Moms and dads so often worry about their children’s teeth, eyes, and most other regions of the body, but don’t get worried so much over the growing feet. As many adult foot conditions can have their beginnings when people are young, attention to shoes in children can minimize the risk of these issues in adults.

Significance of the footwear to the child:
Inadequately fitting children’s footwear can cause a number of conditions in adults such as hammer toes, ingrown toe nails, foot corns, calluses and deformed joints. Due to the high level of discomfort and pain that these conditions can cause, it is obviously sensible to attempt to prevent these disorders by ensuring that the child’s footwear is fitted appropriately. Foot conditions in kids are usually avoidable.

Fitting footwear for the child:
The most crucial factor in shoes for a kid is that they fit. Ideally, this means that shoes are fitted by somebody who has had some special training in the fitting of children’s footwear.

Tips for the fitting of children’s footwear:
* Children should have their feet measured around every three months (thus making sure the need for new footwear if required).
* Usually, for a shoe to be accurately fitted, there really should be a thumb width between the end of the shoe and the end of the longest toe.
* When looking at the bottom (sole) of the shoe, it should be fairly straight (not curved in too much) – the foot is straight, so the shoe needs to be straight.
* The attachment mechanism (laces, velcro, buckles) must hold the heel securely in the back of the shoe (the foot ought not to be able to slip forward in the footwear).
* the heel counter (back portion of the shoe) should be strong and stable.
* the shoe should be flexible along the ball of the foot, as this is where the foot flexes.
* Leather and canvas are a better material – they are stronger and can breathe. Man-made materials usually do not breathe as well, unless they are of the ‘open weave’ variety. Steer clear of plastics.
* Check that the footwear have curved toe boxes to give the toes more room to move and grow.
* Shoes should not need to be “broken in”. If they do, they can be either poorly developed or inadequately fitted.
* An absorbent insole is useful, as the feet can sweat a lot – kids are quite active!
* A number of retail stores concentrate on footwear for the child – make use of them!
* Fitting shoes adequately in adults is also just as important

3 tips for checking the child’s shoe:
There has to be a thumb width between the end of the footwear and the end of the longest toe = length is correct.
You ought to be able to pinch the upper of the footwear between the thumb and forefinger (this can depend on the nature of the material) = width is correct.
Does the footwear fit snugly around the heel and arch? How stable is the shoe when trying to ‘pull off’ the shoe? = great fit.

What is it?
Plantar fasciitis is the most common cause of heel pain in adults. It is a painful condition of the plantar fascia which is a long ligament that’s role is to pretty much support the arch of the foot. The pain is most often near where it attaches to the the bottom of the heel bone. The classic symptom of plantar fasciitis is that it is most painful after rest. This can be especially bad when getting out of bed in the morning after a nights rest.

How to manage it?
There are lots of myths and bad advice being given online as well as snake oil being sold for plantar fasciitis. The condition is due to too much load on the plantar fascia, so obviously the best way to treat it is to reduce that load. You do that by lots of calf muscle stretching, wearing good foot supports and if you can, loose weight. It is that simple. If you get that right, it will generally go away. If it doesn’t, then do more of it and then also add in some ice, anti-inflammatories and other physical therapies to help it heal. However, it is still crucial that the load is reduced. Once it starts to get better then add in some strengthening exercises.

When to see the doctor?
If none of that helps, then its time to see the doctor for more aggressive therapies such a proper foot orthotics, shock wave therapy or even surgery in the most resistant cases.

What are they?
MBT shoes were originally development in Switzerland and were the first of the toning shoes to come on the market. These are shoes that are deliberately made unstable to encourage the muscles to work differently. The MBT shoes do this via a rocker sole. Like the toning shoes in general, a lot of health claims get made for this type of shoe.

Do the MBT Shoes work?
The evidence is that the shoes do work at altering the gait and changing the pattern of muscle firing. What the evidence does not support is the wide ranging health claims that get made for these types of shoes. The change in gait may help some people and hurt others; with a lot depending an which structures are made to work harder by the change and which structures do not have to work so hard. There is a strong suggestion that the rocker nature of the shoes may help those with hallux rigidus.

What are they?
These are insoles that have magnets embedded in them allegedly so that a magnetic field can be applied to the body. This allegedly has healing properties. Some of the claims for this are suggested to be due to magnets improving blood supply.

Do magnetic insoles work?
No they don’t. Every single study that has been done on them shows that they do not work. They are a scam and there is no mechanism by which the could work. The magnetic field in the magnets used in therapy devices are too weak to affect blood flow. They are no better than snake oil.

Foot reading has become a recent trick doing the rounds at parties. There is a group of people known as foot readers who claim that they can determine a person’s personality by reading and looking at the characteristics of someone’s feet. There are plenty of books on this and there are plenty of people charging money to provide the service. It is a scam. It is a sham. The claims made by foot readers are ludicrous and are not to be believed. They are charlatans out to fleece your money.

What is it?
Functional hallux limitus is a problem in which the range of motion of the big toe (“hallux”) joint is limited (“limitus”) when the foot is weightbearing (“functional”). The limitation is not there when the foot is up in the air or non-weightbearing. As this joint is extremely important for walking and allowing the body to move forward over the foot, things are going to go wrong if the foot can not move at this joint. Overpronation, a toe out gait, a more flexed knee are just some of the consequences of functional hallux limitus. A hallux rigidus is different in that the range of motion is restricted both on weightbearing and on non–weightbearing.

How to manage it?
This is pretty close to impossible to self-diagnose, let alone self manage!

When to see the doctor?
If you think you have it, then it is probably a good idea to get to the doctor. Padding and/or foot orthotics are often needed to facilitate the motion at the joint to encourage a more normal git.

What is it?
A bunion is an enlargement of the joint at the base of the big toe and is almost always accompanied with a hallux valgus, that is the deviation of the big toe to rewards the lesser toes. The enlargement of the joint creates problems with pain in the joint and pressure on the enlarged joint from the footwear. This can be due to an arthritis in the joint because of the deviation and the pressure from footwear can cause a bursitis swelling and pain. There is often corns on the adjacent toes. The most common cause of bunions is generally considered a combination of genetics, forefoot biomechanics combined with inadequate fitting footwear. Lots of questions get asked online about bunions and lots of different answers get given.

How to manage it?
As the pain from bunions is from two sources a different strategy is needed to manage it.

If the pain is due to the arthritis type symptoms inside the joint then the approach to this is generally the use of medication for pain relief and exercises to keep the joint mobile.

If the pain is due to pressure from the shoes on the enlarged joint then the approach is to use better fitting footwear and to use doughnut like pads to keep the pressure off the joint.

There is no way to make a bunion go away without surgery, all that can be done conservatively is to manage the symptoms using the two approaches outlined above. Generally this will be successful.

When to see the doctor?
It will be necessary to see the doctor for bunions if the Conservative self managed measures are not successful, in which case better advice can be given on how to self manage the problem. The other reason to see the doctor is that if these conservative measures are not successful or if you need surgery. Surgery is the only way to remove a bunion. There is also a high possibility that a bunion can occur after the surgery if the factors that cause the bunion, such as poor fitting shoes, are not addressed.

What is it?
An abductory twist, also sometimes called a medial heel whip is a sudden abduction or medial ‘whip’ of the heel just as the heel comes off the ground during gait. The cause is generally considered to be a foot that is overpronating when the leg is rotating in the opposite direction. These opposing motions continue to oppose each other until the weight comes of the heel and friction then can not stop the foot pronating it. There is also some thought that it could be due to a weakness of the adductor muscles in the hip.

How to manage it?
It is managed by managing the underlying cause of the overpronation and exercises to strengthen the hip adductor muscles.

When to see the doctor?
When the self managed treatment of the overpronation are failing to help. You will need to be assessed fro the exact cause that is underpinning it and a plan put in place to manage it.

What is it?
Overpronation is a problem that occurs when the ankle rolls inwards and the arch of the foot flattens. It is widely known in the running community and is widely assumed to be associated with a number of different running injuries, though there is a lot of debate about that. Overpronation has also been the basis in which running shoes are often used, though there is a lot of debate about that as well! Overpronation is not always a problem and there is a lot of misunderstanding about it. It can be associated with an abductory twist.

How to manage it?
As overpronation is not always a problem it does not always need treating. If it is contributing to a problem that you have, then yes it needs treating. The problem with overpronation is that there are many different casues, so there are many different treatments. The first line approach is to use supportive shoes and inserts.

When to see the doctor?
If that does not help, then you really need to see someone who knows enough about pverpronation to determine the casue, so can advise the appropriate treatment. Fpr some people it is muscle strengthening; for others it is foot orthotics; for others it is strecthing; and for others it is a more minimalist approach to running. To blindly apply one treatment ahead of another without determining the cause is just plain silly.

What are they?
Toning shoes area class of footwear that is what is considered unstable. They have designs in the sole that creates an environment in which the muscles of the foot and leg work harder and changes the alignment of the posture. The extra effort from the muscles is claimed to give an extra tone up, which is how the shoes got there name. The change in alignment also is claimed to help with some postural alignment problems. There is a lot of marketing hype associated with these shoes which is not supported by the scientific evidence.

Do they help?
The problem with toning shoes is that they help some people and do not help other people. Some people can walk fine in them, others fall over in them! They are more likely to help people with arthritis of the big toe joint than other problems. Some of the companies claim they help plantar fasciitis, but some people get plantar fasciitis using these shoes.

It is difficult to give clear advice on this. It is going to have to be a matter of trial and error to see if they can help your foot problem or not. If you want to try them, then the key os to use them only in small amounts initially and build up the use of them gradually.