Ask the Therapist: Shoes or No Shoes?
by Brittany Ricciardi, DPT
Kids Place West Pediatric Physical Therapist
Is it better for my child to walk with shoes or barefoot? When should my child start wearing shoes? What shoes are best for my child to wear? These are all questions we often receive from new parents.
The primary reason shoes are needed is to protect the foot. The human foot has 26 bones and many muscles, tendons, ligaments, nerves, and blood vessels. Unlike adults, the newborn foot is very flexible. It is more cartilage and begins to ossify to bone later in life.
Newborns and young infants not walking or standing do not need to be wearing shoes or booties unless they are needed to help keep the foot warm. If socks are not sufficient, we recommended that shoes be very light and allow for full ankle/foot/toe mobility. We also recommend that the shoes not be tight or restrictive so as to not restrict foot growth and development. It is beneficial for infants to be barefoot so they may experience different tactile input to their feet. This also allows them to move their feet and toes uninhibited which helps promote natural development by kicking and moving.
For new walkers, being barefoot when able is best. This allows the child to develop the muscles and ligaments in their foot responsible for arch and foot development. This also allows for the child to receive proprioceptive input from the walking surface. Proprioceptive input allows for children to know where they are in space and assists with balance development. Unfortunately, it is not always safe for a child to walk barefoot, so shoes are recommended to protect the feet when outside or when unsafe to be barefoot inside. We recommend that shoes for new walkers be flexible. Restrictive and stiff shoes are not optimal and can increase the risk of foot deformities and muscle weakness.
According to the American Academy of Physicians and American Podiatric Medical Association:
- In the early months, babies’ feet develop best if they’re not confined in shoes
- Nonskid soles will decrease risk of falling
- Parents should check the fit of the child’s shoe once a month
- Children grow rapidly and require a new pair of shoes every 2-3 months
- Shoes should be lightweight and flexible made of natural materials
Arch support is not necessary for an infant or toddler. Arch support does not typically develop until 2 years of age. Further, it is best developed by walking barefoot and with general play. A leather or canvas based shoe is recommended since it is an easier fit. To assess shoe fit, we recommended checking towards the end of the day to accommodate for any swelling. There should be about a finger width of space from the child’s big toe to the inside edge of the shoe. It is also important to note that every shoe fits a little bit differently, so it is important to try them on. As children near school age, shoes are recommended to be a little more supportive.
For more information, please visit The American Podiatric Medical Association which provides helpful tips for buying shoes that will provide adequate support without being too restrictive. As always, if you need additional information or have further questions, please contact Kids Place.
Sources:
Staheli, L. T. (2007). Shoes for Children. Pediatric Orthopaedic Secrets, 84-87. doi:10.1016/b978-1-4160-2957-1.10016-8
Children’s Feet: How They Grow. (n.d.). Retrieved January 10, 2017, from http://www.ipfh.org/foot-care-essentials/childrens-feet-how-they-grow
Choosing children’s shoes: Mechanical considerations. (n.d.). Retrieved January 10, 2017, from http://lermagazine.com/article/choosing-childrens-shoes-mechanical-considerations
Murphy, S. (2010, August 09). Why barefoot is best for children. Retrieved January 28, 2017, from https://www.theguardian.com/lifeandstyle/2010/aug/09/barefoot-best-for-children
Shoes for Active Toddlers. (n.d.). Retrieved January 10, 2017, from https://www.healthychildren.org/English/ages-stages/toddler/Pages/Shoes-for-Active-Toddlers.aspx
E. (2016, December 07). Finding the Right Shoes For New Walkers. Retrieved January 19, 2017, from http://www.yourilpodiatrist.com/finding-the-right-shoes-for-new-walkers/
