Unfortunately there are tradeoffs that often have to be made with kid’s footwear. These include the following:

1. Durability – let’s face it – kids are hard on shoes. Unlike adult running shoes which may only see use for 30-60 minutes a day, the shoes we buy for our kids are typically on their feet the entire day when they are at school. Thus, when we invest in a pair of kid shoes we want it to last. I have had mixed experiences with more minimal children’s footwear in the past, and a $50+ pair of shoes that lasts a month is not going to sell well once reviews start rolling in on Zappos, Amazon, and the like.

2. Weather – my kids wear Crocs almost exclusively when its warm. The shoes are darn near indestructible, and they are super wide. Of all the aspects of a kid shoe that I value most, a non-constricting fit is most important to me, and Crocs fit that bill as well as anything. Unfortunately, winter in NH means Crocs go away for 5-6 months of the year, so other options need to be found that can handle nasty weather. That usually means a pair of sneakers and some type of winter boot.

3. Appearance – though I might be willing to wear an ugly shoe out for a run, my kids will only where what they perceive to be “cool.” Thus, what I want them to wear and what they will wear are not always in agreement. There’s no way my kids would wear moccasins for example, my 10yr old son will only wear shoes that look athletic (i.e., sneakers), and my 8yr old daughter would wear heels to school every day if I let her (she’s a bit of a fashion diva, no idea how that happened…).

Given the above considerations, I have tried a number of different options and have two that I highly recommend.

Altra Instinct Jr.

Altra is a relatively new company and they specialize in making “zero drop,” foot shaped shoes (i.e., wide in the toebox). Zero drop means that the sole of the shoe is level from heel to forefoot, which is not the case for the vast majority of shoes on the market. Before they had even launched their first adult shoe, the founders of Altra told me that making a good kid’s shoe was a top priority. Last year they released their first model: the Altra Instinct Jr. They sent me pairs for my two older kids to try out, and I have been quite impressed! (Disclosure: these shoes were media samples provided free of charge by Altra).

My first impression of the Instinct Jr. was that it was a bit heavy and stiff. I still think they are a bit on the heavy side (v2 is supposedly going to shave off over an ounce), but flexibility has improved considerably as my kids broke them in:

On the plus side, they look great, they are zero drop, and they offer a very roomy fit (no toe squeezing!). My 10yr son told me they are super comfortable and are his favorite shoes (well, second to Crocs I suppose). My 8yr old daughter likes them as well, she wears them to school on occasion and for indoor soccer.

Best of all, the Instinct Jr’s have been indestructible. My 10yr old is very active and tends to be extremely hard on his shoes. He would go through some of the Merrell Barefoot shoes we bought him in the past really quickly. Not these. They have had the Altras since the beginning of this school year (Sept. 2013) and both pairs are holding up great! The only place I am seeing any real wear is some scuffing on the toe bumper (cosmetic, not a problem) and a bit of wear along the lateral side of the sole (minor considering how long they have been in use).

I think this shoe is a good example where the tradeoff between minimal and durable is apparent. It’s a sturdy shoe with a heavy duty upper (though it lacks a plastic heel counter – awesome!) and full rubber outsole. That makes it heavy, but it has lasted as well or better than any kids shoe they have worn.

The Altra Instinct Jr. is available at Altra.com and at Amazon. Since it is being updated in the next few months, the current version can also be found in kid’s sizes 1.5-6 for under $30 at 6pm.com (6pm is essentially the Zappos clearance site). For a kid’s shoe that is this durable, that’s a great deal! I’ll probably buy another pair for each of them unless I can hold out until the new model is released (not sure on an exact date).

Merrell Mix Master Jam

My little guy is about to turn 4 and is still too small to wear the Altras. For a long time we had him in a pair of Merrell Flux Glove toddler shoes and we loved them. They were flexible, minimally cushioned, and had plenty roomy for his fat little feet. Unfortunately, it seems Merrell has stopped making the toddler Flux Gloves, so when he outgrew them it was time to look for something else. We bought a pair Merrell Mix Master Jam strap shoes from Amazon at the end of last summer and he has been wearing them regularly since.

Unlike the Altras, the Mix Master Jam has a bit of a heel lift, though not too exaggerated (I measure them about 4mm drop from heel to forefoot). They are super flexible, they fit his chubby feet really well, and they are super easy to slip on and off. Most of the time I don’t even need to undo the velcro strap to put them on. Like the Altras, they have a durable rubber outsole which has shown very little wear in 6-7 months of use (wear is mostly along the outer margin of the sole at the heel and forefoot).

The only place I am seeing a bit of breakdown is where the upper meets the toe bumper – the outer layer of fabric seems to be fraying a bit, but the inner layer is holding up so it seems to be just cosmetic (you can see this in the image above). In any event, he’s about to outgrow them so the shoes have lasted as long as I could possible want a kid shoe to last.

The Merrell Mix Master Jam is available in a number of styles – Mary Jane, water shoe, lace-up, and velcro closure at Merrell.com, Zappos, and Amazon. 6pm.com has some models of this shoe on clearance for under $30. As with the Altras, I’ll likely either get my son another pair of these for his next shoe, or give a try to the new version of the Merrell Trail Glove kid’s shoe.

How about you, do you have any favorite kid’s shoes?

The Instinct Jr. will have a wide toebox as is typical of other Altra shoes, and it looks like it matches an Altra Instinct 1.5/Torin style upper with the more flexible sole of the Altra Superior.

I can’t tell you how happy it makes me to see more shoes like this coming out for children – my hope is that they sell well so we can get them in smaller sizes too. My 3yo has been wearing a pair of Merrell Flux Gloves for almost a year, and it’s a fantastic shoe, but it looks like it is no longer available. Here’s hoping Altra will come to the rescue!

You can read more about the Altra Instinct Jr. on the Altra website.

Looks like a beautiful place, and love that the kids are mostly running the race barefoot!

Ohope Beach School Cross Country 2011 from smart as productions on Vimeo.

Thanks to @dodgyfr1 on Twitter for passing this along!

I have three children: a 2 year-old boy (that’s him in the photo above sporting his Merrell Flux Gloves), a 7 year-old girl, and an 8 year-old boy. Given a choice, they prefer to be barefoot most of the time, and this is a habit that I encourage. But, there are times when shoes are needed, so this list presents the shoes that they wear most often.

I’ll start with the shoe that all three of my kid’s absolutely love and that would be their preferred option 99% of the time if allowed to choose on their own:

I can already hear the gasps of horror, but the venerable Croc is a favorite in my household. It’s cheap, practically indestructible, and easy to put on and take off (minimal parental assistance needed) – the benefit of this is it means they are more likely to just pull them off and go barefoot. Although it is well-cushioned and has a bit of heel lift, I’m willing to accept that given the fact that they are incredibly roomy and will not scrunch up their toes. Crocs may be the least restrictive option available for a kid’s foot short of a loose fitting moccasin.

Now, because my older kids are in elementary school and gym class will not allow Crocs, they have more traditional looking shoes that they wear as well. For my 8 year-old boy, his current “running” shoe is the Merrell Barefoot Flux Glove:

The Merrell Flux Gloves are awesome kid shoes because they’re zero drop, minimally cushioned, super flexible, and provide a roomy toebox. The Vibram sole is very durable – the same sole is found on the kid’s Trail Glove which my son wore for most of the last school year without wearing through it – the kid’s Trail Glove is another great option:

One issue my son had with the Trail Glove is that the toe bumper began to separate from the upper material – I think the black portion of the upper at the tip of the toebox shrunk a bit after getting wet which let to the delamination. It never progressed beyond being a cosmetic defect, so not a big deal, and he could have cared less.

Some parents may balk at the price for the Merrell kid’s shoes ($65.00 for the Flux Glove, $60.00 for the Trail Glove), but my take would be that if you are buying a shoe that your child will be wearing for 7-8 hours per day at school, better to spend a bit extra on something that is flat and roomy and does not constrict their growing feet (though mine were review pairs provided by Merrell for review, I will happily buy another pair when he outgrows his current pair of Flux Gloves, and have spent a roughly equivalent amount on a pair of NB Minimus kid shoes). Given that my son’s Trail Gloves lasted for most of the last school year, I have no issues with the cost of these shoes (especially since we adults often don’t hesitate to throw down a hundred bucks or more for a pair of running shoes that might get used for a few hours a day at most).

My daughter also wore the girl’s Merrell Trail Glove last year, and she was a big fan. This year she has been wearing the Skechers GoRun girl’s shoes:

The kid’s version of the Skechers GoRun (currently available for girls only)differs from its adult counterpart in lacking the midfoot “bump” or rocker that is present in the adult shoe (I’ve done some shoe development work with Skechers and shared my opinion that the kid’s version should have no bump and should be as flat as possible – was pleased with the final product they sent me, though I’d love to see it zero-dropped). Although the kid’s GoRun is fairly soft, it’s super flexible (both longitudinally and torsionally), fairly roomy, and has a minimally structured upper (e.g., no heel counter). The heel-forefoot differential is about 4mm, so much less than the shrunken-adult monstrosities that many manufacturers put on the market for our little ones.

In addition to the Skechers shoe, my daughter also has a pair of the girl’s Merrell Flux Glove (provided free of charge by Merrell for review purposes), which in my opinion is probably the best kids shoe available right now:

Until recently, Merrell did not make their barefoot line in toddler sizes. I was pleased to see that with the release of the Flux Glove, they now have “barefoot” shoes for the little guys. My 2 year-old was in Robeez for most of his early toddling days, but now when his “piggies” aren’t free he wears either Crocs or the toddler Flux Glove (just like his big brother, except his have a velcro closure):

As you can see, I’m a big fan of the Merrell Barefoot shoes for my kids. If I had to pick just one shoe for them to wear, it would either be the Flux or Trail Glove for all three of them. I did recently buy a pair of the New Balance Minimus Trail kids version for my son, but they are still too big for him (dad got his size wrong…). These strike me as another decent option – probably wider in the forefoot than the Merrells, but less flexible and they have a slight heel lift.

So there you have it, my picks for kids footwear. If you have any additional suggestions, please leave them in the comments below!

The Merrell Barefoot Kid’s &Toddler Flux Glove can be purchased at Zappos

The Merrell Barefoot Kids Trail Glove can be purchased at Zappos

The Skechers GoRun youth girl’s shoe can be purchased at Skechers.com. Use code ENT15 to save 15%.

Below is another photo of my son sporting his fancy new shoes:

In the issue of RT, my good friends Jay Dicharry (a physical therapist) and Mark Cucuzzella (a family doctor) wrote a multifaced guide to minimalist running as it relates to the little ones. There are multiple articles, a guide to what to look for in kids shoes, reviews of selected minimalist kids shoes (I’ll share some of my thoughts on these soon – you can find some of my top picks in the Zappos ad in my right sidebar), and even a summary of a pilot study on the effects of footwear on the running gait of children.

I highly recommend that you check it out (full text of the article is available on-line) – here’s an excerpt from one Dicharry’s opening article about childhood foot development and how it relates to footwear:

In essence, we still practice the ancient art of Chinese foot-binding. Glance over at the foot of any newborn and you’ll notice that the widest part of their foot is not the ball of the foot but their toes. Then take a look down at your foot. You’ll likely notice that these feet don’t look the same. The narrow toe boxes in athletic and fashion footwear have changed the alignment of our feet, just like braces once did to legs. We’ve been taught that a pointy shoe looks normal — both fashionable and fast — and we’re willing to change our foot shape to accommodate this look.

In addition to shoes that bind the foot and change its shape, we typically put kids in shoes that are too stiff to allow natural flexion. Typical running shoes are produced for a man weighing 150-plus pounds and a woman weighing 130 pounds or more. Many of the same materials are used in the construction of shoes meant for kids who weigh a fraction as much. And the smaller physical size means that all that stitching and those material attachment points net a much stiffer shoe than the adult versions. Kids don’t have the physical weight to flex these shoes.

Is this a problem? Yes. The foot is designed to move. And that movement helps strengthen the muscles, which in turn impact the changes in our natural alignment throughout our development.

I’ve had the privilege of working with a number of runners who grew up sans shoes, and their feet are different from ours. As adults, these runners don’t rely on stiff shoes because they’ve developed strong, stiff feet. Years of barefoot movement have resulted in robust muscular attachments to anchor and stabilize the foot. The average Western foot — having grown up dependent on shoes — pales in comparison.

“…if we can encourage kids to run naturally, the way they already know how to, and to feel strong and grounded in their bodies and free in their feet, why wouldn’t we?”

My own kids have been in Merrell Kids Trail Gloves for most of this school year, and I rarely ever discourage them from going barefoot when they want to. I’m encouraged that additional options are starting to appear beyond the Vibrams and Merrells – New Balance recently released the Minimus KT20 for kid’s (bought a pair for my 8yo son), and Skechers has a kid’s version of the Go Run on the way (my daughter has a pre-release pair and loves them – 4mm drop, light, super-flexible, and lacks the midfoot ‘bump’ found in the adult version).

I highly encourage you to head over and give Arnold’s article a read: http://www.outsideonline.com/blog/mini-minimalists-are-barefoot-shoes-good-for-kids.html.

My goal with Benjamin is to avoid for as long as possible having him wear a constrictive, stiff shoe with excessive cushioning and a lifted heel. I simply cannot understand why a 30 pound child would ever need a shoe like this, or why we insist on moving them into this type of shoe the moment they emerge from toddlerhood. He can walk around all day in his Elmo Robeez without complaint, and I see no reason why the simple act of getting older means that he needs a shoe built like a tank. Call me crazy, but given all that I have learned over the past few years, this is something I feel very strongly about.

Given this, I’m always on the lookout for decent options for parents who would like to keep their kids in shoes with flat, flexible soles. I happened to be at a Nike Outlet store yesterday afternoon and I happened upon a shoe called the SMS Roadrunner. The shoe looked interesting as it had a flexible plastic sole – all of the cushion was built into the insole, which was removable. Since I get a lot of questions about kid’s shoes (my older kid’s wear Merrell Barefoot Kid’s Trail Gloves and Crocs – the latter are cushioned, but at least are extremely wide and flexible), I thought I’d share this one as it seems like a decent option and it is available in sizes up to 10c (which bridges the gap to where they can fit in something like a Merrell Trail Glove).

Since I just bought them yesterday, I can’t comment on durability, but removal of the insole makes the SMS Roadrunner completely flat and very flexible, and also makes for a pretty roomy little shoe. I’ll try and update this post after he wears them a bit. For now, here are some photos of the shoe, which is available for sale in both boy’s and girl’s colorways at Nike.com.

Watch them run down the homestretch – love it!

Watch more video of 2011 Stanford Invitational on flotrack.org

Mark was kind enough to send me a few pairs of Terra Plana Vivobarefoot Kids shoes for my own children, and my daughter loves them (she has Pally’s) – they have a nice wide toebox, and are flat and extremely flexible. My son, on the other hand, is picky and will only wear Crocs or typical sneakers (though he is almost always barefoot, by his own preference, around the house) – unfortunately, good options for kids running shoes that support natural foot function are simply not available yet (things will thankfully be improving soon if rumors I hear from a big company are correct – stay tuned). Anyway, given my frustration, as well as that of a number of readers who have contacted me about this issue, I asked Mark if he would be willing to write a guest post about children and shoes. Mark happily obliged, and his expertise as both a physician and shoe store owner makes for a very informed and unique opinion on the topic. Enjoy – be sure to share your thoughts and/or experiences in the comments!

Thoughts On A Proper Child’s Shoe

As a family physician, I firmly believe that children should play in their bare feet or in activity shoes that complement natural foot development and proper biomechanics of movement. Runners, walkers, coaches, and the medical community are all awakening to the benefits of allowing proper natural foot motion to occur in all of our daily activities. Leaders in the running mechanics, sports medicine, dancing, and yoga/tai chi communities all understand that the smartest design that will ever be developed for human movement and injury free activity is the human foot itself. Running shoe companies are slowly hearing this message and adapting their product lines to create footwear that allows your foot to behave like a foot, but most have only applied this new thinking to adult models. Unfortunately, the modern shoe industry and its marketing machine effectively convince parents that when running, a child should wear miniature versions of traditional adult running shoes; almost all of which have elevated heels, extreme cushioning, and some form of motion control technology. Many dress shoes for children are also stiff and overly supportive. Personally, as a doctor I firmly believe that the strongest form of support for a child is a strong foot that is flat on the ground.

Here’s an important point to keep in mind – a child’s foot is not a miniature version of an adult’s foot. In early development, a child’s foot is widest across the toes. If our population wore shoes that were designed with this functional shape from birth, most adults would also have feet with the greatest width located across the toes, and the toes would be perfectly aligned with the metatarsals (the long bones in midfoot). Most of a child’s developing foot is composed of cartilage, which is gradually replaced by bone. If the cartilage is deformed by badly shaped or rigid shoes, the bones will take on the deformed shape. More than 80% of foot problems, bunions and injuries are a result of misshaped and inflexible shoes. It’s vital that kid’s shoes allow enough room for natural growth, until the foot bones mature. This doesn’t happen until ages 18-19 for girls and 20-21 for boys. Simply put; inflexible, poorly shaped shoes are potentially harmful – they restrict the natural movement and development of the foot.

Research and education efforts from places, people, and organizations like the University of Virginia SPEED Clinic, Dr. Daniel Lieberman of Harvard University, and Chi Running are together allowing runners and walkers to re-look at old concepts related to form and footwear. More importantly, innovative shoe manufacturers such as Newton Running, Terra Plana Vivo Barefoot, Vibram, Kigo and newcomers Altra and STEM are now producing foot-friendly shoes that people can use to more effectively apply new concepts in their own self-experiments. It is hard to find a single one of the now thousands of runners and walkers who have made proper changes in their gait, and complemented this with footwear void of elevated heel/motion control features, who wants to return to the old way of heel crash pads and inefficient gait.

Currently, almost every running shoe company has products in development supporting natural running, and we are beginning to see the very first steps by many of them away from heavy cushioning and elevated heels. Again though, most of these new shoes are being made solely for adults. Outside of a few select brands, with Terra Plana Vivo Kids being the model (see the photo of the TP Pally to the left), a void exists in the development of proper youth footwear, where natural foot function and development are perhaps most critical.

Unfortunately, the medical establishment often fails to recognize what to many seems so obvious – a child’s foot is best off when it is interfered with the least. For example, without any supporting evidence, the President of the American Academy of Podiatric Sports Medicine (AAPSM ) David Davidson made this comment when asked about children’s footwear by Running Times Magazine “Kids should not be running in minimalist footwear at all, and as in other shoes, should be wearing brand name running shoes with good motion control, cushioning, etc…” I believe the opposite. I feel children should run barefoot as much as possible, and when they need a shoe, they should wear one that allows the young foot to develop its natural strength, support, and function. Parents should think twice before heeding the message that their children need “sturdy” or “supportive” shoes. As Dr. Lieberman demonstrated so well in his landmark paper in Nature (Jan 26, 2010), footwear can have a large influence on natural gait.

I find it highly unusual and there are no supporting documents to the APMA (American Podiatric Medical Association) parent flyer which states that parents should “Select a shoe that’s rigid in the middle. Does your shoe twist? Your shoe should never twist in the middle.” Curiously, right below that piece, and written in fine print, there is this accurate statement: “Step three does not apply to toddlers shoes. For toddlers, shoes should be as flexible as possible.” I’m left wondering “So at what time does a toddler become a child and we bind their feet up?”

As a parent and physician I believe that the APMA statements could cause harm in a developing child’s foot. A foot builds its own intrinsic support via communication with the ground, building strength and stability through proprioception, and allowing normal force loads to be applied to the areas that nature intended. If you change anything from what is normal in a developing child, then you proceed at your own peril. For example, when I was a child the APMA suggested bracing as a treatment for intoeing (feet that turn inward instead of pointing straight ahead) – fortunately this practice has been banned. The results were extreme tibial rotation and for me, I wound up needing patellar tendon realignments at age 13 due to completely misaligned tibia and patellas (kneecaps)….I missed a large portion of my high school running due to this.

A parent will almost always do what the experts say is best for their children, and the APMA statement that is mentioned above is one that I would challenge. Do I have studies for this….unfortunately, not good ones. Conceptual and evolutionary evidence is the best we have here. For one example, we see many high school runners with hallux valgus — “big toes pointed in.” Hallux valgus is generally caused by ill-fitting shoes with a pointed toebox. Furthermore, most runners, both young and old, cannot stabilize and balance on one foot. To run properly, you must be able to do this.

The next time you are in a park, watch a child run barefoot (see video below). Notice the relaxed movement and foot placement. They lean slightly forward and their legs fall out behind them. They do not strike hard on their heels. Then watch the child with the highly cushioned or supportive shoe. The difference is easy to see.

5yo Barefoot Running in Grass from Runblogger on Vimeo.

So what are the important features to look for in a child’s shoe?

· Ultra-thin soles to allow proper proprioception, neuromuscular activation in the entire kinetic chain, and to complement the body’s natural ability to absorb ground forces.

· Low, flat to the ground profile – shoes should allow all play activity that involves climbing, running, and jumping. Shoes should enhance lateral movement since the foot will not be up on a platform or have a slope from heel to forefoot.

· The materials should be soft and supple, thereby allowing natural foot function. The shoe should bend easily at the toe joints – this is where a foot is designed to bend to recreate the arch on takeoff. See the TR Treads website on Footwear Education for more on this.

· The toebox should be wide enough to allow natural toe spread (Runblogger’s note: check out this video of running toe splay on ground contact in my 5 year old daughter). Foot support is created by the natural arch of the foot with the great toe stabilizing the arch. When the heel is elevated and great toe deviated toward the second toe (a common design flaw in many shoes which come to a point), this stability is compromised. The foot produces the most leverage when the toes are straight and aligned with the metatarsals. A child’s foot is widest at the ends of the toes (as should an adult’s be if they have been in proper shoes or barefoot).

· A single piece midsole/outsole allowing protection on unnatural surfaces (concrete, asphalt) and natural rough surfaces (rock,trail) while allowing proprioception and natural dissipation of ground reaction forces.

· Upper material should be soft, breathable, and washable.

· Get over the notion that shoes need “traction.” In a moving child the more stickiness and grip, the more heat produced in the foot and braking moments on running activity.

· Discourage the use of thick, heavy socks as these interfere with foot proprioception.

· All efforts should be made to use recycled materials in the construction of the shoe.

· Shoes should be a good value and of comparable price to other children’s shoes.

· Design and colors should inspire fun and play.

· And critical is proper fit. For tips see the Two Rivers Treads Shoe Fitting Guide in their expansive Footwear Education section.

· For another great resource on children’s footwear, read this article by Dr. William Rossi DPM.

Why do I care so passionately about this? The most important reason is that I am a parent and want to do what is best for my children and not be influenced by marketing claims or trends. I have been a competitive distance runner my entire life and am personally involved in multiple projects and grants involving both youth and adult physical fitness. If we can teach proper approaches to pain free activity throughout life then the daily walk or run will be sustainable.

I had both of my feet operated on 10 years ago at age 33 for severe arthritis caused by a combination of improper gait mechanics, lots of hard miles as a collegiate and post collegiate runner, and the negative influence of new trends in footwear such as elevated heels and crash pads. The foot instability this created and greater impact in the great toe joint caused this joint to deteriorate. I had the joints fused in both feet and instead of taking the standard doctor’s advice of not running anymore, I chose to relearn how to run. I also got heavily involved in footwear design and function for runners and children. Read my story here on zero-drop.com.

I have watched my own children dramatically change their movement patterns after discarding the heavy, inflexible “Sketchers with lights” and getting them into slip-on Vivo Barefoot kids shoes. They will not put anything else on their feet now when they need to have shoes. We gave away 180 pairs of Vivo Barefoot kids shoes at Freedom’s Run for our kids run thanks to the combined generosity of Two Rivers Treads and Terra Plana. See story….scroll down. Dozens of moms and kids have thanked me for the discovery they have made (Runblogger’s note: as do I – Mark was kind enough to send me a pair of Vivo Barefoot Kids Pally’s for my 5 year old daughter, and she and I both love them).

The beauty of this field is that it is evolving rapidly, we are all discovering new things, there is no one correct answer, and as a field we are doing the needed research. My personal results as a study of one give me the authority to say that you can retrain how you move, and that footwear does have an influence. I began running barefoot at the beach when I was 12. This was the beautiful movement that I can still remember. Thirty-one years later, I finished in the top 10 for runners over age 40 at the 2010 Boston Marathon in a time of 2:34. I’ve run under 2:35 for a marathon 22 of the last 24 years, with misses only during my medical intern year and in 2009 when I ran a 2:37. My training miles are minimal now for these efforts. Knowledge and application of gait principles and use of optimal footwear allows effortless movement to occur. It’s “no pain…thank you” instead of “no pain…no gain”.

It all starts with the children. Adults make their own decisions but children cannot. We need to see further collaboration among many fields – as Dr. George Sheehan so eloquently stated in 1975:

“If athletes were given less care and more thought, the doctors might come up with some original ideas on why illness persists, why injury doesn’t clear up. If more non-physicians – podiatrists and physiotherapists for instance – could be induced to lend their ideas and talents, we might see a completely new approach to sports medicine. If the athlete had to wait longer for surgery, he might have time to recover from his ailments.”

Footwear designers are a critical part of the future of preventive sports medicine, and they need to start thinking more about our children.

Long may you run…

Mark Cucuzzella MD FAAFP

Associate Professor of Family Medicine West Virginia University

Lt Col USAF Reserves – Coach/Captain USAF Marathon Team

Race Director Freedom’s Run www.freedomsrun.org

Owner of Two Rivers Treads- A Center for Natural Running and Walking

A few additional articles and websites of interest:

· Rossi- Proper Children’s Footwear

· Rossi- Fashion shoes….see page 10 and 11 of this interesting article

· Journal of Family Practice review of functional flat feet in children….this is NOT a disease needing treatment.

· Barefoot Parents Website

· Template for proper fitting of child shoe . Size up at least a half centimeter to allow for sock and foot spread

Medical Consultant for ChiRunning, Newton Running, and the US Air Force Marathon