Weekend Dr. 'Back to School Shoe Tips' - August 7th, 2010

Kids are heading back to school soon and, of course, everyone wants new shoes.

While flip-flops are all the rage for the beach and the pool, they can create problems in crowded school hallways and getting on and off the school bus.

While it may not be easy to coax your kids out of flip-flops for school, it's safer for them to wear a shoe with more support.

Don't let fashion take a front seat topracticality and safety.

Your podiatrist can recommend some great options for teenagers that may fit the bill in the fashion area while still providing support and comfort throughout the day. To help busy parents with shoe choices, I 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.

Kids come in all shapes and sizes, and so do their shoes. Shop at stores with experienced sales people that feature a wide selection of footwear styles, sizes and widths. Do not assume a given size will fit the same for different brands of shoes.

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 a few months, so it's critical to allow room for growth in the toe box, about a finger's width from the longest toe.

If your children will be participating in sports this fall, send them onto the field orthe court with properly fitted shoes that are designed for the specific sport they are playing. Basketball shoes, for example, are designed for quick stops and starts, and ankle support, while a football cleat needs to serve an entirely different purpose. Let the shoe fit the sport and try to get help when choosing shoes for each sport.

Avoid man-made materials, like rubber and plastic, because they limit breathability. Hand-me-down clothes are great, but not shoes.

Once you've purchased those new shoes, remember to check them every several months, since kids' feet grow rapidly. Snug shoes can put pressure on the toes, causing ingrown nails, which is when a nail compresses and grows down into the skin.

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 can slide forward and put excessive pressure on the toes.

I recommend parents 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 indicates 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.

For more information about childhood foot care, contact your podiatrist.

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