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Shoes and Footwear

When healthy and well, each of our feet carries the weight of our whole body through it's relatively small structures. There is a clear sequence in how each foot strikes the ground, absorbs the body's weight, and pushes off the ground as the body transfers its weight to the other foot. We learn the sequence in our early years and from then take each pain free step for granted.

Any pain, swelling or stiffness in a child's lower back, or hips, or knees or ankles can disrupt the normal weight bearing function of a child's feet. Also any arthritic disease within the foot itself (either at the forefoot or hindfoot) can disrupt the normal flexible structures of the foot and cause considerable pain or potential deformity. It is an important priority therefore to monitor your child's feet and pattern of walking. The hospital -or or G.P. can do this but a referral to a podiatrist would be helpful.

Seek a podiatrist's advice early and help them monitor your child's feet. Ankle and foot misalignments are common complications and require professional aid. Innersoles individually made for your child are far more effective than 'off the shelf' products. Get your GP or consultant to refer you to a NHS podiatrist who may make a pair of innersoles that helps prevent deformities and relieves pain.

General tips

• Buy the lightest shoes possible.
• Go shopping in the afternoon so that if the child's feet swell, you make sure you get the right size.
• Modern shoes should be comfortable immediately. They should not need to be 'worn in'.
• Look for shoes with a contoured inner sole. This helps to support the foot and relieves pain.
• Try to find shoes that rock slightly when on a flat surface. These shoes are easier for children than shoes that sit flatly on the level surface. They are sometimes called 'rocker' shoes.
• Trainers may be necessary for school. Choose lightweight ones that have a protected toe and good soft rubber/plastic soles.
• Allow your child to have one pair of trendy fashion shoes for special occasions with their friends. This enormously helps their morale when they have to wear 'sensible' shoes the rest of the time.
• Laces may be easier to manage than Velcro fastenings, so help your child to learn to tie as soon as possible.

The Foot Health Register holds a updated register of shoe shops that measure children professionally. Contact Foot Health Register P 0 Box 123 Banbury, Oxon OX15 6WB www.shoe-shop.org.uk email: cfhr@netcomuk.co.uk or contact The Society of Chiropodists and Podiatrists I Fellmonger's Path Tower Bridge Road, London SE1 3LY Telephone: 020 7234 8620 www.feetforlife.org

Getting about

Riding bicycles: This is an excellent way for the young child with arthritis to keep mobile and fit. This is because the child is keeping their heart and lungs fit while exercising their joints but bearing their body's weight. If you are able to create an '8' shaped track on some level paving outside the home this helps give the child a safe place to keep peddling without having to stop. Some children can enjoy peddling their bikes even when they cannot walk far.

Initially a sturdy three-wheeler provides children with the chance to race their friends. Later, bicycles with strong stabilisers prove useful, but remember to use safety helmets. Newer designs of bicycle, like a child's bike hitched onto an adult's cycle, or adapted tandems are now used by families. Look in your telephone directory for a bicycle shop for advice and ask the physiotherapist.