Ticking Time Bomb:
Children's Shoes Cause Health Problems Later in Life for Adults
Dr. Phil Maffetone
Twenty years ago, a review of shoes and gait in the journal Pediatrics outlined some key factors that affect children’s feet. Pediatric orthopedist Lynn Staheli, M.D., from the Children's Hospital and Medical Center, Seattle, Washington, listed these important points:
- Optimum foot development occurs in the barefoot environment.
- Stiff and compressive footwear may cause deformity, weakness, and loss of mobility.
- The term "corrective shoes" is a misnomer.
- Shoe selection for children should be based on the barefoot model.
- Physicians should avoid and discourage the commercialization and "media" obsession with faddish footwear.
- Merchandising of the "corrective shoe" is harmful to the child, expensive for the family, and a discredit to the medical profession.
Perhaps the most offensive aspect of the footwear industry is the harm it deliberately inflicts upon unsuspecting children by encouraging them to wear bad shoes. Between the twin forces of television and parental encouragement, little Johnny or Jill are defenseless. In particular, the potential damage to the young developing body and brain. And, this could be a primary cause of physical imbalances, injury and disability as adults.
It was evident from Dr. Staheli’s article that shoe companies in 1991 were already heavily marketing unhealthy children’s shoes, playing on the parent’s emotions and those of older children. Today, shoe companies continue to use clever million-dollar advertising campaigns to encourage kids to ask for, and parents to buy, harmful shoes. And it’s obviously successful. The U.S. children’s footwear industry, which includes shoes for kids up to 16 years of age, generates over $5 billion annually, where products are made for cuteness and style rather than function.
What’s the best shoe for your child? None—barefoot is best and nothing comes close. Children should be barefoot, most, if not all the time. This provides the optimal stimulation of the foot by the ground, which helps train the brain for proper gait and other natural movements that children require from the start.
When a shoe becomes absolutely necessary, Dr. Staheli says it should be lightweight, flexible, shaped more or less quadrangularly, and should not have arch supports and stiff sides. She says that pediatric orthopedists strongly oppose "corrective" or "orthopedic" shoes for straightening foot and leg deformities like flat feet, pigeon toes, knock-knees, or bowlegs, claiming there’s no evidence that these so-called therapeutic shoes are effective. Instead most of the supposed deformities in children naturally correct themselves. How you might ask?
Being barefoot is the best way for that to happen. Most healthcare professionals who properly understand a child’s body mechanics know this. (Yet there are many “experts” who recommend the regular use of shoes for young children, but they are usually aligned with the shoe industry or companies making orthotics and other corrective devices.)
Any shoe has the potential to seriously disturb the gait of a young child. His or her sensitive feet sense footwear much more than the adult foot. Even relatively minor pressure on a child’s foot from a shoe can begin deforming it, leading to a permanent problem.
During the first year following the acquisition of independent walking, most of the child’s gait activity, in particular, the neurological memories—the communication between brain and body—becomes well established. During this time, if the feet are not allowed to develop well, gait and balance disorders begin to occur. In many children, these irregularities are often subtle (the “clumsy kid”) while others more serious such as increased vulnerability to physical injury and various neurological imbalances anywhere in the body, including those associated with eye movement.
The full development of a child’s balance and compensatory mechanisms, and overall gait mechanics, takes years to mature. While the first five years of life are most delicate, neuromuscular interference from footwear can occur at any and every stage along the way into early adulthood. This can lead to more serious and chronic physical imbalances later in life, such as a running injury or back pain, and even amplify the stress caused by imperfect shoes.
Earlier this year, Caleb Wegener, Ph.D., and colleagues from the University of Sydney, Australia, reviewed the problems associated with a variety of different shoes worn by children for walking and running. Their study, published in the Journal of Foot and Ankle Research, states that, “Shoes affect the gait of children. With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity. Shoes reduce foot motion and increase the support phases of the gait cycle. During running, shoes reduce swing phase leg speed, attenuate some shock and encourage a rearfoot strike pattern.” In short, these are some of the specific items that are a recipe for physical and neurological disaster, and the start of a process of chronic injury and disability that could last a lifetime.
These researchers noted Dr. Staheli’s 20-year old suggestion that shoe design should be based on the barefoot model. But some of the shoes they tested were designed on these principles and still caused gait irregularities in children.
The researchers also state that, “Further attention could also be paid to reducing the weight of shoes which may be responsible for some of the [abnormal] changes found in children’s walking and running gait.” (It’s interested that this type of “free” information is available to shoe manufacturers but may never be utilized—instead, they test their shoes on machines, not real people.)
