I was curious as to what the general thought is in regards to shoegear for pediatric patients, specifically toddlers who are still in essence going through the osseous development of their feet.  I get a lot of questions in regards to "what kind of shoes should I buy for my child"?  Should I buy the "expensive" shoes, what brand is best (stride rite and others), etc.

Would love to hear people's thoughts on recommendations.  How aggressive do you shoe your toddler patients or is there a period in their development where you stress greater shoe mechanics/support?

  • Comments (7)
  • I think I had the wrong url

     

    try this one or if not

     

    go to ezines  click on biomechanics then the foot in closed chain and go to #16.

    https://www.podiatry.com/ezines/#ezine880

     

    Dennis

     

     

  • I have waited for others to comment in this subject before commenting.

     

    Perhaps you may wish to visit an installment that I published on this subject on these very pages.

     

    It explains my position on the subject.

     

    https://www.podiatry.com/baby-foot-pregnancy/index.php?action=viewPublication&nopopout=true&confirmOff=true

     

    Dennis

  • I had my son in orthotics by the time he was 3.  His feet are quite flat and flexible.  I tried BirkoBalance, a European prefab before that, but the arch was a bit much for him to tolerate.  He tolerates the orthotics without an issue.

  • Thanks for all the comments.  I agree with the selection criteria.

    Carla, you are right, cost becomes such an issue for most parents especially since the children do grow out of them faster than we'd like.  Sometimes they hardly look worn.

    For those who mention orthotics, what are your criteria for age, development, clinical findings etc. as to how soon you put these patients in an orthotic?

  • The APMA has some great articles about how to select shoe gear, including shoe gear for children.  Here are a couple of links:

    http://www.apma.org/kids-shoes

    http://www.apma.org/MainMenu/News/Tip-Sheets.aspx

    With such a wide selection of shoes it's difficult to give people a specific brand.  Although I hear a lot about Stride-Rite being a great place to buy, you have to be selective even at their stores.  They have a lot of shoes that I wouldn't want to see my kids in.  I have a 3 and 5 year old, so I know the challenges of finding good shoes for that age group.  Generally the European brands have a much more foot friendly fit and feel, and are biomechanically better shoes.  I agree with Dr. Estrada about the stiff heel counter with flexion at the MPJ's.

    It's hard to find shoes with a good arch support, so orthotics are important for the kids who need them.  Parents can then buy the less expensive shoes and put the orthotics in them. 

    A big problem is that most kids want the character shoes or the bells and whistles that aren't usually found on biomechanically sound shoes.  Mine want lights, or Spiderman or Dora. 

    Another big problem is cost.  Kids grow out of shoes fast, and the good ones run at least $50 and up.  With my 5 year old I was diligent about getting a sound shoe, and paid an average of $70 per shoe.  Seeing him grow out of them within months, I've since changed my strategy quite a bit to cut costs. 

    I love Beeko, Crocs and Umi.  Merrell, Pediped, and Hushpuppy also have a good selection.  Again, though, I would follow the APMA guidelines as even the better brands have shoes that don't bend at the right places or are too flat, too unsupportive, etc.  You really have to go shoe by shoe.

    Hope this helps.

    Carla

  • I used to also recommend Garvalin shoes as well as Stride Rite or Pediped shoes to my patients.

    Basically we are looking for a stiff heel counter with a flexible sole to allow for MPJ dorsiflexion. I see allot of kids sneakers / shoes with thick rubber or even plastic soles which do no tallow for normal sagittal plane motion.

     

  • I dont think you will find a universally accepted approach to toddler shoes and reccomendations, I did an orthopedic fellowship with a very heavy dose of pediatrics ( with pediatric ortho surgeons) and as you may guess shoes were not a main concern. I think there is more of an orthotic role than a shoe role. However you need to recognize is the deformity or abnromality need to be controlled by the foot with an orthotic or a combonation of a shoe that goes above the ankle for better controll along with an orthotic.

    I have found this shoe below by a spanish company ( Garvalin) that I have my own children wearing and I am very happy with them, they have a good mix of shoes and high tops with good controll

    http://tienda.garvalin.com/zapatos-biomecanics-verano/primeros-pasos/Pro00357.html

    http://tienda.garvalin.com/zapatos-biomecanics-verano.html