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December 2002 Newsletter
Welcome to the December Edition of The SportsMedicine Advantage,
the official online newsletter of South Florida Institute of Sports
Medicine.
We hope that all of our subscribers have had a safe and enjoyable
holiday season to date and that 2003 will bring more of the same.
Our newsletter this month focuses on an issue that our foot and
ankle specialists educate our patients about every day- proper shoe
gear fit. Although the focus of the article in on children, these
shoegear criteria hold true for all people, not only children.
Successfully selecting shoe gear for your child
Patrick M. Felton, DPM
Medical Director, Sports Medicine Outreach Program
Medical Director, Computerized Gait Analysis Services
How a shoe fits your child's foot is quite important for providing
proper stability, protecting the foot, and helping to prevent injury.
Unfortunately, there are few resources available to educate parents
about how to determine not only if a shoe is appropriate for a child,
but also if the shoe is fitting properly. Taking the time to examine
shoes properly, ensure that the shoe fits, and to be aware of the
life span of shoes can help your child's lower extremity health.
Some key points to remember about shoe gear:
1. There is no "Universal Standard" for shoe gear size,
both in width and length. Due to this fact, it is difficult to buy
shoes solely according to shoe size. How the shoe feels on the foot
and fits on the foot is more important.
2. More expensive is not necessarily better. Depending on the money
that a shoe company may spend on factors (marketing) other than
the materials and the methods used to create a shoe, the quality
of a shoe may suffer.
3. There is no such thing as a "break-in period" for
shoes- if the shoe feels too tight, it is too tight- after your
foot stretches the material (which is what most people assume to
be the "break-in period"), the shoe is actually less supportive.
Take a look at some dress shoes that women wear- the upper of the
shoe is actually expanded out over the platform on the sole and
you can see the outline of the toes on the upper of the shoe- henceforth,
the upper is trying to make up for lack of a sole under the foot.
4. Shoe gear has laces for a reason- to be tied so that the foot
is supported from the sides as well as the bottom. Fashion trends
tend to cycle and every so often the latest fad is to leave the
shoes untied- this can lead to falls, twists, sprains and possibly
fractures of the feet and/or ankles.
What to look for in a stable shoe:
The heel counter should be rigid- if you grasp the heel counter
of the shoe between your index finger and thumb just above the sole
and squeeze, you should not be able to completely collapse the counter.
If you hold the shoe in both hands and attempt to bend the shoe
from the front, it should bend at the area of the toes. If the shoe
bends more in the middle, then it has poor flexion stability, and
will provide poor support in the arch as a person is rolling toward
the ball of the foot and rolling off of the toes.
Torsion Stability is another excellent test- if you grasp the
front of the shoe, then hold the shoe at the back and attempt to
twist it, you should not be able to torque the shoe very much- if
you can completely fold the shoe in half lengthwise, there is little
chance of supporting the foot properly, particularly if your child
has a pronated foot (a tendency for the arch height to collapse
and the foot roll inward).
When shopping for shoes:
Take your child shoe shopping in the evening. The feet naturally
swell during the course of the day. This will ensure a proper fit.
If your child is going to have his or her feet measured by a staff
member at the shoe store, this measurement NEEDS to be taken standing-
the foot can elongate and certainly widens as a person puts weight
on the foot. Also, use the measurement as a GENERAL GUIDLINE- recall
that there is no universal standard for shoe gear size.
Perform all of the stability testing as outlined above.
After the shoe passes the stability testing, have your child try
the shoe on.
Check to see that the width of the shoe is adequate- if it appears
as though the foot is pushing the upper of the shoe out over the
platform of the sole, the shoe is too narrow. At the same time,
do not neglect the width and fit at the heel of the shoe. Although
there should be adequate room at the front of the shoe, a compromise
must be made so that your child's heel does not slip out of the
shoe or slip around inside of the shoe.
There also should be approximately ½ inch(about the width
of a thumb) between the tip of the longest toe(IT'S NOT ALWAYS THE
BIG TOE, IN SOME PEOPLE IT IS THE 2ND TOE) and the front of the
shoe.
After determining that the shoe is stable and fit is proper, have
your child walk around in the shoes for 5-10 minutes; a quick walk
back and forth for 10 seconds does not relay how the shoe actually
feels on the foot. Although this may appear time consuming, it can
save time spent in a doctor's office treating a chronic or acute
injury resulting from a poorly fitting shoe or even worse, time
away from activity for your child.
Please ascertain in what types of activity your child is going
to be participating , and be sensible about not trying to get one
shoe to be an all purpose shoe- if your child plays sports that
are at a different spectrum or plays a sport that requires specific
shoegear, whether competitive or recreational, he or she may need
a shoe that is specific to their sport and another shoe for general
wear.
The most important part of shoe gear that is often overlooked
is shoe gear LIFE SPAN. For general shoe wear, the materials in
the shoe are worn out after 6 months, no matter what the visual
appearance of the shoe. At the chemical/molecular level, the shoe
material loses its supportive properties. A good analogy is that
of car tires- even if you let a car sit idle for months, the rubber
in the tires breaks down and wears out. For athletic shoes, probably
one season is the limit; for those athletes who participate in their
sport year-round, the shoe gear should be evaluated and most likely
replaced every 4 months. For runners, replacing the shoes every
300-400 miles is an excellent interval.
By following these guidelines, your child should run into little
problems; however, if he or she is noticing any type of foot or
ankle problems, despite using proper shoe gear that is replaced
at regular intervals, have him or her examined by a Foot and Ankle
Specialist.
Have a great 2003
Patrick M. Felton
Online Editor
SportsMedicine Advantage
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