Measuring up for back to school
Published: 14 January, 2010
In the back to school rush at the start of each term, shoe shops all over the country are heaving with parents and children intent on buying school shoes. Yet many school children are wearing shoes that are either too small or unsuitable, despite the associated risks of deformity and injury caused by such footwear.
According to a recent YouGov survey for the Society of Chiropodists and Podiatrists (SCP), more than three quarters of women and two thirds of men suffer from foot problems, yet nearly half have never sought medical advice about them. Experts agree that around 70% of foot problems in adults can be attributed to ill-fitting shoes worn in childhood.
Three years ago, research from the Glasgow Caledonian University revealed that an estimated four out of five children in the UK were wearing the wrong shoe size, which may cause them long-term damage. The University found 83% of a random sample of children attending a local primary school were wearing shoes that were too small.
Gordon Watt, a consultant paediatric podiatrist at Glasgow Caledonian University says that problems arising from ill-fitting shoes ranged from pressure marks and blisters to more worrying deformities and problems with gait and posture.
Watt explains: “Children are born with relatively soft and flexible cartilage, which gradually converts to bone with age. As they are growing their feet are vulnerable to injury and deformity due to ill-fitting or inappropriate footwear.”
He says he has also seen many children with foot and lower limb pain, caused by wearing the wrong type of shoes, such as slip-on shoes without adequate heel support and no strap or lace, such as ballet pumps, worn in schools where indoor shoes are now required.
“We increasingly see osteoarthritis in teenagers’ toes that has been caused by such footwear. That affects how they walk, causing excess wear and tear on the big joints. And, once you have toe deformities, they get worse with age,” says Watt.
Lack of support in children’s shoes often leads to long-term joint and postural problems, particularly if they are overweight. A recent study of 200 children aged 9 to 12 years, presented to the Society of Podiatrists and Chiropodists conference, revealed that obese children had feet that were longer and wider than normal. Obese children were also found to have problems balancing and walked at a slower pace.
The Society of Shoe Fitters is concerned about the number of children’s shoes being purchased over the web adversely affecting feet and foot health, leading to an increase in visits to GP’s and podiatrists in the future: “There is no substitute for taking your children to a reputable shoe shop to see a qualified shoe fitter and allowing them to assess the right size and fitting shoe suitable for your child,” says Laura West, Secretary of the SSF. “A child may have a high arch, low ankle-bone, pronation, supination; they may even require remedial advice and need to be referred to their G.P. or chiropodist’. Shoe fitting is not just common-sense it requires knowledge and experience. Only a third of children have average feet, therefore a qualified shoe fitter is the best person to look after your child’s feet, as it is their job to continually look, feel and assess many different pairs of feet in a day. What you consider to be ‘cheap’ now, may cost your children dearly in the future, and there is no extra charge for an expert service”.
Professor Wesley Vernon, OBE, chairman of the Healthy Footwear Group, comments: "It is very important to get shoe fitting right in childhood as this will set up the right patterns for life and in doing so, prevent many of the problems that are dealt with by the NHS much later in life.”
Mum’s not always right
Independent research commissioned by children’s shoe company, Start-rite, has revealed parents could unwittingly be making the wrong footwear choices for their children, storing up foot health and posture problems for the future.
Start-rite’s research suggests that as many as seven out of every ten four-year-olds starting school in September could be wearing ill-fitting shoes.”
Whilst the majority of parents surveyed (75%) recognise the importance of having children’s feet professionally measured and fitted for shoes, most are unaware of how frequently this should happen and at what stages in their child’s development.
The survey revealed that while 70% of parents take their children to the dentist at least once every six months, less than half have their feet professionally fitted for shoes more than once a year. And, although nearly half of parents surveyed think it is important for toddlers to be properly measured and fitted for first shoes, by the time a child reaches school age, 7 out of 10 parents think fitting is unimportant.
Children’s shoes should only be fitted by trained staff; the shop will either display a Certificate/diploma, or the Fitter will be wearing a badge of merit. Only a member of the Society of Shoe Fitters can say that he or she is a ‘qualified’ shoe fitter.
“Damage can be done in a child’s formative years that may affect their complete physiology, which in turn may affect their health in later life. Even migraine can be attributed to ill-fitting shoes,” warns Laura West, Secretary of the Society of Shoe Fitters.
Summary of Key Findings
- While the majority of parents (75%) agree it is important for their children to be properly fitted for shoes by a qualified fitter, in reality less than half (46%) take their children to be fitted for shoes twice a year or more, and a quarter go once a year or less.
- Almost a quarter of parents never take their children to be properly fitted for shoes.
- Just over half the parents surveyed are aware of their child’s foot width size. Only one in three of these children is a standard ‘F’ fitting. (Shoes which come in only one width-size are usually an ‘F’ fitting.)
- 47% of parents believe that the most important age for children to be properly fitted for shoes is during year one. Only 14% believe that it is still important at age 12.
Fitting facts:
- At birth, the bones in a baby’s foot are only partially formed and are very soft and pliable. At six months the foot is still so delicate that it can be pushed out of shape by a tight sock or sleep suit. By school age the cartilage in the feet has hardened but remains vulnerable to damage, and the bones will not be fully formed until a child reaches his late teens.
- Children’s feet grow in spurts so their footwear should be professionally checked for fit every six to eight weeks when they are toddling and then every three to four months.
- To ensure the best possible fit from their children’s footwear, it is recommended that parents choose from brands that offer a full range of sizes and width fittings. Start-rite offer shoes in whole and half sizes, and up to 6 width fittings (C, D, E, F, G and H).
- Qualified shoe-fitters provide free, no-obligation fit checks and will not recommend purchase of new shoes unless the child needs them
- Qualified shoe-fitters will only use the foot gauge as a guide to selecting the correct footwear. Trained shoe-fitters use their skill and experience to interpret and fit every child’s feet individually for shoes.
Checklist for choosing the right children’s shoes:
- Avoid slip-on’s. Choose shoes with laces, straps or Velcro fastenings, which hold the shoe onto the foot. Beware the fashion for girl’s ballet style pumps, and ‘lazy boots’. Both lack adequate support and provide no shock absorption.
- Ask if the assistant is a trained shoe fitter and, if not, if one is on the premises. Always have both feet measured for length and width. Shoes that are the wrong size can damage a growing foot.
- A newly fitted shoe should be approximately a finger’s width longer than the longest toe to allow for growth and elongation of the foot when walking.
- Trainers are designed and manufactured for sporting purposes and not everyday wear. Avoid the use of plimsolls in school all day, every day. Both trainers and plimsolls can create their own associated problems.
- Have your child’s feet measured in every shoe shop you visit but remember a gauge is only a guide and different styles, manufacturers, materials, country of origin, will all affect the fit of a shoe.
- Heel height should be no more than 4cm. Lower for younger children. The heel should have a broad base and be made from a shock-absorbing material.
- Natural material uppers such as leather are best. Check inside the shoe for seams or stitching that may cause irritation.
- The toe area of the shoe should be deep enough to allow the toes to move freely and not be squashed from the top or sides.
- The shoes should fit exactly snugly around the heel to keep the foot from sliding forward into the toe box and restricting the toes.
- The inner border of the shoe at the heel and arch area should be firm and support the foot. Think about hosiery – are they outgrown? Have they shrunk? Socks that are too tight can also restrict toes and natural development.
- Do not be tempted to ‘hand shoes down’ - they take on the wear pattern of the original owner and can rub where they have become misshapen.
Sources: The Society of Shoe Fitters and The Society of Chiropodists and Podiatrists
Tips on looking after your children’s feet:
- Inspect their shoes regularly for unusual wear and seek professional advice if you are concerned. Unusual wear may be the first indication that there is a problem with the foot posture or general posture and should always be investigated by your registered podiatrist. Normally, wear is across the back of the heel or between the back and the outside. You should look out for severe wear on the inside or outside of the heel. This may carry forward to the sole of the shoe. Also the heel area of the upper may be broken and bulge inside or outside.
- Be aware that blisters and sores may develop with new shoes.
- Inspect children’s feet regularly for inflamed nails, red pressure marks in the top of the small joints of the toes, below the ankle bones and the back of the heel.
- Remember that teenagers in particular can be secretive about foot problems and a trivial, easily rectified problem can be more serious if neglected.
- If your children complain of itchy or painful sites or you see any rashes or hard raised areas on the skin seek professional advice immediately.
- Children have naturally sweaty feet but smelly feet may be an indication of poor hygiene.
- Due to being enclosed in a shoe and living close to potential sources of infection the foot is at relatively higher risk of infection compared to other parts of the body. Any blisters, cuts or abrasions should be treated with antiseptic and dressed immediately.
Source: The Society of Chiropodists and Podiatrists
