For this reason, podiatric
physicians, also known as
podiatrists, consider this period
to be the most critical stage of
the foot’s development.
Cut along the dotted line and keep as a reference.
As a child’s feet continue to develop, it may be
necessary to change their shoe and sock size every
few months to allow room for the feet to grow.
Although foot problems result mainly from injury,
hereditary factors, deformity or illness, improper
footwear can aggravate pre-existing conditions.
Before parents invest in a new pair of children’s
footwear, some foot factors need to be considered:
Shoes that don’t fit properly can aggravate
the feet. Always measure a child’s feet before
buying shoes and fit the shoe to the foot.
Never hand down footwear. Just because a
shoe size fits one child comfortably doesn’t mean it
will fit another the same way. Sharing shoes can
spread fungi like athlete’s foot and nail fungus.
Watch for signs of irritation. Redness is a sure
sign that a shoe is too tight or too loose. If your
child always wants to remove one or both of their
shoes, this may be an unspoken sign that the shoes
don’t fit properly.
Examine the heels. When children begin to show
in-toeing, they may wear through the heels of their
shoes much quicker than outgrowing the shoes
themselves. Uneven heel wear can indicate a foot
problem that should be checked by a podiatrist.
Here are some suggestions to help ensure
normal development:
Look carefully at your baby’s feet. If you notice
something that does not look normal to you,
contact an APMA podiatric physician. Many
deformities will not correct themselves if
left untreated.
Keep your baby’s feet unrestricted. No shoes
or booties are necessary for infants. These can
restrict movement and can inhibit toes and
feet from normal development.
Provide an opportunity for exercising the feet.
Lying uncovered enables the baby to kick and
perform other related motions that prepare
the feet for weight bearing.
Change the baby’s position several times a
day. Lying too long in one spot can put
excessive strain on the feet and legs. Be sure
to limit how much time your baby spends
standing in an activity center to no more than
15 minutes at a time.
Baby’s First Shoes
It is ill-advised to force a child to walk. When physically
and mentally ready, the child will walk. Comparisons
with other children are misleading, since the age for
independent walking ranges from 10 to 18 months.
When a baby first begins to walk, shoes are not
necessary indoors. As a toddler, walking barefoot allows
the youngster’s foot to grow normally and to develop
its musculature and strength, as well as the grasping
action of toes. Of course, when walking outside or on
rough surfaces, babies’ feet should be protected in
lightweight, flexible footwear made of natural materials.
Walking Warning Signs
Once your baby is on the move, assess your child’s
walking pattern or gait. It is not uncommon for little
ones to walk on their toes. However, persistent
toe-walking is not normal. An APMA podiatric
physician can examine a child to make a proper
diagnosis and determine the best treatment option.
Abnormal walking, including toe-walking, can lead to
foot and ankle problems later in life. Flat footedness
beyond the early years can lead to bunions,
hammertoes, heel pain and tendon problems. Children
with a family history of foot problems should see a
podiatric physician once the child begins walking to
ensure the feet are developing normally.
Other common childhood walking irregularities include
in-toeing and metatarsus adductus (MTA).
In-toeing occurs when one or both feet point toward the
other due to a rotation in the foot, leg, thigh or hip.
Often children will sit on their legs in a W-shaped
position. This can also cause feet to point inward.
Excessive tripping, like many walking irregularities, can
often reveal a more serious condition such as in-toeing.
Ways to combat in-toeing at home include having the
child stand in ballet’s first position with heels touching
and feet pointing outward, as well as sitting with legs
“crisscrossed.” Since it should never be assumed that a
child will grow out of a foot condition such as in-toeing,
an APMA podiatric physician can prescribe more
aggressive treatment options such as a cast or brace.
metatarsus adductus, a bending of the foot inward at
the instep resembling the letter “C,” is also prevalent
among early walkers. Tripping is also a warning sign of
MTA. In addition, parents need to pay close attention
to their child’s foot formation and walking pattern. An
APMA podiatric physician can diagnose and treat MTA
with serial casting and in more severe cases, surgery.
Since not all children
are quick to tell their
parents when they
are experiencing
foot pain, parents
should pay attention
to unspoken signs
such as a child’s
limping, tripping,
taking their shoes off
frequently or
unevenly worn
footwear. The feet of
young children may be unstable, which can make
walking difficult or uncomfortable. A thorough
examination by an APMA podiatric physician may
detect an underlying defect or condition, which may
require immediate treatment or consultation with
another specialist. To find a podiatrist in your area,
visit www.apma.org.
1.
2.
3.
4.
5.
Take your child shoe shopping.
It’s important to have your child’s
feet measured before buying shoes.
Every shoe fits differently. Letting a
child have a say in the shoe-buying
process promotes healthy foot
habits down the road.
Shop for shoes later
in the day. Feet tend
to swell during the day;
it’s best to be fitted
while they are larger.
Buy shoes that do not need a
“break-in” period. Shoes should
be comfortable immediately.
Always buy for the larger
foot. Feet are seldom
precisely the same size.
Have your child try
on shoes with socks
or tights, if that’s
how 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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