Shoe recommendations are among the most common questions I receive from parents and other therapists. The right shoe can make a big difference!
What a Supportive Shoe Can Do
- Provide stability
- Support alignment
- Facilitate weight bearing
- Improve balance and control
- Promote efficient movement
What a Difference a Shoe Makes!
Before: Notice the lack of medial arch, tilted heel, and poorly aligned malleoli. The child has a less stable base of support.After: Notice the improved medial arch, more parallel malleoli, and vertically aligned heel. The child has a more stable and aligned base of support.
Here are three common Pediatric gait presentations and what to look for in supportive footwear:
Flat Feet (aka Pes Planus)
Children with flat feet may have a history of late walking, toe walking, or hypotonia. You may notice little or no medial arch, the feet turning outward, and decreased control during weight shifting.
Flexible flat feet are common in young children and do not always require intervention. When they affect function, supportive footwear combined with PT can help promote appropriate weight bearing, strength, range of motion, and motor control.
Read more about Treatment Tips for Children with Flat Feet here!
Idiopathic Toe Walking
Children with idiopathic toe walking walk on their toes without an underlying neurologic or orthopedic condition.
Some children may toe walk for stability or sensory input. Others may develop calf tightness or limited ankle range of motion over time.
PT can address range of motion, strength, balance, sensory needs, and gait mechanics. Footwear should be selected based on the individual child’s needs.
Read more about Idiopathic Toe Walking here!
In-Toeing
Children with in-toeing turn their feet inward when walking or running. This can contribute to tripping, decreased foot clearance, and difficulty navigating uneven surfaces.In-toeing can result from:
- Metatarsus Adductus – the foot curves inward
- Tibial Torsion – the tibia rotates inward
- Femoral Anteversion – the femur rotates inward
PT and appropriate footwear can help support alignment, balance, strength, and motor control.
What Should You Look for in Children’s Shoes?
Stability: A stable base of support with a flexible but durable sole.
Support: A supportive heel cup and midfoot to help maintain alignment.
Comfort: Breathable materials, adequate toe room, and appropriate cushioning.
The best shoe depends on the individual child. Supportive footwear can be an important part of a larger PT program addressing gait, alignment, strength, balance, and motor control.
For more check out Shoe Recommendations for Children
Learn more about Dinosaur Physical Therapy!
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Thank you so very much for your great article. Also for thr shoe recommendations. I m in the UK and shoes with arch support are nowhere to be found on the high street. I have searched online for hours and hours and could not find anything.
Till i came across your site. Pediped.com offers great variety and in the UK.
Thank you again. God bless you.
Anna
So glad it was helpful for you!
Our little guy is 5 and has toe walked since he started walking (at 16 months). Our family Doc says he’ll outgrow it and that we shouldn’t worry. He CAN walk on his “flat” feet but doesn’t unless we remind him to. Should we worry? Is it likely he’ll start walking “normally” on his own? What should our next steps be?
Thank you for reaching out! I would definitely recommend consulting with a Pediatric Physical Therapist in your area. They are specifically trained to evaluate and treat idiopathic toe walking and address the underlying cause. Feel free to email me directly at info@dinopt.com if you have any other questions!
What about out toeing? Which shoes are recommended for that?
Thank you for your question. It depends upon the cause of the out toeing and how the presentation manifests itself. Many times children turn out because they lack true medial arch in their feet, other times children turn out because of external rotation at the hip joint itself or due to alignment at the knees. If you would like more specific recommendations feel free to email info@dinopt.com to discuss your child’s gait pattern.
Hi,
Thank you for this article on intoeing. My 5 year old is starting to develop a corn on either side of his tiny toes. I always try to buy shoes that are soft and with at least my finger fitting in as well. I really do not know what shoes to get him. He has tibial torsion and the last thing I would want is for him to develop these. What would you suggest please
Thank you for reaching out! I definitely recommend finding a Pediatric PT in your area that can consult with you directly, observe your son’s gait pattern & lower extremity alignment and give specific recommendations that would best suit his needs! Feel free to touch base directly at info@dinopt.com if I can help in any other way!
Thank you so much. Will try and get a referral and will be in touch via email. Many Thanks