The Center for Podiatric Care and Sports Medicine

Fitting Kids’ Shoes: Choosing the Right Shoes for Your Kids, and the Problem With Kids’ Shoes These Days

Posted by on Monday, November 2nd, 2015

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Like many parents, I had experienced the frustration of trips to the shoe store with a wriggly, screaming, diaper-soiling toddler.1http://thestir.cafemom.com/toddlers_preschoolers/177525/how_buy_best_shoe_toddler “Never again!” I’d said, vowing to take my shopping online. It wasn’t so easy, though. All summer, my active toddler was walking, climbing, running, and playing in a size 5 shoe. It seemed simple enough: come fall, we’d graduate to the next size up and be on our merry way for another three months or so, right?

While her foot did indeed cram into a 5.5, my daughter started walking on tip-toes with greater frequency and telling me “No, no, no” when it was time to put her shoes on, so I knew something was up. We even tried a size 6 dress shoe, but that fit worse than the 5.5. Imagine my surprise when the old Brannock Device at the shoe store revealed that her actual shoe size was a 6.5 wide!

In actuality, a child’s foot can grow up to 12 sizes in their first three years of life!2http://www.kidoshoe.com/things-every-parent-should-know-about-their-children%E2%80%99s-feet One study found a half-size increase:3http://www.ipfh.org/foot-care-essentials/childrens-feet-how-they-grow

  • Every 2 months for kids ages 0-15 months
  • Every 2-3 months for kids ages 15-24 months
  • Every 3-4 months for kids ages 2-3 years
  • Every 4 months for kids ages 3-5 years

The podiatrists at The Center for Podiatric Care and Sports Medicine in NYC are here to assure you that you need not beat yourself up over the fact your kid’s been wearing the wrong shoe size, because it happens more commonly than you might think.

toddler shoe size
Is your toddler falling a lot or walking on tippy-toes? It could be related to wrong shoe size. Fitting kids’ shoes can be tricky, but we have some tips. Image Source: Wikipedia.org

Top Issues With Kids’ Shoes:

1. Wrong Fit

A 2009 Swiss study found that 66% of children ages 5-10 were, in fact, wearing the wrong shoe size.4http://www.aaos-annualmeeting-presskit.org/2009/Clinical_6.html Their examination of 248 kids found that 53% of kids had shoes that were too small and 13% had shoes that were too big. Three percent of the kids in the study were already well on their way to developing bunions.

“Improper footwear is well recognized to be an extrinsic factor regarding the development of forefoot deformities. Small forefoot boxes in children’s footwear could impair toe function and proper development and promote early establishment of forefoot deformity,” stated lead author Norman Espinosa, MD, of the University of Zürich.

Perhaps the most surprising finding in the study was that 90% of shoes measured smaller than the manufacturer-specified size! “It was a truly striking finding,” says Dr. Espinosa. “The shoe sizes given by the manufacturers almost never matched with the true sizes measured by our group.” Researchers recommended that parents always measure the actual shoes for themselves at a shoe store. Ideally, they said, the inner shoe length should be at least 10-12 mm (or 1-1.2 cm) longer than the longest toe for a “perfect fit.” Shoe size should be reassessed every month, according to the American Academy of Orthopaedic Surgeons.

Another study of 858 preschool children conducted by the Medical University of Vienna found that most children wore shoes that were too short, and more than half of the children were predisposed to bunion development with hallux valgus angles of 4 degrees or more.5http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806334/

“Without enough space in the front of the shoe, the toe cannot move forward as the child steps and so the toes begin to squish inward, forcing the big toe joint toward the outer part of the shoe,” explains Center for Podiatric Care and Sports Medicine doctor Dr. Lai. “Conversely, when the shoe is too big, the flex point of the shoe and the flex point of the foot do not synch up, causing the Achilles tendon to work too hard, not to mention chafing and blisters as the foot slides around in the shoe.”

2. Too Rigid

“Most children’s shoes ought to come with a government health warning,” UK podiatrist Tracy Byrne tells The Guardian. She contends, “They are like awful little bricks – too stiff, too rigid, with no flexibility at the sole and too much heel raise. This is of particular concern with toddlers learning to walk, because it causes them to bounce and tip forward.” I have witnessed some of these walking abnormalities in my own child, so I believe it!

Similarly, British barefoot enthusiast John Woodward shows off an expensive Nike Air sneaker made for toddlers that offers “no bend or give in the sole” that will undoubtedly restrict movement of the forefoot. “Kids this age should be turning cartwheels, skipping, climbing trees, running around. A shoe like this would seriously restrict such playful physicality – make it less fun, less enjoyable,” he says.

They recommend a shoe like the Vivo Barefoot shoe, which comes with a completely flexible sole, wide and deep toebox, anatomically correct shoe mold, and adjustable closures to ensure a snug fit. Of course, not every parent will jump at the chance to spend $70 on a shoe that may only last three to six months at most. But if you do your homework, there are affordable, minimalist options. Some brands with affordable and flexible footwear include: Skidders, See Kai Run, and Robeez.

3. Too Much Heel

Unlike adults, children are not heavy heel-strikers. They tend to lean slightly forward and fall on their forefeet. When the heel is elevated, the great toe tends to deviate toward the second toe. Kids — girls, in particular — who haven’t reached skeletal maturity run the risk of altering forefoot development, shortening the Achilles tendon, and fracturing the ankle in wedge-heeled shoes.

Even so, that hasn’t stopped children’s shoe designers from jumping on the “wedge sneakers” band wagon. Designers like Isabel Marant, Marc Jacobs, Ash, Zara, Michael Kors, Skechers, and Kenneth Cole Reaction are all guilty of marketing wedge shoes to kids, according to Today.6http://www.today.com/style/high-heel-sneakers-wedge-their-way-kids-feet-should-they-1C8378577 Ideally, a child’s shoe should enhance lateral movement and allow natural foot function with a relatively flat sole.

4. Too Expensive

Research conducted by Clarks shoe company found that 4 million children are wearing improperly sized shoes — with two-fifths of parents admitting that they bought shoes for their kids that were too big so they could “save money.”7http://www.bbc.com/news/magazine-11790486 A quarter of parents said their decision on kids’ shoes boiled down to cost. Blisters, pressure sores, ingrown nails, hammer toes, knee problems and posture issues were common complaints identified in the study.

5. Too Narrow

With many kids’ shoes built too narrow, parents have little choice but to go up a size. Colorado Springs Podiatrist Dr. Nicholas Sol warns, “The blunder occurs when we ask for a half-size larger shoe just to get a little extra width.”8http://motherhood.modernmom.com/happens-children-wear-shoes-big-16546.html The end result is an inability for a child to grip surfaces with their feet, so they cannot climb and play like their peers. Rubbing, chafing, blisters, calluses, and corns can also result, and often lead to infections. Furthermore, falls occur most frequently when kids are in shoes that are too big or too small.

How to Get the Best Shoes for Toddlers & Kids in NYC

Fitting kids’ shoes correctly can be difficult, so for starters, I decided to buy a device that could measure my girl’s feet in the quiet comfort of our own home. Some people swear by The Squatchi or the equally inexpensive Footer Family Foot Measure. Others print out the sizing charts offered by American Podiatric Medical Association recommended brands like Pediped or Stride Rite. I prefer the good old Brannock Device you find at most shoe stores. It’s not cheap, but it’s easy and accurate. But if, like me, you’ve got a couple kids who will need their feet measured every few months before they reach their teenage years, you’ll get a lot of use from it.

Next time you shop for shoes, ignore the shoe sizes and take the inner length measurement. In terms of wiggle room, if your child’s foot measures less than six inches, add on about 0.5 cm between the longest toe and end of shoe. For little kids who are walking confidently or who have feet of about six inches or more, you can add a full centimeter (rounding up, when necessary) to the end of the shoe.

When I first saw my daughter in her new shoes, I thought, “Wow, her feet look huge now!” That’s completely normal. The average one-year-old has feet half of their adult foot size already. So the next time I have any concerns about my child’s shoe size or foot development, I’ll contact my NYC podiatrist friends at The Center for Podiatric Care and Sports Medicine to put my fears to rest, and get some great advice on shoe shopping and foot health, too.

 

 

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1. http://thestir.cafemom.com/toddlers_preschoolers/177525/how_buy_best_shoe_toddler
2. http://www.kidoshoe.com/things-every-parent-should-know-about-their-children%E2%80%99s-feet
3. http://www.ipfh.org/foot-care-essentials/childrens-feet-how-they-grow
4. http://www.aaos-annualmeeting-presskit.org/2009/Clinical_6.html
5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806334/
6. http://www.today.com/style/high-heel-sneakers-wedge-their-way-kids-feet-should-they-1C8378577
7. http://www.bbc.com/news/magazine-11790486
8. http://motherhood.modernmom.com/happens-children-wear-shoes-big-16546.html

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.