These Boots are Made for Walking! - A Physical Therapist's Guide to Shoes and Early Walking

Toddler Boots

How do we know what footwear is best for our new little walkers?  Here is my guide to help parents understand what to focus on after those little feet take their first steps.  

Shoes vs Barefoot 

Barefoot

There is a ton of research out there supporting the importance of barefoot walking. The foot plays a major role in balance, proprioception and postural support. Babies who walk barefoot walk faster with a smaller step width and experience less falls when compared to babies walking with shoes.  In addition, during barefoot walking, the foot is not restricted in movement and feedback from environment is maximized.  Therefore, our babies need lots of barefoot practice time for optimal walking development. (1)

What type of shoe is best for my new walker?

At some point, we start introducing shoes to protect those little feet. What are the important things to look for when buying a shoe for our kids?

Size Matters:

The proper fit impacts foot development, speed, step length and falls.  Toddlers have really wide feet due to immature muscles and a fat pad under the medial arch of the foot (2,3). Here is a check list to make sure you find a shoe that fits your toddlers’ feet properly and does not restrict their growth.

Check List

• Check the width in stance making sure the foot is not pushing or pinching on the outside of the shoe

• Check the depth pushing on the top of the shoe

• Check the length (1/2 inch) use your thumb finding the big toe in the shoe in standing

• Check the top of your baby’s toes for red spots or callouses

• Check the shoe fit is tight around the heel without slipping

Special Note: Toddler feet can grow a half size every 2-3 months so check every 2 months! (3)

Shoe fit guide

Flexibility and support: 

Flexibility can improve feedback to the foot, and imitate a “barefoot” style for walking. (1,4) Flex and extend the sole of the shoe to feel how pliable the shoe is.

For our typically developing kiddos, there is no need to worry about arch support.  The biggest thing the research points to is that in our healthy, typically developing kiddos, a baby’s walking speed and stability are quick to adapt to ANY shoe type with practice.  In order to challenge these adaptations, we need to introduce variability to help improve early walking. (4)

How do I help my baby practice walking?

Expose your baby to different walking environments like carpet, tile, and grass with different shoes.  These environmental changes can help train them for variability that occurs naturally in the environment and thus improve walking skills. (4)

changes in surfaces challenges early walkers

As a final note, these suggestions focus on our typically developing population.  Pediatric physical therapists are experts in understanding and identifying problems in movement.  If your baby is delayed in walking, is falling frequently after 3 months of independent walking, or is complaining of pain while walking, there is help for you.  Boost Babies offers in-home pediatric physical therapy, wellness and infant massage.  Contact us today!

References

1. Staheli L. Shoes for children: a review. Pediatrics. 1991;88:371–375.

2. Gould N, Moreland M, Alvarez R, Trevino S, Fenwick J. Development of the child's arch. Foot Ankle. 1989;9:241–245.

3. Gould N, Moreland M, Trevino S, Alvarez R, Fenwick J, Bach N. Foot growth in children age one to five years. Foot Ankle. 1990;10:211–213.

4. Buckland M, Sevin C, Hafer J, Choate C; Kraszewski A, Hospital for Special Surgery Pediatric Research Team. The Effect of Torsional Shoe Flexibility on Gait and Stability in Children Learning to Walk. Pediatric Physical Therapy. 2014; 26(4):411-417.