Childrens Feet And Shoes

Overview

Children's feet are not just small copies of adult feet. At birth, a baby's foot is mostly soft cartilage — a bendy, gristly material that slowly turns into bone over many years. The bones keep hardening and the foot keeps changing shape until roughly the mid-teens. The arch of the foot usually only becomes easy to see somewhere between the ages of about 3 and 6. Because feet are still forming, they are soft and very flexible, and that is normal. Shoes have one main job: to protect feet from cold, sharp objects and rough ground. They are not there to 'support' or 'correct' a healthy growing foot. This topic explains how children's feet grow, what is normal, what to look out for, and how to pick shoes that fit well.

Very common. Nearly all toddlers have flat-looking feet, and lots of young children walk on their toes, point their toes in or out, or complain of aches in the heels and legs after a busy day. Most of these patterns are a normal part of growing and need no treatment at all.

Babies, toddlers, school-age children and teenagers — because feet keep changing until around the mid-teens. Boys and girls are affected equally. Children who are growing fast, or who are very active in sport, may notice foot changes sooner.

Symptoms

Common symptoms

• Feet that look very flat when standing, or an arch that only appears when the child stands on tiptoe
• Walking on tiptoes most of the time after about age 3
• Toes that point noticeably inwards or outwards when walking
• Tripping or falling more often than other children of the same age
• Complaints of pain in the heel, ankle, shin or ball of the foot, especially after running or sport
• Red marks, blisters or hard skin where shoes rub
• Being reluctant to walk, or asking to be carried more than usual
• A limp that comes and goes

Symptoms in children

• Young children often cannot say where it hurts. Instead, watch for changes: a child who suddenly refuses to walk, who is clingier, or who wants to be carried can be telling you their feet or legs are sore.
• Shoes that leave red marks, or a child who pulls their shoes off as soon as they can, may be a sign the shoes are too small or too narrow.
• It is normal for children to have a wobbly, wide-legged walk when they are learning. A walk that stays very different from other children the same age is worth checking.
• Growing pains are common in the legs in the evening and usually feel better with a cuddle and a warm bath. Pain that is only in one spot, or that stops a child joining in, deserves a doctor's look.

Symptoms in older adults

• This page is about children. Foot problems in adults — such as bunions, heel pain or arthritis — have different causes and different advice.
• If you are an adult with foot pain, speak to your doctor, a podiatrist (a foot specialist) or your pharmacist for advice that fits you.

Causes

Main causes

• Normal growth: bones, ligaments and muscles change at different speeds, which can cause flat-looking feet, toe walking, or legs that turn in or out
• Shoes that are too small, too narrow, or too stiff, which rub and squeeze growing toes
• Very flexible joints, which are common in children and can make feet look flat
• Minor knocks, trips and sports injuries
• Skin and nail problems such as verrucas (small hard lumps on the sole, caused by a virus), athlete's foot (a fungal infection that makes skin itchy and flaky), and ingrown toenails
• Being very active, especially with lots of running and jumping, which can irritate the heel bone in growing children

Risk factors

• Feet growing in sudden bursts, so shoes quickly become too small
• Wearing hand-me-down shoes every day
• A family history of flat feet or other foot shape patterns
• Being overweight, which puts extra load on growing feet
• Certain health conditions that affect joints, muscles or feeling in the feet, such as some nerve or joint conditions
• Diabetes or skin conditions such as eczema, which can make feet more prone to infections and sores

When to see a doctor

See a doctor urgently if:

• Your child has a fever and a hot, red, swollen foot or joint
• Your child has a new limp and seems unwell, or refuses to walk at all
• There is a deep wound, pus, or spreading redness
• Severe pain after an injury, or the foot looks deformed
• A toe or foot has turned blue, white or numb

Book a routine appointment if:

• Your child is still walking on tiptoes most of the time after about age 3
• The way your child walks has changed and stayed changed for more than a few weeks
• Your child complains of foot or heel pain that keeps them from joining in with play or sport
• One foot looks very different from the other, or the shape is getting more noticeable
• Shoes wear out very unevenly, or your child keeps getting blisters in the same spot
• You are unsure whether shoes are fitting properly, or you need help choosing the right style

Diagnosis

A doctor or podiatrist (foot specialist) will usually start by asking about your child's health, how long the problem has been going on, and what makes it better or worse. They will watch your child walk, stand and sometimes run, and look at the shape of the feet, how the shoes fit, and how the shoes have worn down. They will also check the skin and nails and feel for tender spots. In most cases this simple check is all that is needed — no scans or tests.

Tests that may be done

• A careful physical examination of the feet, ankles, legs and walking pattern
• Looking at the child's shoes for signs of rubbing or uneven wear
• An X-ray, only if there has been an injury or the doctor is worried about the shape of the bones
• Blood tests, only if there is fever, swelling or the doctor suspects an infection or another condition
• A referral to a podiatrist, physiotherapist or children's foot clinic for a second opinion or specialist assessment

What to expect at your appointment

Appointments are usually relaxed and brief. Your child may be asked to take off their shoes and socks and walk up and down. Bring the shoes they wear most often, as these give useful clues. If your child is shy, it can help to explain beforehand that the doctor will just look at their feet. You will normally be told whether anything needs doing and what to watch for.

Treatment

Most children's foot problems need very little treatment. Time, good-fitting shoes and plenty of comfortable activity are often all that is needed. When something more is required, the focus is on simple measures first — the right footwear, nail and skin care, exercises, or a referral to a foot specialist. Surgery is only considered for a small number of children.

Self-care at home

• Measure both feet every few months and always fit the larger foot. Children can go up a shoe size quickly.
• Check shoes by feeling inside for space at the toes — about a thumb's width — and by watching your child walk in them before buying.
• Choose shoes with a flexible sole, a snug heel and a roomy toe area, and let your child try them on with the socks they normally wear.
• Let your child go barefoot indoors and on safe soft ground when possible — it helps feet get strong and learn to grip.
• Wash and dry feet every day, especially between the toes, and cut toenails straight across rather than curving into the corners.
• Treat verrucas and athlete's foot with advice from your pharmacist, and keep feet covered in shared changing rooms and pools.
• For aches after sport, rest, a warm bath and gentle reassurance often help. Ask your pharmacist before giving any pain relief, and always follow their advice for your child's age.
• Rotate between two or three pairs of shoes so they can dry out between wears.

Medical treatments

If a problem does not settle, your doctor may refer your child to a podiatrist or physiotherapist. A specialist can suggest simple exercises, stretches, or padded insoles (orthotics) to make standing and walking more comfortable. Skin infections such as athlete's foot and lumps such as verrucas can be treated with products from a pharmacist or prescribed by a doctor. Ingrown toenails may need a minor procedure. Your care team will explain any treatment in plain terms and tell you what to expect — never be afraid to ask why something is being suggested and what the alternatives are.

When is surgery considered?

Surgery is rarely needed for children's feet. It is considered only for a small number of problems, such as an ingrown toenail that keeps coming back, an injury that has not healed in line, or a structural foot problem that is causing real pain or difficulty walking and has not improved with other treatment. If surgery is ever suggested, your child's team will explain the reasons, the risks and the alternatives in detail, and you will have time to think and ask questions.

Living with this condition

Day to day, the main thing is comfort and fit. Check shoes often during growth spurts, keep toenails tidy, and let your child run, jump and play as much as they like — movement builds strong feet. If your child has a foot problem being monitored, you may be asked to note how often they limp or complain of pain. Keeping a simple diary can be useful at appointments.

Lifestyle tips

• Encourage plenty of walking, running, dancing or ball games — active children tend to have stronger, more flexible feet.
• Build in barefoot time at home and on grass or sand, which lets toes spread and grip.
• Keep a spare pair of dry socks in the school bag for wet or sweaty days.
• Choose trainers with laces or adjustable straps so the fit can be tightened as needed.
• Check feet once a week — look for red marks, blisters, hard skin or nail changes.
• For children with diabetes or reduced feeling in the feet, check feet daily and see a foot specialist regularly.

Diet and exercise

There is no special diet for healthy feet, but a balanced diet with enough calcium and vitamin D helps bones grow strong — ask your doctor or pharmacist if you are unsure whether your child needs a supplement. Staying active with a mix of running, jumping and stretching games keeps muscles and joints healthy. Children should get plenty of everyday movement and time outdoors, and any sport they enjoy counts.

Mental health and emotional wellbeing

Foot problems can affect how a child feels. Being teased about a limp, wearing special shoes, or being left out of games can make children feel self-conscious or sad, and parents often feel anxious too. Most of these problems are temporary, and simple reassurance helps. Let your child know their feet are fine and still growing, and speak to their school if teasing is happening. If your child seems very worried, low or withdrawn, or if you are struggling to cope, talk to your doctor — support is available. If you or your child ever have thoughts of harming yourselves, contact your local emergency number or a crisis support service straight away.

Prevention

You cannot control how your child's feet grow, but you can prevent a lot of discomfort. The biggest single step is well-fitting shoes, checked often. Good foot hygiene, sensible nail cutting, and letting children go barefoot safely also help keep feet healthy. Many childhood foot patterns improve naturally whatever you do — so try not to worry if your child's feet look flat or turned in for a while.

Vaccines

There is no vaccine for foot growth problems. Routine childhood vaccinations are still important for your child's general health, and your doctor or health visitor can answer any questions about them.

Screening programmes

There is no national screening test just for children's feet, but foot checks are often part of routine baby and child health reviews. Your health visitor or doctor will look at your child's hips, legs and feet at these appointments. If you have a concern between visits, you can ask for a check at any time.

Complications

If left untreated

• Shoes that are too small over months can cause lasting rubbing, blisters, hard skin and nail damage
• A foot or nail infection can spread or become painful if it is not treated
• A child in pain may stop joining in with sport and play, which can affect fitness, confidence and mood
• Rarely, an injury or structural problem that is not checked can heal in a poor position
• A limp that is ignored might delay finding a treatable cause

Long-term outlook

The outlook for children's feet is generally very good. Most childhood foot patterns settle as bones and muscles mature, and most problems that remain respond well to good shoes, simple care and advice from a foot specialist. If your child needs further help, it is usually easy to treat, and children's feet heal and adapt quickly. Keep checking in with your doctor or podiatrist if something is not improving, and remember that asking early is always better than waiting.

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