Thursday, April 30, 2009

Be smart about shoe fitting

To help busy parents with shoe choices, foot and ankle surgeons recommend some simple guidelines to prevent or minimize possible foot problems from inappropriate shoes, such as painful ingrown toenails, blisters, heel pain and flat feet.

When choosing kids’ shoes, size and shock absorption are the key considerations, especially if your child has flat feet that can worsen from improper fitting or worn-out shoes. Also, a child’s foot can grow a size or two within six months, so it’s critical to allow room for growth in the toe box—about a finger’s width from the longest toe.

Snug shoes put pressure on the toes, causing ingrown nails. The nail compresses and grows down into the skin.

According to, the ACFAS consumer website, infection can occur when an ingrown nail breaks through the skin.

If there’s pain, redness and fluid draining from the area, it’s probably infected. The ingrown nail can be removed in a simple, in-office procedure. Don’t try to remove a child’s ingrown nail at home; this can cause the condition to worsen.

Tight-fitting shoes also cause blisters, corns and calluses on the toes and blisters on the back of the heels.

Never buy shoes that feel tight and uncomfortable in the store. Don’t assume they will stretch or break in over time.

Conversely, shoes that are too loose can cause problems, too.

If a shoe is too loose, the foot slides forward and puts excessive pressure on the toes.

Parents should carefully inspect both new and old shoes to check for proper cushioning and arch support.

Shoes lose their shock absorption over time, and wear and tear around the edges of the sole usually indicate it’s worn out and should be replaced. If a child keeps wearing worn-out or non-supportive dress or athletic shoes, it elevates the risk for developing heel pain, Achilles tendonitis and even ankle sprains and stress fractures.

A good tip for parents when buying new shoes: The toe box should flex easily and the shoe shouldn’t bend in the middle of the sole.

For children with flat feet, parents should buy oxford, lace-up shoes that have enough depth for an orthotic insert, if necessary.

Unfortunately, there isn’t much choice for kids with flat, wide feet. They need shoes with a wide toe box and maximum arch support and shock absorption. Slip-on loafers aren’t right for them.

Please contact Dr. Vail if you have questions about buying the correct shoe for your child. 419-423-1888 or

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