Maintaining and caring for a child’s feet will benefit their health, mobility and well-being throughout their entire lives. This guide provides concise practical advice and information on feet, their care and potential problems from birth until leaving school. It addresses the main problems that may be encountered with the young and developing foot and give guidance on how you can keep children's feet in the best condition.

The human foot is a highly complex structure, composed of 26 bones working together to allow the foot to adapt to uneven walking surfaces, and acting as a shock absorber with each step. These bones are usually fully hardened by the age of 18. In the newborn, the foot is composed mainly of relatively soft and flexible cartilage which gradually converts to bone with age. In the young foot, the conversion to bone can be seen as areas that are known as ‘primary and secondary centres of ossification’. On an X-ray, this can make the young foot look as though it has more bones than an adult. This is not the case, and these centres gradually fuse to make individual bones. During this period of development, the foot can be at risk from injury and deformity due to ill-fitting footwear and great care should be taken with shoe types and shoe fitting.

The foot also has a large number of ligaments binding the bones together and helping to form joints that allow free and painless movement. The foot contains approximately 19 muscles and numerous tendons running from the muscles in the lower leg to allow the foot to work as part of the leg, and allow proper walking. There is also a large network of blood vessels and nerves. All of these structures have to adapt to the changes in foot posture as the child grows.

As the old nursery rhyme goes, ‘the foot bone’s connected to the ankle bone, the ankle bone’s connected to the leg bone, the leg bone’s connected to the hip bone....so it should be remembered that the foot cannot be considered in isolation to the rest of the leg or body. Any postural foot abnormality could have an effect further up the body, altering posture and walking style. This is similar to the way that poor foundations can cause general structural problems and instability to a house.