As you might expect, there’s a fair amount of debate out there as to the benefits of being barefoot as opposed to the protection of shoes and footwear. Parents of babies and young children often ask the Body Mechanix paediatric team for advice regarding footwear in the early years. Read on for the answers to questions like:
– When is the best time to buy shoes for my baby/toddler?
– What sort of shoe is best for my child?
– My child has flat feet, do I need to consider an arch support?
– Should my child wear shoes at all?
Some research suggests that wearing shoes is actually doing more harm than good and that delaying your child’s first pair of shoes or keeping them barefoot more often than not in their younger years is likely to be very beneficial.
To strengthen muscles, they need regular use under load. Implementing a firm shoe sole with high ankle support will reduce the amount of movement at the joints in the foot and ankle as they absorb the forces from the ground and terrain when walking. Reduced joint movement means the 4 layers of muscles in the foot and the lower limb muscles will not have to work as hard to stabilise. It’s easy to understand how shoes can hinder muscle development in the lower extremities and how within a short period of time, a child’s muscle development can be easily compromised comparably to a child who has spent more time out of shoes at a young age.
But it’s not just the strengthening of muscles which is affected as there’s less ability to stretch the toes, the arches of the feet and lengthen through the legs and hips too. Greater ability to stretch leads to improved overall flexibility, important for a healthy musculoskeletal system, especailly as we age.
Arches develop as the bones of the feet ossify, muscle tone increases, ligaments strengthen and gait is mastered. Transverse and longitudinal arches develop in the feet at around three years old, hence the difficulty to detect an arch in a baby/young toddler. Some doctors may tell you that children grow out of flat feet. Unfortunately, this is not always the case. Recognising and treating flat feet (pes planus) early will help an arch to develop, alleviate potential pain and prevent muscular and bony deformities. If your child’s arch hasn’t developed by the age of seven or eight, their flat feet might become permanent. Should your child look like they are struggling with their arch development or there is a history of flat-footedness in the family, it is a good idea to bring your child to the clinic for an appointment. Leaving flat feet untreated can result in many serious, potentially permanent foot and ankle problems including hammertoes, bunions, frequent ankle sprains and arthritis. You might also find your child starts avoiding sport and outdoor activities so it’s always a good idea to intervene early.
The feet have a huge influence in our sensory feedback and development. Appreciating different surfaces underfoot from carpet and tile to vinyl and grass at an early age will help children understand the need for balance and careful gait dependant on the surface of the terrain. It is argued that shoes can cloud the messages sent from the feet to the brain reducing this useful feedback of information.
Stretching our ligaments gives the brain feedback as to the range of movement available and where our joints are in space. This is known as proprioception. It is well understood that a strong proprioceptive foundation will pay dividends later in life, aiding balance and coordination; reducing the risk of trips, falls, and injuries in childhood.
An example of a loss of proprioception is often noticable after ankle ligament sprain. Those who have suffered such an injury will appreciate the reduction of stability and balance at the ankle for a number of months and potentially years should they not rehabilitate effectively, hence the importance of ligaments within our joints.
Children’s shoes play an important role in supporting their physical development and whilst there are many brands on the market, the top three which continue to stand out are Bobux, Geox and Clark’s. Whilst we appreciate peoples budgets will vary and shoes can be expensive, it’s important to remember, no other item of clothing has the same impact on a child’s growth or comfort. It’s well worth investing in the most reliable brand you can afford. Poor and ill-fitting shoes such as flip flops are often the cause of many accidents, trips and falls so it is important to remember this when considering the right type of footwear.
Babies, toddlers and young children’s bones have a higher collagen content than that of adult bones. As such their bones are more malleable and responsive to compression so it is important to have your child’s shoes fitted by a professional who can ensure there is enough room for appropriate structural foot, toe and toenail development without being squashed or compressed. It is also worth remembering the speed of which children’s feet grow and the importance of having children’s feet regularly measured.
Whilst there are many benefits of being barefoot, we can’t forget that there are some places where children probably should wear shoes, especially on hazardous terrain. On hot, cold, slippery and wet surfaces it’s a good idea for children to wear shoes to protect the soles and reduce the risk of slips. The same goes for walking in long grasses and unknown terrain as there may be some unexpected insects, parasites, snakes and critters that your child’s feet could come into. Certainly, some areas are safer than others when it comes to running about barefoot.
In conclusion, evidence suggests there is a significant benefit to encouraging children to spent as much time out of shoes as possible, especially in the house and safer terrain, but continuing to recognising the importance of good quality, sensible footwear as and when required.
To provide first class treatments, our paediatric Osteopaths have additional postgraduate qualifications from the prestigious Osteopathic Centre for Children. The clinical team is led by lead Osteopath Claire Mckenna who has been practising in the complex field of paediatrics since 2012. Should you have any concerns regarding your child’s foot, ankle and lower limb development, feel free to book an appointment.