This School Year, Make Sure the Shoe Fits Before Wearing It; Orthopaedic Surgeons Offer Advice on Choosing the Best Children's Footwear.

ROSEMONT, Ill. -- While saddle shoes and penny loafers were all the rage with American boys and girls in days gone by, fashion comes and goes -- but healthy feet are meant to last a lifetime. Parents and children today have an extraordinary wealth of styles and materials from which to choose when it comes to buying new shoes and what better time to focus on the subject than during the annual back-to-school shopping expedition. According to the American Academy of Orthopaedic Surgeons (AAOS), parents buying back-to-school gear should make sure their children have properly fitting shoes that offer both protection and comfort.

"The primary purpose of shoes is to protect your feet and prevent injury but in order to do so, they must fit well," said Lori A. Karol, MD, pediatric orthopaedic surgeon and fellow of AAOS. "Shoes that don't fit well like those that are too narrow, too short or too large--can cause discomfort or injury in some cases."

It's important for parents to make sure their children's shoes offer quality construction and a good fit. Because children, like many adults, may sacrifice fit for style, Dr. Karol said parents always need to check that shoes fit properly. She explained that parents should look for shoes that conform to the shape of the child's foot, fit well in the heel and allow plenty of room for the toes to move. Foot comfort is essential to maintaining stability, mobility and safety, she explained.

In order to prevent injuries, the AAOS offers the following helpful tips on buying properly fitting shoes for children:

--Measure each foot every time shoes are purchased; children's feet are constantly growing and shoes that fit a child last school year may not fit this year.

--Have the child stand and place his or her full weight on the feet while being measured, to ensure accuracy.

--If the feet differ in size, choose the shoe that fits the larger foot. Pads can be added to shoes so that the smaller foot fits well.

--There should be a thumb's width of space between the toes and the front of the shoe.

--A shoe should fit snugly at the heel and instep, and be wide enough to prevent rubbing or squashing from side to side.

--The shoe should be deep enough so the toes do not push against the upper of the shoe.

--The shoe should bend at the ball of the foot, not in the middle of the foot.

--Look for a soft, pliable shoe with enough length in the area surrounding the toe for growth and wide enough for the toes to wiggle.

--Don't let a child sacrifice fit for fashion by buying tight shoes. There is no "break-in" period, and a tight shoe can damage the foot.

--Sizes may vary among brands and styles. Have the child walk around in both shoes - wearing normal socks - prior to purchasing.

--Feel inside the shoes for rough spots, glue, staples or anything that can cause irritation.

--If the child slips out of a shoe, it may be the width and not the length that is incorrect.

--Try to choose footwear that is adjustable to provide greatest all-around comfort at all times.

--For teens insisting on wearing a higher heel or platform shoe, a one-and-a-half to two-inch chunky heel with padded insoles and plenty of room for the toes to move is the best choice. Limit the amount of time they wear higher heels, and have them alternate with good quality flat-heeled shoes for part of the day.

For additional information on foot care and more, please visit the Academy's public and patient education Web site, Your Orthopaedic Connection (www.orthoinfo.org), or call the public service line at (800) 824-BONES.

An orthopaedic surgeon is a physician with extensive training in the diagnosis and non-surgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.

With more than 29,000 members, the American Academy of Orthopaedic Surgeons (www.aaos.org) is the premier not-for-profit organization that provides education programs for orthopaedic surgeons and allied health professionals, champions the interests of patients and advances the highest quality musculoskeletal health. Orthopaedic surgeons and the Academy are the authoritative sources of information for patients and the general public on musculoskeletal conditions, treatments and related issues. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (www.usbjd.org) -- the global initiative in the years 2002-2011 -- to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life.

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