children’s health

by Kim Jackson M.S.S.F.
Klodhoppers Ltd, Haywards Heath

We have to accept that as a nation we are getting bigger and heavier, and in the light of the Government’s recently updated document ‘Childhood Obesity: Applying All Our Health’ (1st May 2020), it is clear that as a nation we have an obesity problem that isn’t going to go away any time soon.

For many grown-ups and children, lockdown hasn’t helped! Childhood obesity and excess weight are significant health issues for children and their families. There can be serious implications for a child’s physical and mental health, which can then overlap into adulthood.

Obesity is associated with poor psychological and emotional health, and many children experience bullying and stigmatisation linked to their weight. Children and young people living with obesity are more likely to become adults living with obesity and therefore have a higher risk of morbidity, disability, low self-esteem and premature mortality in adulthood.

For some children it can mean more school absences (in order to avoid the bullies) in addition to the obvious health concerns such as high cholesterol, high blood pressure, diabetes, breathing difficulties and bone and joint problems.

So what has this got to do with shoes?
There has been a marked increase in overweight children in the last few years, and this can affect how a shoe is worn and its durability. Members of the Society of Shoe Fitters are trained in many aspects of shoe fitting for children and young people, and one of the factors to be taken into consideration is the weight of a child and the impact it may have on the wear and fit of a shoe.

The most important thing to remember about any footwear is that ‘it is essential to wear the right shoe for the right occasion’, so that footwear will perform correctly and in accordance with its design and manufacture. Shoes are designed to do different jobs and take varying amounts of wear and tear.

So for example:
• Party shoes are not designed for climbing trees.
• School shoes are designed to be worn five days a week within a school environment.
• Wellies and waterproof boots are made for puddles and muddy walks!

Overweight children (particularly boys) often resort to wearing trainers all day, every day, mainly because it’s the only type of footwear that fits and feels comfortable. The construction of a trainer offers comfort for the foot due to all the padding inside, the soft chunky soles and the ability to easily open up wide for a chubbier foot.

Strictly speaking, however, trainers are designed and manufactured to be worn for sporting activities, and not for all day wear. Daily wearing of trainers can be harmful to your feet and general health and can lead to another different set of foot health problems such as allowing the feet to ‘spread’ and become more flaccid. As a result when you go back to wearing a more structured shoe, you may suffer for a while.

Overweight girls often choose fashionable flat ‘pumps’ like a ballet shoe, but with no fastening. Again these are not ideal especially if they are not fitted correctly, as the foot can bulge over the topline of the shoe. This is not just unsightly, it can be very uncomfortable. It can also create the potential for the skin to be chafed and for blisters to develop. The child also has to ‘claw’ her toes in order to keep the shoes on, then the shoes either gradually stretch and turn into ‘flip flops’ or the backs get broken down so there is no support for the heel. Unless the pump is of high quality there is likely to be inadequate shock absorption in the sole and insole which can make the foot prone to plantar fasciitis – which is extremely painful. The arches of the feet become overworked and bear the child’s entire weight, as opposed to a properly constructed shoe which is designed to take weight in specific places throughout the shoe.

Taking a shoe wider and wider is not necessarily the answer to fit a chubbier foot. In fact it often pays to go longer and narrower (although the depth and the style of the shoe would be a greater consideration with an overweight child) as it is all about how the weight of the child’s foot is distributed within the shoe.

Extra body weight puts strain on the arches and muscles in the feet, ankles, legs and hips, affecting your entire physiology. Even migraines can be attributed to ill-fitting footwear.

Finding comfortable and supportive shoes for overweight children is important to keep young people active and mobile. If your feet hurt due to ill fitting shoes, then you exercise less and are likely to gain more weight – a vicious cycle.

GPs, chiropodists and podiatrists inevitably see more foot health problems due to obesity, but their knowledge of mainstream footwear may be limited. Contact a qualified shoe fitter who is more likely to be ‘in the know’ with the latest brands, designs or trends, and who has the knowledge needed for giving the correct fit.

A qualified shoe fitter will always recommend a structured shoe, preferably with a fastening (such as laces, or a Velcro® strap, or a strap with a buckle) for children who need the correct footwear and who need to get in shape.

What adults choose to do with their feet is their concern, however as a parent we have a duty of care to our children to ensure that during the long growing period extreme care must be taken to avoid persistent pressure on the developing foot. Before the bones in a child’s foot have fully formed there is a danger of the bones becoming distorted by pressure due to inappropriate or ill fitting footwear. The additional problem of obesity in a child is another vital factor to be taken into account when getting their shoes fitted correctly.

If in doubt, then always consult a health professional or take advice from a qualified shoe fitter – remember that a child’s formative years shape the future of their feet and the way they walk and can have profound and far-reaching effects on their whole physiology.

Kim Jackson M.S.S.F (Member of the Society of Shoe Fitters & Children’s Foot Health Register accredited) Klodhoppers, Haywards Heath. www.klodhoppers.com

by Kim Jackson M.S.S.F.
Klodhoppers Ltd Haywards Heath

Generally speaking, we only get one pair of feet, and considering the amount of work we ask them to do we really need to take good care of them. Staff at our shop are qualified as members of the Society of Shoe Fitters. They are encouraged to share their knowledge and expertise with their colleagues, thereby ensuring that everyone at the shop should be able to tell how well (or badly) a shoe fits initially by the way the shoe slides onto the customer’s foot (or not!) This is one of the main reasons why we will put the shoes on our customers’ feet ourselves.

The amount of ease on the areas of resistance can be felt as the shoe slides onto the foot and indicates to the experienced fitter how the shoe is going to fit. The customer may not like the style or the design of the shoe once it’s on, but at least the fitter can be honest about the fit. Remember that the size on the box is just a number and merely a starting point for the fitter. As qualified fitters we will always tell you if we think the fit can be tweaked and improved.

Once the shoes are on the feet we will ask the child to walk around so that we can check the fit. We are looking to see not only if the gait appears ‘normal’ (unless of course, that is a separate health issue), but also whether the shoes look as though they are ‘behaving normally’ when worn.

So we are checking primarily that the shoe is not slipping up and down at the back of the heel and there are no big gaps around the ankle. We are also looking to see if the topline of the shoe is comfortably clear of the anklebone – if not it may rub, especially if there is no padded heel collar. In addition we are checking that the vamp of the shoe (where the shoe ends at the top or front of your foot) is not gaping or creasing abnormally, which would prompt us to think that the shoe might be too wide or too deep.

We will also be considering the shape and height of the heel collar – is it complementing the natural contour of your child’s foot? What is the extent of any gaping? A certain amount of space is to be expected, but if the gape is too wide then the foot will not be held in place securely. A style with a higher or tighter topline may need to be selected instead. Also, if there is too much slipping going on at the heel, we may need to play around with a different, possibly narrower brand, or even a different size.

Having over 30 years combined shoe-fitting experience, we could line up at least 10 pairs of the same size shoe, but if they are all 10 different brands, even if they are similar styles, we can guarantee that they will all fit slightly differently on one child’s feet! Some of those fits will be better than others – this is where our guidance, advice, knowledge and expertise comes into play.

A fitter’s hands and eyes are their chief fitting tools, with the measuring gauge being the starting point. Practice improves their precision in dealing with each individual customer, alongside a thorough knowledge of all of the brands stocked. There is absolutely no point in fitting a pair of shoes unless it is known how each particular brand or style fits.

For example, if we are fitting a pair of Dr Martens boots or school shoes we know that this brand is quite true to UK sizing lengthwise, but the shoes more often than not tend to suit a wide, deep foot. There is very little point in bringing this brand out for a slim narrow foot, unless the customer is intent on having them, and is happy to have lots of space taken out with insoles – but that is the customer’s choice and it is likely to be pointed out by the fitter as probably ‘not the best fit’ on offer.

However, if I brought out a specific style of Superfit trainers for a very wide, deep foot, it would more often than not be a complete waste of time, as that style tends to fit slim ankles and narrow feet. A wide foot is going to feel completely squashed and restricted.

Most parents will expect a certain amount of growing room in their child’s shoes, depending on growth spurts, but most fitters will try to allow for at least a three month growth period. Most children’s growth spurts are erratic and do not happen at regular, predictable intervals. Smaller children can grow up to two and a half sizes in one year, so that is why it is very important that for their foot health’s sake they are measured and checked frequently by qualified fitters.

It doesn’t cost anything to pop in and have your child’s shoes checked and to be re-measured on a regular basis. All shoe shops that offer a measuring and fitting service and have qualified fitters will do size checks for you for free, but it is essential to remember that different shops use different gauges – as mentioned previously, the size gauge is merely an indication of the approximate size for the shoe fitter to start with.

It is wise to regularly check the fit of your child’s shoes every four to six weeks for infants (up to three years), every six to eight weeks for toddlers (three to four years), and every 10 – 12 weeks thereafter. It’s likely that a child will need at least four pairs of shoes each year in the formative years while the growth spurts are quite rapid. Any damage done to your child’s feet during these early years can be long-lasting and often irreversible. Most girls will start to slow down foot growth-wise by approximately age 13-14 years old, but boys’ feet can keep growing up to around 18 years old.

An infant requires a style which holds firmly onto the foot and which is easy to put on by the parent. It also needs to allow the foot to develop naturally and which does not restrict the freedom of the ankle.

In a first walker or a pre-walker the most important factor should be that the uppers and soles are soft, lightweight and very flexible which allows the foot to move naturally and enables the child’s foot arch muscles to develop correctly.

There must be adequate toe room in a child’s shoe not only for growth but also for the elongation of the foot when walking.

If there is sufficient room the vamps of the shoe will not become distorted and if there is sufficient depth it will prevent any downward pressure on the toes too.

If the shoes are too shallow there will be no ‘wiggle’ room for toes, and if the shoes are too short then the longest toe(s) will hit the end of the shoes and potentially do damage to the nails and nail beds, as well as cause the formation of a ‘hammer’ or ‘claw’ toes.

Once children start school the bones have started to form and their muscles and arches are developing and being exercised, therefore a child needs a shoe with more protection and support. Their school shoes must be able to withstand the rigours an active lifestyle at school will require, otherwise parents will need to be prepared to replace them more frequently.

On average a school-age child will need a minimum of two pairs of shoe shoes per academic year – if their shoes ‘last a whole year’, it’s more than likely that they are wearing a pair that are much too small for them!

As a parent the most important thing to remember is to get your child’s feet checked. If you take them to a qualified dentist for their dental check ups, and a qualified GP for any health issues, so why wouldn’t you protect your child’s foot health by taking them to a qualified shoe fitter for a shoe check and a re-measure on a regular basis?

Kim Jackson M.S.S.F (Member of the Society of Shoe Fitters & Children’s Foot Health Register accredited) Klodhoppers, Haywards Heath www.klodhoppers.com