Why is children's footwear fit especially important?
Children's feet can change size quickly, and they may not always describe pressure or discomfort clearly.
Adaptive footwear therefore needs regular checking rather than being assumed to fit until it looks visibly small.
How much growing room is appropriate?
Some growing room is useful, but the shoe should not be so long that the child trips, slides forwards or loses heel control.
The appropriate allowance depends on the shoe design, activity and whether an orthosis is being worn.
How should the forefoot fit?
The toes should have room to sit naturally without being compressed together.
The widest part of the foot or orthosis should sit comfortably within the shoe rather than pushing strongly against the upper.
What if the child wears an AFO or SMO?
Fit the footwear with the orthosis correctly applied.
The shoe needs enough opening to accept the device and enough internal width and depth for it to sit fully inside.
How secure should the heel be?
The rear foot should remain reasonably stable during walking.
Repeated heel lifting can create rubbing and may reduce control, particularly when an orthosis is also present.
Why are wide-opening designs useful?
A wide opening can make it easier to place the foot or orthosis into the shoe without twisting the ankle or forcing the device through a narrow entry.
Once the foot is inside, the fastening should still close securely.
Should removable insoles be taken out?
Only where the shoe is designed for the insole to be removable and additional depth is required.
Do not remove structural components that are intended to remain in the footwear.
Important: Do not alter a child's prescribed AFO or SMO to make it fit inside footwear. If the device and shoe are incompatible, contact the orthotic or clinical team.
What signs suggest the shoe is becoming too small?
- toes approaching or touching the front;
- fastenings reaching the end of their adjustment;
- new red marks or rubbing;
- the upper stretching over the orthosis;
- the child resisting the shoes or walking differently;
- the orthosis no longer sitting fully into the footwear.
How often should fit be checked?
Check regularly and after any growth spurt, orthosis adjustment or change in socks or insoles.
The younger the child and the faster they are growing, the more frequently fit may need reviewing.
When should professional advice be considered?
Seek review where repeated pressure occurs, walking changes, the orthosis no longer fits securely in the shoe or there is uncertainty about sizing around a prescribed device.
