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Category: Toe Walking

A Step in The Right Direction: PT-Approved Footwear For Your Kiddos!

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Choosing the right footwear for children can be a daunting task for parents, especially when considering the importance of comfort, support, and proper development. As kids grow, their feet undergo significant changes, and the right shoes can help promote healthy foot development, prevent injuries, and enhance overall mobility. Here’s a guide to help you find PT-approved footwear for your little ones.

Why Footwear Matters – Qualities of Good Kids Shoes That PT-Approved

Children’s feet are still developing, making it crucial to provide them with shoes that offer proper support while also allowing room to grow. Poor footwear can lead to a variety of issues, including flat feet, overpronation, and discomfort. Physical therapists often emphasize the following features in kids’ shoes:

  1. Arch Support: Proper mid-foot arch support is essential to promote natural foot development and prevent conditions like flat feet. Look for a shoe that flexes at the toe vs. mid shoe when you bend it.
  2. Flexibility: Shoes should allow for natural movement. A shoe that has a flexible toe/forefoot region enables kids to engage in physical activities without restriction.
  3. Adequate Cushioning: Ample cushioning helps absorb shock during activities, reducing the risk of injuries.
  4. Room for Growth: Kids grow quickly, so it’s important to choose shoes that allow for a little extra room without being too loose. A shoe with a wide toe box allows for extra growth and room for their toes to splay, which helps to provide a wider base of support and improve balance!
  5. Breathability: Shoes made from breathable materials help keep feet dry and comfortable, reducing the risk of blisters and fungal infections.
  6. Adjustable closure: Shoes with adjustable closures can be adjusted for a sung but comfortable fit. This helps provide the ideal support during movement without worrying about their foot sliding around in the shoe. Look for a shoe with velcro or laces/straps that can be adjusted for the perfect fit.
  7. Sturdy/solid heel cup: Shoes that have a sturdy heel cup provide solid support and stability for your little one’s ankles. In addition, they help to promote proper leg alignment while walking, running, and during general play activities! Look for a shoe that when you push on the back of the shoe it doesn’t collapse in. 

Brands that offer PT-approved footwear options:

1. New Balance

New Balance offers a variety of children’s shoes that are known for their excellent arch support and cushioning. Models like the Kids Rave Run v2 are lightweight, have moderate arch support for higher impact activities, and have a wide toe box that give the feet plenty of space!

2. Saucony

Saucony’s Kid’s Cohesion line features good arch support and a breathable upper. They’re designed for running and play, offering stability without sacrificing flexibility.

3. Asics

Asics shoes are known for their GEL cushioning system, which provides excellent shock absorption. The Gel-Contend series is a great choice for everyday wear and sports.

4. Stride Rite

Specializing in children’s footwear, Stride Rite offers shoes that prioritize foot health. Their shoes often feature rounded toes and flexible soles to promote natural foot movement.

5. Pediped

Whether you’re looking for sandals, sneakers, or boots, Pediped provides a variety of shoes that promote healthy foot development. Their Originals, Grip ‘n’ Go, and Flex designs have been officially recognized by the American Podiatric Medical Association (APMA) as being beneficial for children’s growing feet!

6. Cat and Jack and Walmart also have various cost effective options that provide adequate fit and stability. Use the tips above to find shoes that fit these criteria!

More tips for Choosing the Right Shoe

  1. Measure Feet Regularly: Kids’ feet can grow rapidly, so measure them every few months to ensure a proper fit.
  2. Try Shoes on in the Afternoon: Feet can swell throughout the day, so fitting shoes later in the day can ensure a better fit.
  3. Check the Fit: Compressive footwear may cause weakness, deformity, and mobility loss, so you want to ensure there’s about a thumb’s width of space between the end of the shoe and the longest toe. The heel should fit snugly without slipping.
  4. Look for Quality Materials: Choose shoes made from durable and breathable materials, such as leather or mesh, to ensure longevity and comfort.
  5. Involve Your Child: Allowing kids to choose their shoes can make the experience fun, but guide them toward options that meet their physical needs.

***Special Tip for Little Ones: These recommendations are mostly for experienced walkers. If you have a baby who is just starting to learn to stand and walk, barefoot is best so they can gain strength and balance. If a new/early walker needs shoes for daycare or outdoor use, look for a flexible option with a wide toe box that fits securely on the foot (adjustable closure) without sliding off.***

How Can Carolina Therapy Connection Help? 

Investing in the right shoes for your children is crucial for their foot health and overall well-being. With the recommendations from physical therapists and a focus on supportive, flexible, and well-fitting options, you can help your little ones stay active and comfortable. Remember, the right shoe today can lead to healthier feet tomorrow!

 

Written By: Anna Seguin, PT, DPT

What is Toe Walking?

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Toe walking means that a child is walking and standing on tiptoes, and their heels do not make contact with the ground. Walking up on their toes can be a normal occurrence in children aged three and under as they continue to develop their ability to walk. Beyond that age, without any definitive medical reason, it is considered idiopathic toe walking (walking on toes without a known cause).

Toe Walking Causes

To understand, what’s not so simple about toe walking is the why behind it. There are many possible reasons that children might develop this pattern:

Developmental phase: A child occasionally walking on the balls of their feet can be part of normal development.  When children first begin walking, usually between 12-15 months of age, they often try different foot positions including walking up on their toes.  However, it is expected that typically developing children will only walk on their toes occasionally.

Neurological concern:

  • Sensory processing concerns: Children with sensory issues, including those on the Autism Spectrum related to the vestibular system, have a different awareness of their body position and feel stabilized during toe walking. The tactile system includes our sense of touch, pain, and temperature. Some studies conclude that children with differences in vestibular processing can also have tactile senses that exacerbate their toe walking. They may not like the feeling of the floor touching their feet, and toe walking minimizes this contact. Children seeking proprioceptive input toe walk because the gait prolongs stimulation of joint receptors and causes their muscles to tighten. The movement provides a calming input sensation for the child. (Williams 2010)
  • Cerebral Palsy: The most common cause of toe walking in those with cerebral palsy is spasticity, which can cause stiffness and involuntary muscle contractions in calf muscles, keeping their heels from touching the ground. Over time, without proper stretching and bracing, these muscles can become shortened, making it challenging to achieve heel contact. 

 

Idiopathic toe walking: Toe walking can occur because of an underlying anatomic or neuromuscular condition, but in most cases, toe walking is idiopathic without a discernible underlying cause. Idiopathic toe walking occurs in children between 3 and 7 years old and is more commonly seen in males than females. Idiopathic toe walking is not related to any specific diagnosis and can presenty of reasons, due to a variet including decreased stability and sensory involvement. For some families, toe walking may be a cosmetic concern, whereas it can cause pain or functional issues in other cases. (Ruzbarsky, Scher, & Dodwell, 2016)

Treatment

You may wonder how to stop toe-walking with your child. Therapeutic treatment depends on the cause, how strong of a habit it is, how tight the calf muscles have become, and what other changes have occurred in the child’s foot and ankle due to walking this way. 

Treatment can include:

  • Stretching: To improve muscle length, increase ankle mobility, and promote heel contact
  • Orthoses: Ankle-foot orthotic worn to keep the foot at a 90-degree angle and promote heel contact
  • *Turtle bracing: New bracing technique utilizing a removable, re-moldable, lightweight brace to achieve optimal ankle positioning, obtain and maintain ankle mobility, and promote heel contact
  • Serial Castings: Hard cast used to obtain and maintain a 90-degree angle at the ankle joint for extended periods (1-2 weeks at a time)
  • Night splints: Braces worn at night to keep the foot in a 90-degree angle and achieve prolonged stretch
  • Botox injections are most commonly used with those dealing with spasticity; they weaken their calf muscles and make them easier to stretch and cast.

A careful history, clinical exam, and selective diagnostic testing can be used to differentiate between different types of toe walking and determine the most appropriate treatment for each child. 

 

How Can Carolina Therapy Connection Help with Toe Walking?

Being evaluated by a Physical or Occupational Therapist can further help determine which treatment routes are appropriate for your child. Call us today at 252-341-9944 for a free screening! 

 

By: Taylor Saunders