We are so lucky to have a guest post from podiatrist Dr. Samuel Cantor. Healthy feet are happy feet and 0 to 3 is the prime time for feet to develop and for kids to get the best start for their early walkers. Thanks again to Dr. Cantor!
|Tiny baby feet...|
The human foot has twenty-six bones which are connected by millions of ligament fibers. A newborn's feet are soft and pliable because the bones are not fully calcified, and abnormal pressure can cause deformities. In the first ten months, the child does not have conscious control of the lower extremities because the spinal cord is not fully matured. In the first year a child's feet will grow to almost half their adult size. Babies will graduate from crawling to walking anywhere between ten and eighteen months. This is usually considered a miracle, but is simply a natural progression as the spinal cord matures and the brain gains better control of the lower extremity muscles. Prior to taking those first steps, shoes are unnecessary while indoors. Being barefoot allows for better development of the musculature in the lower leg and foot and improves grasping ability of the toes. The tips of the toes are rich in nerve endings which aid in balance. This increase in muscle strength and nerve feedback to the brain eventually allows enough control to make walking possible.
Being barefoot outdoors exposes children's feet to numerous hazards including papilloma virus, which causes warts, fungus, bacteria and physical injuries such as cuts, contusions, sprains, or fractures. When outdoors, children’s feet should be protected in lightweight flexible footwear made of natural materials. Leather is usually the best material because it can be flexible in the forefoot and stiff around the heel area. Shoe and sock size may change every few months depending on the rate of growth. The good news is that by the age of fifteen most feet will reach their mature size and stop growing. Improper footwear or the wrong shoe size can aggravate pre-existing conditions from injury, deformity, illness, or hereditary factors. Shoe buying tips:
1. The heel counter, the leather around the back of the heel, should be stiff enough to control excessive inward and outward rocking motion of the heel without irritating the bony prominences at the ankle.
2. The insole should be adequately cushioned with a built-in arch.
3. When bending the shoe, it should flex at the ball of the foot rather than the middle of the arch.
4. The child's foot size should be determined while standing to assess the proper length and width. The foot lengthens as the arch rolls in and the forefoot will splay wider when pressure is applied. Sizing the foot with no pressure applied may result in a shoe that is too short or too narrow.
5. There should be at least one-half inch of space between the tip of the longest toe and the front of the shoe to allow wiggle room for the toes and for growth.
6. The child should be allowed to walk around the store for at least five minutes to ensure that the shoes are comfortable and well fitted. In the first minute or two the shoe may not elicit any complaints but by the end of five minutes or more the child may realize something hurts.
7. Examine the interior of the shoe for any possible sources of irritation such as staples, tacks, or irregularities in glue or stitching. These may be very subtle and not initially irritating.
8. Check the child's feet for any signs of irritation after the few first few days of wearing the shoes.
9. The heel should not slip out of the shoe while walking. If it does, the shoe may be too wide or the laces may not be tight enough. Excessive slipping can eventually cause blisters.
10. Some children with flexible ankle ligaments may do better with high-top lace up shoes or boots. These will give better stability to the ankle joint.
11. Always measure both feet and if the sizes are different, shoes must be bought for the larger foot.
12. Don't hand down shoes from one child to the next, since their feet may have different characteristics. Also, shoes that have not been worn for a long time will become stiff and uncomfortable.
13. Shoes should not need a break in period. They should be comfortable immediately.
14. Different shoe manufacturers use lasts, the molds used to make shoes, that may vary, so sizes may be slightly different among different manufacturers.
15. Try on shoes with the same type of socks your child normally wears.
The American Podiatric Medical Association awards its Seal of Acceptance to a wide variety of shoes and shoe-related products. The APMA's website lists these products by categories.
Dr. Samuel N. Cantor is a practicing podiatrist in Pembroke Pines, Florida. He has been in private practice for 35 years. After graduating the University of Vermont, he attended the Illinois College of Podiatric Medicine, (now the Dr. William M. Scholl College of Podiatric Medicine in North Chicago, Illinois. He is currently a member of the American Podiatric Medical Association and Florida Podiatric Medical Association. He is past president of the Miami-Dade County Podiatric Medical Association.