The ideal shoe is very difficult to find and is often a matter of compromise, particularly with older children who are under the influence of fashion and peer group pressure. Footwear which is too large, too small, or does not fit properly, can cause lifelong foot problems. These problems can easily be avoided by taking care with the type of shoe purchased and considering a few main points. These are:

Adequate length and width Retaining medium

All children’s footwear should be measured for length and width fitted by an appropriately trained shoe fitter. If fitting is not available, or is refused, go elsewhere.Poorly-fitting footwear in young children could result in deformity, whereas in older children it may result in toenail and skin problems. The Children’s Foot Health Register is a register of retailers who guarantee to be ‘centres of excellence for children’s Upper Material shoe fitting’ and ‘provide comprehensive training for staff and offer children’s shoes in whole and half sizes and in up to four width fittings’.

Heel stiffener

This is the part of the shoe at the back and sides of the heel. It stiffens the back of the shoe and stops the heel slipping out of the shoe. Along with a broad base of heel, it helps to prevent sprained ankles. It also helps to prevent claw toes, as a shoe which slips at the back will cause the toes to claw to keep the foot in the shoe.

Height of heel

This can be increased as the child gets older but should be no more than 1.5 inches (4 cm).

Broad base of heel

This should be as wide as the heel to give stability, and be made of a shock-absorbing material.

Retaining medium

This is the term used to describe how the shoe is kept on the foot. Ideally it should be by laces, Velcor ot 'T' bar, which acts like a seatbelt in a car, holding the shoe on to the foot. This helps to prevent toe deformities, as a por retaining medium can allow the foot to slide up and doen in the shoe and damage the toes or cause the toes to claw to help keep the shoe on. This is a particular problem with the current fashion of not tying shoelaces.

Upper Material

Ideally this should be made of leather and have a Gore-Tex liner if they are going to be subjected to prolonged wet conditions. Synthetic materials e.g. plastic, nylon and rubber can cause the foot to sweat excessively and increase the likelihood of athlete's foot, verrucae and in-growing toenails.

Toe area shape

This should be foot shaped and not pointed. Pointed toe areas may result in the formation of bunions.

Adequate depth of toe area

This is particularly important in individuals with a big toe that curls up at the end and helps to avoid toenail problems.

Soling Material

This should be of a slip-resistant, shock-absorbing material.